Transanal abdominal transanal proctosigmoidectomy with descending coloanal anastomosis (the TATA procedure) for low rectal cancer treated with chemoradiation

Full‐thickness neorectal prolapse after transanal transabdominal proctosigmoidectomy for low rectal cancer: a cohort study

“…Patients are highly motivated to avoid a permanent colostomy and an APR for rectal cancer, which has been the dominant treatment choice since its description by Miles in the 1900s. In an effort to extend sphincter preservation, the TATA procedure was developed and first performed in 1984 . By starting the dissection at the dentate line and excising the proximal half of the internal sphincter, the TATA approach permits a known distal margin in the postirradiated low rectal cancer and assures avoidance of transecting the tumour when trying to place the stapler from above.…”

“…Transanal transabdominal proctosigmoidectomy (TATA) with coloanal anastomosis was first described and performed as an alternative to abdominoperineal excision (APR) for low rectal cancer in 1984 . More recently, transanal total mesorectal excision (taTME), with laparoscopic extension of the taTME dissection, has increased interest in the TATA/taTME combined approach.…”

Transanal Surgery: A History of taTME Ancestry

“…Dr. Gerald Marks at Thomas Jefferson University developed this approach. 5 The two dominant drivers for this operation were to avoid a permanent colostomy in patients with cancers of the distal third of the rectum and to have a known distal margin after neoadjuvant therapy. However, it was also immediately well recognized, but not emphasized in publications, that by beginning the operation transanally, the most difficult portion was performed at the start of the operation.…”

“…This effort was furthered by Dr. Gerald Marks who described the transanal abdominal transanal (TATA) proctosigmoidectomy with descending coloanal anastomosis in 1984 to spare the sphincter, avoiding a permanent colostomy, for cancers of the distal third of the rectum, introducing the first experience of intersphincteric resection (ISR). 5 In 1983, in Tubingen, Germany, Dr. Gerhard Buess invented the transanal endoscopic microsurgical (TEM) platform. 6,7 He developed this for clear vision and reach within the confines of the rectum to resect en bloc rectal polyps and early cancers.…”

From TATA to NOTES, how taTME fits into the evolutionary surgical tree

“…During this same period, Dr Gerald Marks implemented the first program in the world of sphincter preservation surgery following high-dose preoperative radiation therapy [4]. Responding to the challenge of determining an adequate distal margin, in 1984 Dr Marks developed the technique of Transanal Abdominal TransAnal proctosigmoidectomy with coloanal anastomosis (TATA) [5]. The TATA procedure, unwittingly ushered in the era of taTME.…”