TaTME (transanal total mesorectal excision) – state of the art

Abstract

Transanal total mesorectal excision (TaTME) is a modern hybrid method, which has emerged by conjunction of two minimally invasive techniques – laparoscopy and transanal minimally invasive surgery. The main aim of the method is to offer a better operative approach into the narrow pelvis and thus to support an oncosurgically radical TME. Mesorectal excision is performed transanally via a flexible single port platform. Safe implementation of the technique requires advanced skills in minimally invasive surgery, transanal endoscopic surgery as well as experience with surgical dissection from different points of view. Controversial results regarding TaTME in the available literature suggest that oncosurgical radicality of the method has to be examined by prospective clinical studies. Currently, two randomised studies (COLOR III and ETAP-GRECCAR 11) are ongoing which might soon clarify a proper position of TaTME in clinical practice.