Transanal total mesorectal excision (TaTME) for rectal cancer: Step by step description of the surgical technique for a two-teams approach

Quality of life after rectal cancer surgery: differences between laparoscopic and transanal total mesorectal excision

“…We initially worked with one team, starting transanally. We currently use a two-team approach, as advocated by Lacy and coworkers [21], wherein the splenic flexure is mobilized, followed by mobilization of the sigmoid and upper rectum by the abdominal team, while the transanal team simultaneously mobilizes the low and mid rectum [22]. Another significant change in protocol we introduced during the learning phase was the level of the proximal purse string suture.…”

Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer

“…Following the introduction of transanal TME (TaTME) in 2012, all patients with rectal cancer were treated by transanal approach. This technique was performed either with a one-team approach as previously described by Veltcamp Helbach et al [12] or with a standard two-team approach as described by Arroyave et al [17] The specimens were extracted through an umbilical incision or at an ileostomy site after placement of a wound protector. After extraction, evaluation of the denuded pelvic area and specimen was performed for persistence, respectively completeness, of residual mesorectum.…”

Transanal Total Mesorectal Excision - A Case Report

“…When the distal sigmoid was clamped, the pneumorectum was initiated with a pressure of 15 mmHg. Transanal pressure must be higher than the abdominal pressure to ensure a good distention (4). Then a purse-string closure of the rectal lumen was performed with a 0 polypropylene suture at 2 cm distal from the tumor, starting from the anterior wall clockwise ( Fig.…”

“…1). It has the role to maintain the pneumorectum and to avoid tumor contamination/spillage, but it is recommended to keep the same distance from the device the entire circumference and to mind including the surrounding structures, as the vagina, in the suture (4). A tattoo line done with the electric hook marked the dissection plane, subsequently full thickness and perpendicular incision of the rectal wall was performed circumferentially (Fig.…”