V7 - Combined Transanal and Robotic TAMIS Excision of Giant Tubulovillous adenoma

Saturday, May 9, 2026

On-Demand

Senior Author(s)

CN

Carla Newton, MD

Colon and Rectal Surgeon. Assistant Professor of Surgery, Baylor College of Medicine
Baylor Scott & White Medical Center
Belton, Texas, United States

Disclosure information not submitted.

Video Presentation(s)

Rene Flores, MD

General surgery resident
Baylor Scott & White Medical Center
Baylor Scott and White - Temple
Temple, TX, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

CME Eligible

Purpose/Background: Rectal masses extending into the anal canal or near the anorectal junction can be challenging to manage both patients and surgeons who strive for sphincter preservation. We present as 79-year-old female with a large rectal mass and anemia. Colonoscopy demonstrated a circumferential mass starting at the anal verge extending 10 cm proximally. It was soft, villous, friable, and without ulceration. Biopsies from the colonoscopy and a repeat flexible sigmoidoscopy demonstrated only tubulovillous adenoma without invasive adenocarcinoma. MRI demonstrated a T3b, N0 lesion. However, this was not congruent with pathology. Therefore, a combined transanal and robotic TAMIS excision was offered.

Methods/Interventions: We performed a combined transanal and robotic TAMIS excision of the anorectal mass. The mass was excised transanally with a lone star retractor until the anorectal ring was reached. The robotic transanal platform was then used to continue partial thickness resection circumferentially for a length of approximately 11-12 centimeters.

Results/Outcomes: We performed a combined transanal and robotic TAMIS excision of the anorectal mass. The mass was excised transanally with a lone star retractor until the anorectal ring was reached. The robotic transanal platform was then used to continue partial thickness resection circumferentially for a length of approximately 11-12 centimeters.

Conclusion/Discussion: Local excision and transanal approaches are valuable tools when exploring options for diagnosis and treatment of challenging anorectal masses, especially when sphincter preservation is desired.