Minimally Invasive Options in Rectal Cancer: TAMIS and Robotic Surgery

Dr. Mark Zhao, a colorectal surgeon at UCSF Health specializing in colorectal cancer and pelvic floor disorders, sat down with CURE to discuss how advances in minimally invasive surgery are expanding options for patients with rectal cancer.

In the interview, Zhao explains how carefully selected patients with large benign rectal polyps or early rectal cancers may be candidates for transanal minimally invasive surgery, or TAMIS — an approach that preserves rectal and anorectal function while avoiding abdominal incisions and often allowing same-day discharge.

He also discusses the da Vinci SP single-port robotic platform, which his team at UCSF has been involved in developing and evaluating since its early stages, and how it allows surgeons to perform complex procedures through a single incision without compromising oncologic outcomes.

Dr. Zhao emphasizes that early referral is key to keeping these options available for patients.

Transcript:

CURE: Minimally invasive techniques like transanal minimally invasive surgery are gaining attention. How do these approaches compare with traditional surgery in terms of recovery and effectiveness?

Zhao: Transanal minimally invasive surgery, or TAMIS, is an excellent option for carefully selected patients — most often those with large benign rectal polyps or early rectal cancers that don't require a more radical resection. Early referral is important because patients may lose the opportunity for these local excision options as lesions become larger or more advanced. But whenever it's oncologically appropriate, the TAMIS procedure allows us to preserve rectal and anorectal function while avoiding abdominal incisions and the consequences of abdominal surgery. Often, this results in less pain and faster recovery, and with TAMIS specifically, we can frequently discharge the patient the same day — so it's more convenient for patients as well.

You utilize the da Vinci SP single-port surgical robot for transabdominal procedures. Can you explain what that means and how it helps minimize incisions and enhance recovery for rectal cancer patients who need abdominal surgery?

Yes, the single port platform is another example of how we're constantly expanding our minimally invasive options for patients. For carefully selected patients, it allows us to perform surgery through just a single incision — a single access site — while maintaining the same oncologic principles as conventional minimally invasive surgery, where we often use multiple small incisions around the abdomen. Our group has been involved in the early development and clinical evaluation of the single port robot, which gave us an early preview of what it can do and, I think, substantial experience — not only with the technology itself, but also in how we should carefully select patients for its implementation. We always have to return to our core principle: in cancer surgery, the priority is getting the cancer out — the oncologic outcomes. But if we're able to do that with as minimal trauma as possible, that allows for faster recovery, and I think that's a good use of the new technology.

For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here.