Transanal Minimally Invasive Surgery (TAMIS)
What is TAMIS?
Transanal Minimally Invasive Surgery (TAMIS) is an advanced, minimally invasive technique to remove benign or early-stage malignant tumors in the rectum through the anus, using a specialized transanal platform and laparoscopic instruments. It offers improved visualization and precision compared to standard transanal excision (TAE), making it ideal for lesions in the mid-to-upper rectum (4–15 cm from the anal verge). In India, TAMIS is performed in specialized colorectal surgery centers, offering high-quality care at affordable costs. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.
Why do you need TAMIS?
TAMIS is indicated for:
- Benign rectal polyps: Large or villous adenomas not removable via colonoscopy.
- Early-stage rectal cancer: T1N0M0 tumors (small, superficial, no lymph node involvement), with low risk of metastasis.
- Select neuroendocrine tumors: Small, well-differentiated rectal carcinoids.
- Palliative cases: For patients unfit for major surgery (e.g., elderly, comorbidities) to relieve symptoms like bleeding or obstruction.
The procedure aims to remove the lesion with clear margins, preserve rectal function, and avoid major abdominal surgery or a permanent stoma. In India, hospitals like Apollo, Fortis, Medanta, and Tata Memorial specialize in TAMIS, providing a less invasive alternative to transanal endoscopic microsurgery (TEM) with similar outcomes.
Why Do TAMIS Costs Vary in India?
Costs range from ₹2 lakh to ₹6 lakh:
- Procedure Type: TAMIS costs more than standard TAE due to specialized equipment.
- Hospital/Location: Higher in metro cities (Apollo, Medanta); lower in government hospitals (AIIMS, ₹50,000–₹1.5 lakh).
- Surgeon’s Expertise: Experienced colorectal surgeons charge more.
- Additional Costs: Diagnostics (ERUS, MRI), anesthesia, pathology fees.
- Insurance: Often covered for cancer or symptomatic polyps; Ayushman Bharat offers subsidies.
TAMIS Procedure
The procedure leverages advanced tools for precise rectal surgery:
- Before Surgery Evaluation:
- Diagnosis:
- Rectal exam and proctoscopy visualize the lesion.
- Endorectal ultrasound (ERUS) or MRI assesses tumor depth (T stage) and lymph node involvement.
- Biopsy confirms pathology (adenoma, T1 cancer, or carcinoid).
- CT/PET scans rule out metastasis for cancer cases.
- Blood tests ensure surgical fitness; patients on blood thinners may need to stop them 5–7 days prior.
- Bowel preparation (enema) clears the rectum on the day of surgery.
- Patients are counseled on risks, including recurrence and the potential need for further surgery.
- Diagnosis:
- Surgical Techniques:
- TAMIS Procedure:
- Performed under general anesthesia, lasting 1–2 hours.
- The patient is positioned in the lithotomy position (legs raised).
- A transanal access platform (e.g., GelPOINT Path or SILS Port) is inserted into the anal canal, creating a sealed working space.
- Carbon dioxide insufflation expands the rectum for better visualization.
- Laparoscopic instruments (camera, graspers, electrocautery) are used through the platform to excise the lesion with a 1 cm margin of healthy tissue.
- Full-thickness excision (down to perirectal fat) is performed for cancers; partial-thickness may suffice for benign lesions.
- The rectal wall defect is closed with sutures using laparoscopic suturing techniques, though small defects may heal naturally.
- Tattooing and Retrieval:
- The excised tissue is retrieved for pathology to confirm margins and staging.
- The site may be tattooed with ink for future surveillance, especially for cancer cases.
- The procedure is typically outpatient or requires a 1–2 day hospital stay.
- TAMIS Procedure:
- After Surgery:
- Patients are monitored for a few hours for pain control and to ensure no immediate complications.
- Pathology reports guide further management (e.g., surveillance or radical surgery for cancer if margins are involved).
- Follow-up visits assess healing and recurrence.
Recovery After TAMIS
- Hospital Stay: Outpatient or 1–2 days.
- Post-Surgery Care:
- Mild pain for 3–5 days, managed with painkillers (e.g., paracetamol) and sitz baths.
- Antibiotics are prescribed if infection risk is high.
- Stool softeners (e.g., lactulose) prevent straining.
- Activity/Diet:
- Light activities resume in 1–2 days; strenuous activities avoided for 2–3 weeks.
- High-fiber diet (fruits, vegetables, whole grains) and 2–3 liters water daily promote soft stools.
- Avoid spicy foods for 3–5 days to reduce irritation.
- Follow-Up:
- Visits at 1–2 weeks, 4–6 weeks; cancer patients need proctoscopy/ERUS every 3–6 months for 2–3 years, then annually.
- Healing completes in 2–4 weeks.
Most resume normal activities in 1–2 weeks. Success rates are 90–95% for benign lesions; local recurrence for T1 cancers is 5–15%, often requiring further surgery.
Risks and Complications
- Surgical Risks: Bleeding (1–3%), infection, rectal perforation (1–2%, may require repair).
- Functional Issues: Temporary incontinence (2–5%, resolves in weeks), rectal stenosis (rare).
