Transanal Total Mesorectal Excision


MUSC Health colorectal surgeon Virgilio V. George, M.D., narrates this surgical video illustrating the key steps in transanal total mesorectal excision (TaTME), a new minimally invasive surgery for removing tumors in the lower third of the rectum.

For even experienced colorectal surgeons, excision of tumors in the lower third of the rectum by either open or conventional laparoscopic methods is extremely challenging, particularly in obese patients; in male patients, who have a narrow pelvis; and in patients whose anatomy has been altered by previous radiotherapy.

TaTME has garnered a great deal of attention and created much excitement in the field of rectal surgery because it represents a reversal of perspective—literally—about how to best excise tumors and the surrounding mesorectal envelope in the lower third of the rectum. Unlike traditional TME, which involves introduction of a laparoscopic camera and specialized laparoscopic tools through small slits in the abdomen to excise these tumors from above, TaTME reverses the process and introduces these tools via a multichannel port in the anus so that the tumor can be visualized and removed from below.

Read more about this new procedure in the article "Up From Below" in the Summer 2016 issue of Progressnotes, MUSC's medical magazine.