Overview
During TAMIS, a small specialised platform is placed gently into the anal canal. Through this platform, Mr Nguyen introduces tiny laparoscopic instruments and a magnified camera, allowing him to see and work inside the rectum with great precision — far more clearly than would be possible with the naked eye. The tumour or polyp (a growth in the lining of the rectum) is then carefully cut out, and the defect (the gap left behind) is sewn closed.
TAMIS is suitable for benign polyps that are too large or awkwardly positioned to be removed by colonoscopy, and for early rectal cancers — particularly stage T1 (where cancer is limited to the inner layers of the bowel wall). In carefully selected patients with a T2 cancer who cannot safely undergo major abdominal surgery, TAMIS may also be an option.
Who needs this procedure?
- You have an early rectal cancer (T1 or selected T2) and a bowel-preserving approach is being considered
- You have a large adenoma (a precancerous growth) in the rectum that cannot safely be removed during a colonoscopy
- A polyp has grown back or was not fully removed after previous endoscopic treatment
- You have a carcinoid tumour (a rare slow-growing neuroendocrine tumour) in the rectum
- A lesion is on the side or back wall of the rectum where a standard camera cannot easily reach
- You prefer a less invasive approach, or major abdominal surgery carries too high a risk for you at this time
Benefits
- No cuts on your abdomen — recovery is faster and wound complications are far less likely
- Your rectum and bowel function are preserved — most patients do not need a stoma
- The magnified camera view inside the rectum gives Mr Nguyen far better visibility than conventional surgery from the outside
- The tumour is removed in full thickness (including the deeper muscle layer) which means the pathologist can check every margin accurately and give you a precise staging
- Most patients go home after 1–2 nights — a much shorter stay than major bowel surgery
- Your bowel continues to function normally after the procedure
Risks & considerations
- Incomplete margins — in around 10–15% of early cancers, the pathologist finds that the tumour was closer to the edge of the removed tissue than ideal. If this happens, Mr Nguyen will discuss whether further surgery or radiotherapy is needed. This is not a failure — it is the pathology system working exactly as it should to protect you.
- Perforation into the abdomen — happens in fewer than 1% of cases. If it occurs, it is usually recognised immediately and repaired during the same operation without complications.
- Post-operative bleeding — affects 1–3% of patients; usually settles on its own or is managed with a small procedure
- Tenesmus and urgency — a feeling of needing to go to the toilet frequently, or a constant sensation of pressure in the back passage, is very common in the first 2–4 weeks after surgery. It settles on its own as the rectum heals.
- Local recurrence — for early T2 cancers, the chance of cancer coming back locally is higher with TAMIS than with radical bowel removal surgery. This is weighed carefully against the risks of major surgery in your specific situation.
- Anaesthetic risks — as with any operation requiring general anaesthetic
Before the procedure
Food: You may eat up until 6 hours before your admission time, then fast completely. Do not eat anything after this point — your procedure may be cancelled if you do.
Clear fluids: You may drink clear fluids up until 2 hours before your admission time. Clear fluids include: water (still or sparkling), cordial, sports drinks, lemonade, pulp-free apple juice, black tea or coffee, clear broth. Avoid red or purple coloured drinks.
Medications: Continue all regular medications as usual, taken with a small sip of water. Do not chew gum on the day of your procedure.
Supplements: Stop all non-prescribed vitamins, minerals, and herbal supplements (including fish oil, glucosamine, and vitamin E) at least 5 days before your procedure. Also stop iron supplements at least 7 days before.
Blood thinners: If you take warfarin, rivaroxaban (Xarelto), apixaban (Eliquis), dabigatran (Pradaxa) or clopidogrel, contact Mr Nguyen’s rooms for specific advice — these may need to be stopped or bridged before your procedure.
Diabetes medications: If you take oral or injectable diabetic medications (e.g. Metformin, Diamicron, Jardiance, Forxiga), stop these 2 days before your procedure. Do not stop insulin — contact our rooms for personalised dose adjustment instructions.
Weight loss injectables (GLP-1 agonists): If you take semaglutide (Ozempic, Wegovy), liraglutide (Saxenda), dulaglutide (Trulicity), or similar medications, remain on clear fluids for the full 24 hours prior to your admission time. You do not need to stop your medication. Please inform Mr Nguyen’s rooms when booking.
