TAMIS repair within a structured multimodal management pathway for colorectal anastomotic leaks: surgical technique and outcomes

Abstract

Abstract Aim We describe the transanal minimally invasive surgerical (TAMIS) procedure for the elective repair of colorectal anastomotic leaks (AL) within a structured management pathway based on early leak detection and selective adjunctive therapy. We also report the clinical outcomes of this multimodal approach, along with an operative video illustrating the surgical technique step by step. Method Data on patients who underwent TAMIS for AL at our centre were collected. The operative video demonstrates each step of the technique, highlighting its advantages and feasibility. Results Thirteen patients underwent the TAMIS approach to treat colorectal AL between 2016 and 2024, with a median age of 55 (range: 14–84) years. Anastomosis was repaired and rescued in 12 (92.31%) patients. The median length of hospital stay was 20 (14–38) days. All but one patient (92.31%) with long-term anastomotic healing achieved closed ileostomies. Conclusions Within a structured multimodal management pathway, TAMIS is a safe and feasible option for selected patients with colorectal anastomotic leaks. Limitations This is a single-centre study with a small sample size.