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Transanal total mesorectal excision (TaTME) is a promising approach for the treatment of rectal cancer. Currently, there is growing evidence that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate, particularly in difficult patients, and to improve pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw stronger conclusions.
The transanal total mesorectal excision (taTME) is a challenging technique, especially at the beginning of the learning curve. It requires extensive knowledge of every step of the procedure in order to be properly accomplished. The transanal approach can give rise to some problems related with the pneumorectum and the procedure itself.
Antonio M. de Lacy, Head of the Gastrointestinal Surgery Department at the Hospital Clinic in Barcelona, gives a brief introduction to the current status of TaTME, and then discusses the various pitfalls that can appear during this surgery, as well as possible solutions based on his extensive experience in this technique, having performed a large number of cases.