- Cancer-Specific Risks: Local recurrence (5–15% for T1 cancers), missed lymph node involvement (up to 10%), necessitating radical surgery (e.g., low anterior resection).
- General Risks: Anesthesia reactions.
Report fever, severe pain, or rectal bleeding promptly.
Frequently Asked Questions (FAQs)
What causes the need for TAMIS?
Large rectal polyps, early-stage rectal cancer (T1), or small carcinoids.
How is TAMIS different from standard transanal excision?
TAMIS uses a transanal platform and laparoscopic tools for better visualization and access to higher lesions.
Can it treat all rectal cancers?
Only early-stage (T1) with low-risk features; advanced cancers need more extensive surgery.
How soon can I resume activities?
Light activities in 1–2 days, normal routines in 1–2 weeks.
Is TAMIS covered by insurance in India?
Yes, for cancer or symptomatic polyps; confirm with your provider.
Signs of complications?
Fever, severe pain, rectal bleeding, or incontinence.
Can cancer recur after TAMIS?
Yes, 5–15% risk for T1 cancers; regular surveillance is critical.
Lifestyle changes post-surgery?
High-fiber diet, hydration, avoid straining, regular follow-ups for cancer.
Conclusion
TAMIS is an advanced, sphincter-preserving procedure for rectal lesions, offering improved outcomes over standard TAE with minimal recovery time. India’s top hospitals (Apollo, Medanta, AIIMS) provide affordable, high-quality care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach TAMIS confidently. Consult a colorectal surgeon for personalized guidance and successful treatment.
Looking for Best Hospitals for TAMIS
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
2,00,000 |
5,50,000 |
Ahmedabad |
2,50,000 |
6,00,000 |
Ajmer |
2,00,000 |
5,50,000 |
Aligarh |
2,00,000 |
5,50,000 |
Allahabad |
2,00,000 |
5,50,000 |
Amritsar |
2,25,000 |
5,75,000 |
Aurangabad |
2,25,000 |
5,75,000 |
Bangalore |
2,50,000 |
6,00,000 |
Bareilly |
2,00,000 |
5,50,000 |
Belgaum |
2,25,000 |
5,75,000 |
Bhopal |
2,25,000 |
5,75,000 |
Bhubaneswar |
2,25,000 |
5,75,000 |
Bikaner |
2,00,000 |
5,50,000 |
Chandigarh |
2,50,000 |
6,00,000 |
Chennai |
2,50,000 |
6,00,000 |
Coimbatore |
2,50,000 |
6,00,000 |
Dehradun |
2,25,000 |
5,75,000 |
Delhi |
2,50,000 |
6,00,000 |
Dhanbad |
2,00,000 |
5,50,000 |
Durgapur |
2,00,000 |
5,50,000 |
Faridabad |
2,50,000 |
6,00,000 |
Ghaziabad |
2,50,000 |
6,00,000 |
Gorakhpur |
2,00,000 |
5,50,000 |
Guntur |
2,25,000 |
5,75,000 |
Gurgaon |
2,50,000 |
6,00,000 |
Guwahati |
2,25,000 |
5,75,000 |
Gwalior |
2,00,000 |
5,50,000 |
Hyderabad |
2,50,000 |
6,00,000 |
Indore |
2,25,000 |
5,75,000 |
Jabalpur |
2,00,000 |
5,50,000 |
Jaipur |
2,50,000 |
6,00,000 |
Jalandhar |
2,25,000 |
5,75,000 |
Jamshedpur |
2,25,000 |
5,75,000 |
Jodhpur |
2,00,000 |
5,50,000 |
Kanpur |
2,00,000 |
5,50,000 |
Kochi |
2,50,000 |
6,00,000 |
Kolkata |
2,50,000 |
6,00,000 |
Kollam |
2,25,000 |
5,75,000 |
Lucknow |
2,25,000 |
5,75,000 |
Ludhiana |
2,50,000 |
6,00,000 |
Madurai |
2,25,000 |
5,75,000 |
Mangalore |
2,25,000 |
5,75,000 |
Meerut |
2,00,000 |
5,50,000 |
Moradabad |
2,00,000 |
5,50,000 |
Mumbai |
2,50,000 |
6,00,000 |
Mysore |
2,50,000 |
6,00,000 |
Nagpur |
2,25,000 |
5,75,000 |
Nashik |
2,25,000 |
5,75,000 |
Navi Mumbai |
2,50,000 |
6,00,000 |
Noida |
2,50,000 |
6,00,000 |
Patna |
2,00,000 |
5,50,000 |
Pune |
2,50,000 |
6,00,000 |
Raipur |
2,25,000 |
5,75,000 |
Rajkot |
2,25,000 |
5,75,000 |
Ranchi |
2,00,000 |
5,50,000 |
Surat |
2,50,000 |
6,00,000 |
Thane |
2,50,000 |
6,00,000 |
Vadodara |
2,25,000 |
5,75,000 |
Varanasi |
2,00,000 |
5,50,000 |
Visakhapatnam |
2,25,000 |
5,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.