Nuances on assessment of transanal minimally invasive surgery learning curve for local excision of rectal neoplasms

We read with great interest the recent article “Establishing the learning curve of transanal minimally invasive surgery for local excision of rectal neoplasms. Surgical Endoscopy February 2017.” by Lee and co-workers (1). We congratulate the authors on their excellent work in defining the learning curve for transanal minimally invasive surgery (TAMIS) and being the first to publish it. In addition, we feel that using TAMIS for the local excision of early rectal cancer is a technique that needs more emphasis especially since the introduction of national screening programs has led to the increase detection of stage I rectal cancer (2).