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In this video in the Ileal Pouch Series, Dr. Kienle talks about the disadvantages of TaTME. Restorative proctocolectomy is indicated for treatment of inflammatory bowel diseases such as ulcerative colitis or in familial polyposis.
Only around 20% of cases require an oncological procedure, performing a total mesolectal excision.
In this video Dr. Kienle presents the disadvantages of TaTME-Pouch from his point of view.
There is no hard evidence on nerve damage, functional impact, or better anastomotic results, for taTME versus lapTME.
According to Dr. Kienle, making a purse-string to create an anastomosis is more difficult because if the purse-string is not tight, the risk of tissue and organ injury is higher due to impaired vision.
Dr. Kienle concludes that using taTME for a restorative proctocolectomy has no proven advantages, may be harmful and more expensive, but it is important to investigate further.