Transanal total mesorectal excision with triangle rules: a road map to prevent injuries

Excerpt

Transanal total mesorectal excision (TaTME) is presented as a promising new surgical technique for the approach to the distal rectum, providing the ability to perform a high-quality resection, with technical advantages over the laparoscopic approach [1]. However, the new surgical anatomy of the TaTME resection complicates surgical understanding and increases the risks of inadvertent injuries to important anatomic structures [2]. Detailed technical reports and stepwise description are necessary, to facilitate the surgeon’s familiarization with this new technique and to reduce the learning curve in a safe manner. This video describes, in both sexes, the TaTME approach highlighting the unique anatomic structures and pitfalls, organized into four virtual triangles (anterior, posterior and two laterals) defining a road map of anatomic landmarks [3]. …