To synthesize evidence on oncologic outcomes, technical innovations, and optimal clinical scenarios for robotic transanal minimally invasive surgery (TAMIS) in rectal tumors, highlighting its significance in modern surgical practice.
Key Findings:
Aggregate R0 resection rate of 89.1% for malignant lesions with 91.2% negative margins in T1 adenocarcinomas, indicating strong oncologic efficacy.
Average local recurrence rate of 8.3% at median 28-month follow-up, rising to 12-15% for T2 tumors, underscoring the need for careful patient selection.
Single-port systems reduced operative time by 22% and improved ergonomics compared to multiport systems, enhancing surgeon performance.
Interpretation:
Robotic TAMIS shows promising oncologic outcomes and technical advantages, but long-term data and comparative effectiveness research are needed to fully understand its value and inform clinical practice.
Limitations:
Evidence gaps regarding long-term oncologic outcomes and local recurrence rates, which may affect treatment decisions.
Lack of rigorous comparative effectiveness research between robotic TAMIS systems, leaving uncertainty about their relative benefits.
Poor characterization of economic implications and cost-effectiveness, which is crucial for healthcare decision-making.
Conclusion:
Robotic TAMIS is a transformative technology in rectal surgery, with potential for expanded roles in treatment and salvage excision, necessitating further research to address existing knowledge gaps and enhance clinical application.
A large audit of biomedical publications suggests fabricated references are increasingly appearing in peer-reviewed papers — often in ways that are difficult for reviewers and readers to detect.
