[Transanal total mesorectal excision: the operative platform and potential issues]

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Total mesorectal excision (TME) and laparoscopic surgery are key advancements in rectal cancer treatment over the past two decades.
• Visualization of the distal rectum presents challenges due to narrow pelvis, large tumors, and patient obesity, particularly in males.

Purpose of the Study:

• To explore transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (taTME) as potential solutions for improved distal rectal visualization.
• To highlight the need for careful consideration of patient selection, long-term follow-up, and operative safety in the context of emerging transanal techniques.

Main Methods:

• Review of advancements in rectal cancer surgery, focusing on TME and laparoscopic approaches.
• Discussion of challenges in distal rectal visualization and the proposed role of TAMIS and taTME.

Main Results:

• TAMIS and taTME present a potential method to overcome visualization difficulties in distal rectal surgery.
• The introduction of these techniques necessitates a focus on patient selection criteria and safety protocols.

Conclusions:

• Transanal techniques like TAMIS and taTME show promise for enhancing distal rectal surgery.
• Further investigation into patient selection, long-term outcomes, and surgical safety is crucial for the successful adoption of these advanced rectal cancer procedures.