Transanal total mesorectal excision (taTME) for rectal cancer: a training pathway

McLemore, Elisabeth C.; Harnsberger, Christina R.; Broderick, Ryan C.; Leland, Hyuma A.; Sylla, Patricia; Coker, Alisa M.; Fuchs, Hans; Jacobsen, Garth R.; Sandler, Bryan J.; Attaluri, Vikram; Tsay, Anna T.; Wexner, Steven D.; Talamini, Mark A.; Horgan, Santiago

doi:10.1007/s00464-015-4680-1

Cited by 80 publications

(45 citation statements)

References 38 publications

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“…Those specific complications and difficulties highlight the need for structured and accredited training program. Several authors have addressed the proper training pathway to the incorporation of TaTME into clinical practice [19][20][21][22][23][24][25] .…”

Section: Training Programmentioning

confidence: 99%

The role of transanal total mesorectal excision in rectal surgery

Yellinek¹,

Wexner²

2018

MIS

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Transanal total mesorectal excision (TaTME) is the newest approach for the resection of rectal cancer, according to the principles of TME. The evolution of TaTME started almost 40 years ago and is a combination of several important developments in both micro-endoscopic surgery and transanal surgery. The preliminary clinical data have revealed acceptable TME quality. Clinical trials to determine the long-term oncological results are still in process. In order to master TaTME, the surgeon should be an expert in laparoscopic rectal surgery as well as transanal microsurgery and follow a stepwise training approach. Robotic TaTME using a single-port robotic system is a promising future development.

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Section: Training Programmentioning

confidence: 99%

The role of transanal total mesorectal excision in rectal surgery

Yellinek¹,

Wexner²

2018

MIS

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“…The operative setup included a mobile operating table, laparoscopy tower, energy devices, Lone Star retractor (CooperSurgical, Trumbull, CT, USA), transanal access platform coupled to an insufflation device. c Practical module with one-on-two instruction implying intentional urethral injury and mobilization of prostate (© The authors) addressed potential methodical and psychological issues [9]. The body donors were embalmed previously by modified ethanol glycerin fixation and stored at 4°Cbeforeuse [10].…”

Section: ) Practical Module-tatme Procedures Performed In Body Donorsmentioning

confidence: 99%

“…Because of the novel and unusual approach of TaTME and the increased risk of urethral injuries, a recent report proposed that one of the core elements of TaTME educational programs should be surgical training sessions in human body donor models [9]. In this report, we present effective educational modules offered in a body donor workshop, illustrating how to take full advantage of this type of preclinical training course in order to prevent urethral injury during TaTME.…”

Section: Introductionmentioning

confidence: 99%

Urethral injury in body donor TaTME training

et al. 2017

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“…Aside from simple demonstration of feasibility, considerable endeavour continues to be spent in the standardisation of this approach's practice and dissemination to ensure the highest quality in this innovation's implementation into clinical practice so that the procedure can become a true, broadly applicable step-advance in care for our patients. [678]…”

Section: Introductionmentioning

confidence: 99%

Abdomino-endoscopic perineal excision of the rectum for benign and malignant pathology: Technique considerations for true transperineal verus transanal total mesorectal excision endoscopic proctectomy

Furajii

Kennedy

2017

J Min Access Surg

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PURPOSE:Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature.METHODS:Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed. All cases commenced laparoscopically with initial medial to lateral mobilisation of any left colon and upper rectum. The lower anorectal dissection started via an intersphincteric or extrasphincteric incision for benign and malignant pathology, respectively, and following suture closure and circumferential mobilisation of the anorectum, a single port (GelPOINT Path, Applied Medical) was positioned allowing the procedure progress endoscopically in all quadrants up to the cephalad dissection level. Standard laparoscopic instrumentation was used. Specimens were removed perineally.RESULTS:Of the 13 patients (median age 55 years, median BMI 28.75 kg/m2, median follow-up 17 months, 6 males), ten needed completion proctectomy for ulcerative colitis following prior total colectomy (three with concomitant parastomal hernia repair) while three required abdominoperineal resection for locally advanced rectal cancer following neoadjuvant chemoradiotherapy. Median operative time was 190 min, median post-operative discharge day was 7. Eleven specimens were of high quality. Four patients developed perineal wound complications (one chronic sinus, two abscesses needing drainage) within median 17-month follow-up.CONCLUSION:Convergence of transabdominal and transanal technology and technique allows accuracy in combination operative performance. Nuanced appreciation of transperineal operative access should allow specified standardisation and innovation.

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Transanal total mesorectal excision (taTME) for rectal cancer: a training pathway

Cited by 80 publications

References 38 publications

The role of transanal total mesorectal excision in rectal surgery

The role of transanal total mesorectal excision in rectal surgery

Urethral injury in body donor TaTME training

Abdomino-endoscopic perineal excision of the rectum for benign and malignant pathology: Technique considerations for true transperineal verus transanal total mesorectal excision endoscopic proctectomy

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