MSSV01: ROBOTIC TRANSANAL MINIMALLY INVASIVE SURGERY FOR A COMPLEX ENDOSCOPICALLY UNRESECTABLE DISTAL SIGMOID POLYP
Taylor Williams, MD; Salvatore Parascandola, MD, FACS; Dwight David Eisenhower Army Medical Center
In this video vignette, we describe the use of robotic transanal minimally invasive surgery (TAMIS) for a complex endoscopically unresectable distal sigmoid polyp at 16cm proximal to the anorectal junction in a 40 year old female. While MRI demonstrated possible T1/T2 invasion, biopsies of the lesion, as well as the overall endoscopic appearance of the lesion were benign. While TAMIS is typically reserved for rectal pathology, this case highlights its feasibility of robotic TAMIS in carefully selected distal sigmoid lesions that are not amenable to EMR or ESD. In our video, we demonstrate robotic TAMIS excision of the lesion and closure of a large circumferential mucosal defect. Final pathology of the specimen demonstrated tubulovillous adenoma without evidence of dysplasia or invasive disease. Thus, use of robotic TAMIS allowed for the complete excision of an otherwise endoscopically unresectable lesion and avoided formal oncologic resection for benign pathology.