Introduction of new techniques and technologies in surgery: Where is transanal total mesorectal excision today?

Caycedo‐Marulanda, Antonio; Patel, Sunil V.; Merchant, S; Brown, Carl

doi:10.4240/wjgs.v12.i5.203

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…The use of TA TME for RC in Norway has been suspended as a result of these findings. In this consequence, we also concur with recommendation to await for more randomized control trails which shall offer sufficient evidences either to reject or support definitively TA TME and even more R-TA TME [35], [36], [37], [38].…”

Section: Discussionsupporting

confidence: 82%

Robotic Transanal Total Mesorectal Excision Compared to Laparoscopic Transanal Total Mesorectal Excision: Oncologic Results of the Past 5 Years

Coco

Leanza

2022

Open Access Maced J Med Sci

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Colorectal cancer is one of the deadliest diseases on the planet. Rectal cancer (RC) is the 8 th most common type of cancer disease worldwide, accounting for over 300,000 fatalities in 2018. Total mesorectal excision (TME) is considered as the gold standard approach for surgical RC management. To alleviate technical problems associated with dissection of distal rectal, transanal procedure to mesorectum was developed. The robotic operating platforms’ development has brought about the most significant change. The robotic method, which was described first in the year 2001, is gaining popularity in colorectal surgery. A stable camera platform with three-dimensional imaging and tremor filtering, motion scaling, instruments with numerous degrees of freedom, 3 rd arm for fixed retraction, ambidextrous capability, superior ergonomics, and less fatigue, all these advantages have all influenced robotics implementation. However, there are certain disadvantages to robotic surgery, such as high expenses, lengthy time of operation, a bulky cart, and absence of haptic sense. Robotic transanal TME (R-TA TME) is unique method that integrates potential advantages of perineal dissection with precise control of distal margins, along with all robotic technology advantages with respect to dexterity and greater precision. This review goal is to evaluate the available literature critically regarding R-TA TME in comparison to laparoscopic TA TME (L-TA TME) using the most prevalent histopathological metrics, which are the circumferential resection margin, the distal rectal margin, recurrence rate, specimen quality, advantages, and disadvantages. Oncological results for the past 5 years were used. The resources were obtained from electronic sources such as Google Scholar and PubMed. The conclusion of this review revealed that R-TA TME is as safe as well as feasible as L-TA TME, is technically possible, and has comparable oncological results and short-term post-operative outcomes. However, further investigation is required to evaluate long-term oncological or functional results.

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Section: Discussionsupporting

confidence: 82%

Robotic Transanal Total Mesorectal Excision Compared to Laparoscopic Transanal Total Mesorectal Excision: Oncologic Results of the Past 5 Years

Coco

Leanza

2022

Open Access Maced J Med Sci

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“…GRECCAR 11[ 7 ] and COLOR III[ 8 ] RCTs results are expected soon. In this scenario, we agree with the recommendation to wait for the RCTs that will provide the required evidence either to support definitively or reject TaTME[ 58 ]. The RESET trial is also ongoing to evaluate all the surgical approaches currently used for low anterior resection plus TME in a specific subgroup of high-risk patients[ 59 ].…”

Section: Future Perspectivesmentioning

confidence: 74%

Robotic transanal total mesorectal excision: Is the future now?

Sebastián-Tomás¹,

Martínez-Pérez²,

Martínez-López³

et al. 2021

WJGS

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Total mesorectal excision (TME) is the standard surgical treatment for the curative radical resection of rectal cancers. Minimally invasive TME has been gaining ground favored by the continuous technological advancements. New procedures, such as transanal TME (TaTME), have been introduced to overcome some technical limitations, especially in low rectal tumors, obese patients, and/or narrow pelvis. The earliest TaTME reports showed promising results when compared with the conventional laparoscopic TME. However, recent publications raised concerns regarding the high rates of anastomotic leaks or local recurrences observed in national series. Robotic TaTME (R-TaTME) has been proposed as a novel technique incorporating the potential benefits of a perineal dissection together with precise control of the distal margins, and also offers all those advantages provided by the robotic technology in terms of improved precision and dexterity. Encouraging short-term results have been reported for R-TaTME, but further studies are needed to assess the real role of the new technique in the long-term oncological or functional outcomes. The present review aims to provide a general overview of R-TaTME by analyzing the body of the available literature, with a special focus on the potential benefits, harms, and future perspectives for this novel approach.

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“…taTME is a complicated technique that combines both the laparoscopic and the transanal endoscopic approaches. 11 Therefore, it requires several technical steps in addition to the traditional laparoscopic surgery. Surgeons must master endoluminal suturing skills to complete adequate purse-string closure of the rectum and must master the abdominopelvic anatomy in the intraabdominal and perineal view.…”

Section: Feasibilitymentioning

confidence: 99%

“…taTME is a complicated technique that combines both the laparoscopic and the transanal endoscopic approaches 11 . Therefore, it requires several technical steps in addition to the traditional laparoscopic surgery.…”

Section: Consensusmentioning

confidence: 99%

Controversies and consensus in transanal total mesorectal excision (taTME): Is it a valid choice for rectal cancer?

Jiang

2021

Journal of Surgical Oncology

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Transanal total mesorectal excision (taTME) is a novel approach to radical surgery for low rectal cancer. taTME is associated with the benefits of a higher rate of free distal resection margins (DRM) under direct visualization, better visualization of the mesorectal plane, and the feasibility of overcoming the restriction of the distal pelvis. Thus, it is increasingly used globally. In this review, we investigated whether taTME yields better short-and long-term outcomes than laparoscopic TME.

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Introduction of new techniques and technologies in surgery: Where is transanal total mesorectal excision today?

Cited by 5 publications

References 34 publications

Robotic Transanal Total Mesorectal Excision Compared to Laparoscopic Transanal Total Mesorectal Excision: Oncologic Results of the Past 5 Years

Robotic Transanal Total Mesorectal Excision Compared to Laparoscopic Transanal Total Mesorectal Excision: Oncologic Results of the Past 5 Years

Robotic transanal total mesorectal excision: Is the future now?

Controversies and consensus in transanal total mesorectal excision (taTME): Is it a valid choice for rectal cancer?

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