Anatomical Study for Transanal Total Mesorectal Excision in Cadaveric Surgical Training

Area of Science:

• Surgical Education
• Colorectal Surgery
• Surgical Anatomy

Background:

• Transanal total mesorectal excision (TaTME) presents unique anatomical challenges.
• Cadaveric surgical training (CST) offers a valuable platform for mastering complex surgical procedures.
• This study evaluates the utility of CST for developing TaTME skills.

Purpose of the Study:

• To identify critical anatomical structures essential for successful transanal total mesorectal excision (TaTME).
• To assess the effectiveness of cadaveric surgical training (CST) as an educational method for TaTME.
• To provide an educational perspective on experiences gained during CST for TaTME.

Main Methods:

• Conducted 3 cadaveric surgical training sessions using 6 male cadavers between 2018 and 2020.
• Collected anatomical findings and timed all steps of the transanal total mesorectal excision (TaTME) process.
• Evaluated the quality of total mesorectal excision (TME) by trainers post-procedure.

Main Results:

• Six surgeons with no prior TaTME experience participated.
• Average time for TaTME completion was 84 minutes, with significant time allocated to specific anatomical dissections.
• 77.8% of total mesorectal excisions were graded as complete, indicating proficiency gained through training.

Conclusions:

• Cadaveric surgical training effectively identified essential anatomical landmarks for transanal total mesorectal excision (TaTME).
• CST is a promising educational strategy for surgeons to safely navigate the anatomical complexities of TaTME.
• This training method can enhance surgeon confidence and competence in performing TaTME.