Single-port robotic transanal minimally invasive surgery using a novel access port: initial prospective consecutive case series from the UK

Abstract Background Transanal minimally invasive surgery (TAMIS) is used for local excision of selected benign and early malignant rectal lesions but operating within the confined pelvic space can be technically demanding. This study describes the early UK experience of single-port (SP) robotic TAMIS using a dedicated access port. Methods Consecutive patients undergoing SP robotic TAMIS (SP R-TAMIS) at a single UK tertiary centre between September 2025 and March 2026 were prospectively included. All cases were reviewed by a specialist small early rectal cancer multidisciplinary team. The primary outcomes were completion using the SP platform without conversion and 30-day morbidity. Results A total of 18 patients underwent SP R-TAMIS for benign or non-invasive ( n = 10) and malignant ( n = 8) rectal lesions. Lesions were located 1–20 cm from the anal verge. All procedures were completed without conversion or re-docking. En bloc resection was achieved in 16(89%) cases, and all malignant lesions had clear (R0) margins. Median operative time was 55 min (interquartile range [IQR] 48.5–83.0). All patients were discharged within 23 h. One patient was readmitted with delayed bleeding and was managed conservatively. The 3-month functional data were available for 14 patients; no major low anterior resection syndrome (LARS) was recorded amongst patients with available early follow-up. Conclusions SP R-TAMIS using a dedicated access platform was technically feasible in this carefully selected, single-centre cohort. The small sample, single-surgeon design, absence of a comparator and short follow-up preclude conclusions about its superiority, long-term oncological safety and functional benefit over other established endoscopic and surgical approaches. Further comparative evaluation is needed, incorporating longer oncological and functional follow-up and formal health-economic assessment.