Transanal Endoscopic Surgery: Who Should Be Doing This Procedure?

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Education

Background:

• Transanal endoscopic surgery (TES) adoption accelerated in the late 2000s due to instrumentation and training advancements.
• Minimally invasive surgical trends have facilitated skill transfer for TES among colorectal and general surgeons.
• TES presents unique challenges, including confined surgical spaces and specialized instrumentation, impacting practice opportunities.

Purpose of the Study:

• To review the current evidence on transanal endoscopic surgery (TES) learning curves.
• To identify limitations hindering the widespread adoption of TES by general surgeons.
• To provide recommendations for the safe expansion of TES.

Main Methods:

• Literature review of existing studies on TES learning curves.
• Analysis of factors influencing TES adoption and training.
• Synthesis of evidence to inform recommendations for surgical practice.

Main Results:

• Evidence on TES learning curves is variable and influenced by specific surgical challenges.
• Limited practice opportunities due to uncommon indications can affect surgeon proficiency.
• General surgeons may face unique hurdles in mastering TES techniques.

Conclusions:

• Understanding TES learning curves is crucial for surgeon competency.
• Addressing challenges in training and practice is essential for TES expansion.
• Implementing general recommendations can support the safe growth of transanal endoscopic surgery.