Mr Nguyen's preferred preparation is Picoprep (sodium picosulphate), taken as a split preparation — 3 sachets in total across the day before and morning of your procedure. Timing varies for morning versus afternoon procedures; the schedule below is for a morning procedure. If you have been advised to take a different preparation, refer to the Full Bowel Preparation Guide.
2–3 days before: Low-residue diet — white bread, white rice, plain pasta, eggs, skinless chicken or fish, plain yoghurt. Avoid wholegrains, most fruit and vegetables, nuts, seeds, and legumes.
Day before — until 3pm: White foods only (as above).
Day before — after 3pm: Clear fluids only. No solid food. Avoid red, purple, or green drinks.
Day before — 5pm: First sachet of Picoprep. Stay near a bathroom — bowel activity expected within 1–3 hours.
Day before — 8pm: Second sachet of Picoprep. Continue clear fluids.
Morning of procedure — 5am: Third (final) sachet of Picoprep, then 3–4 glasses of clear fluid. Take regular medications with a small sip of water. Motions should be clear to pale yellow by the end. Stop all fluids 2 hours before your scheduled arrival time — nil by mouth from that point.
- You will be prescribed antibiotics to take around the time of your procedure to reduce infection risk
- Before you sign consent, Mr Nguyen will have a thorough conversation with you about what the procedure involves, what the pathology results might show, and what further treatment might be needed depending on what is found
On the day
- You will be admitted to Warringal Private Hospital or Epworth Eastern on the morning of your surgery
- A general anaesthetic is given so you are fully asleep throughout
- You are positioned carefully on the operating table (either on your back with your legs raised, or face down depending on where the lesion is) so Mr Nguyen has the best possible access
- The TAMIS platform is gently inserted through the anus; laparoscopic instruments are then introduced through it
- The lesion is excised under magnified camera vision; the gap left behind is sewn closed with dissolvable stitches
- You wake up in the recovery room; a urinary catheter may be in place and is usually removed the same day
- Sips of water and a light diet are started on the day of surgery itself
Recovery & aftercare
- Day 0–1: Liquids and light food; you are helped to get up and move around as soon as you feel ready
- Days 1–2: Most patients are well enough to go home with oral pain relief — usually simple paracetamol and anti-inflammatory tablets
- Week 1: Rest and soft foods at home; avoid anything strenuous while the repair inside the rectum settles. Some urgency or frequent toilet trips is normal during this time.
- Week 4: You should be back to your normal activities by this point
- Once pathology results are back (usually within 1–2 weeks), Mr Nguyen will go through them with you in detail. If further treatment is recommended, you will have a clear explanation of why and what it involves — you will not receive news like this without support.
- Ongoing surveillance — including clinic reviews, imaging, camera checks (endoscopy), and blood tests — is tailored to your pathology results. Reviews are generally at least every six months. Mr Nguyen will set this up and coordinate it for you.
- A post-operative review with Mr Nguyen is routinely arranged 2–6 weeks following your procedure, with timing depending on the type of operation — this review is provided at no charge
Post-operative concerns: Please call our rooms on (03) 9816 3951 and leave a message — this will be sent directly as a text to Mr Nguyen. Alternatively, you may text the office mobile on 0499 090 126. We aim to respond promptly during business hours.
Emergencies: For any life-threatening emergency, call 000 immediately or go to your nearest emergency department. Do not wait for a call back from our rooms. For the Austin Hospital Emergency Department: (03) 9496 5000.
Related patient guides
Articles written for patients and their families — to help you understand what you are experiencing and what to expect.
What Symptoms Could Suggest Bowel Cancer?
Bowel Cancer Screening in Australia
Does Bowel Cancer Always Cause Bleeding?
What Happens If Polyps Are Found During a Colonoscopy?
When Should You See a Colorectal Surgeon?
Have questions or ready to take the next step? Mr Nguyen consults at Heidelberg and operates at Austin Health, Warringal Private Hospital and Epworth Eastern. Call (03) 9816 3951, email admin@northeasternsurgical.com.au, or submit an enquiry online →