title: Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery.
abstract: Over the past 3 years, colorectal surgeons have begun to adapt the technique of transanal total mesorectal excision. As international experience has been quickly forged, an improved recognition of the pitfalls and the practical details of this disruptive technique have been realized. The purpose of this technical note was to express the various nuances of transanal total mesorectal excision as learned during the course of its clinical application and international teaching, so as to rapidly communicate and share important insights with other surgeons who are in the early adoption phase of this approach. The technical points specific to transanal total mesorectal excision are addressed herein. When correctly applied, these will likely improve the quality of surgery and decrease morbidity attributable to inexperience with the transanal approach to total mesorectal excision.
authors.affiliation: Florida Hospital, Winter Park, FL, USA. atallah@post.harvard.edu.
authors.forename: S
authors.initials: S
authors.lastname: Atallah
authors.affiliation: Florida Hospital, Winter Park, FL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Albert
authors.affiliation: Florida Hospital, Winter Park, FL, USA.
authors.forename: J R T
authors.initials: JR
authors.lastname: Monson
mesh_terms: D000285:Administration, Rectal; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D017776:Autonomic Pathways / Q000033:anatomy & histology; D004210:Dissection / Q000379:methods*; D005205:Fascia / Q000033:anatomy & histology; D006801:Humans; D007327:Insufflation; D007431:Intraoperative Complications / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D018579:Patient Selection; D011206:Povidone-Iodine / Q000008:administration & dosage; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013048:Specimen Handling; D013536:Suture Techniques; D007507:Therapeutic Irrigation; D000067368:Transanal Endoscopic Surgery / Q000009:adverse effects / Q000193:education / Q000295:instrumentation / Q000379:methods*; D014521:Urethra / Q000033:anatomy & histology / Q000293:injuries
chemical_list: D000891:Anti-Infective Agents, Local; D000970:Antineoplastic Agents; D011206:Povidone-Iodine
keywords: Rectal cancer; TAMIS; Transanal TME; Transanal total mesorectal excision (taTME)