There are several particularities in the evolution of surgical approaches for the treatment of rectal cancer in the USA. It seems that the adoption of minimally invasive surgery has not been as fast as in other regions such as Europe. Another particular fact is that several surgeons have moved from the open to the robotic approach, skipping laparoscopy.

Back in 2007 data regarding the feasibility of the transanal approach in human cadavers was published by Mark Whiteford and Lee Swanstrom (Gastrointestinal and Minimally Invasive Surgery Division, Legacy Portland Hospitals, Portland, Oregon, USA), attracting the attention of several surgeons around the world.

Patricia Sylla is one of the leading surgeons involved in the development and research into the transanal approach for rectal cancer. In this lecture she discusses the U.S experience with the introduction of transanal TME.

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Dr. Patricia Sylla MD, FACS, FASCRS, Past President of SAGES; Professor of Surgery, Icahn School of Medicine; System Chief of Colon and Rectal Surgery, Mount Sinai Health System, USA Colorectal Surgery

Dr. Mark Whiteford MD, FACS, FASCRS Colon and Rectal Surgery, The Oregon Clinic Center for Advanced Surgery Director of Colorectal Surgery, Providence Portland Cancer Institute Affiliate Professor of Surgery, Oregon Health and; Science University Portland, Oregon, USA. Colorectal Surgery