Transanal minimally invasive surgery for total mesorectal excision (ETM) through transanal approach (TaETM) with robotic and Transanal Endoscopic Operations (TEO) combined access: step by step surgery

Abstract

RationalIn the treatment of colorectal cancer, from 1982 Heald proposed standardization of the total mesorectal excision, with a significant reduction in the recurrence rate. But the treatment of lower rectal lesions is still a challenge.AimTo describe the association of robotic low anterior resection- TATA (Transanal Abdominal Transanal Resection), with transanal access using Transanal Endoscopic Operations - TEO in the treatment of lower rectal cancer.MethodThe TATA performs robotic abdominal approach and the TEO performs the perineal approach, developing total mesorectal excision (TME) transanally (TaETM).ResultThe TaETM technique was applied in a woman with rectal adenocarcinoma 5 cm from the anal verge that had been submitted to chemoradiation. The procedure was performed with satisfatory operative time and favorable oncological outcome (grade 3 mesorectal excision).ConclusionThis is a promising minimally invasive procedure in the armamentarium of rectal cancer treatment, specially in challenging scenarios such as narrow pelvis, obesity and very low rectal tumors.

Surgical and oncological short-term outcomes of prone extralevator abdominoperineal excision for low rectal cancer

“…We reserve pELAPE procedure for the very low and locally advanced tumours. In recent years, we indeed increased sphincter preservation surgery for LRC, including interesphincteric resection and transanal excision using transanal endoscopic microsurgery (TEM), 22 relying in more accurate preoperative staging modalities (MRI and endorectal ultrasound) and more moderns' neoadjuvant treatments. 23 The second great imbalance between the two groups was the use of minimally invasive procedures (laparoscopy or robotic surgery) for the abdominal approach.…”

Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.

“…Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide and in 25% of cases are located in the rectum. Due to its slow progression from detectable precancerous lesions and to the much better prognosis of patients diagnosed at early stages, the potential for reducing the burden of the disease by early detection is signi cant (1,2). Adenoma is the most important type of polyp because it is directly correlated with CRC and originates from the colorectal mucosa, accounting for approximately 70% of all polyps (3,4).…”

Surgical and postoperative evaluations of rectal adenomas excised with a rigid proctoscope

“…Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide and in 25% of cases are located in the rectum. Due to its slow progression from detectable precancerous lesions and to the much better prognosis of patients diagnosed at early stages, the potential for reducing the burden of the disease by early detection is significant 1,2 . Adenoma is the most important type of polyp because it is directly correlated with CRC and originates from the colorectal mucosa, accounting for approximately 70% of all polyps 3,4 .…”