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Clin Colon Rectal Surg 2020; 33(03): 168-172
DOI: 10.1055/s-0039-3402779
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Learning Transanal Total Mesorectal Excision

Elisabeth C. McLemore
1   Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
,
Peyman Lavi
1   Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
,
Vikram Attaluri
1   Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Publication Date:
28 April 2020 (online)

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Abstract

A dynamic evolution is occurring in transanal surgery. Transanal techniques began with intraluminal surgical removal of rectal masses and have progressed to transanal total mesorectal excision (taTME) for rectal cancer. TaTME was first performed in 2009 by Sylla, Rattner, Delgado, and Lacy. This article documents the training pathway followed by pioneers in the taTME technique as well as consensus reports outlining the process of learning the taTME technique. A literature search was performed for taTME training, learning, and technique. Key elements in learning the taTME technique include appropriate indications, cadaver training, and outcomes reporting such as participating in a taTME registry. Consensus reports also agree on the following facets associated with improved outcomes: (1) appropriate case selection of mid and low rectal cancers, (2) prerequisite completion of an accredited training program in laparoscopic colorectal surgery and prior experience in transanal endoscopic surgery, (3) a two-team taTME approach from above and below is ideal, and (4) higher rectal cancer volume surgical practice. The unifying international recommendation for surgeons interested in learning the taTME technique conveys the following message: taTME is an advanced and complex technique that requires dedicated training and experience in TME surgery.

Keywords

taTME - transanal - total mesorectal excision - rectal cancer - training

Disclosures

Dr. McLemore, Dr. Lavi, and Dr. Attaluri have no financial disclosures to report.


 

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