Experiencing Transanal TME with a Cadaveric Model

ABSTRACT

Transanal total mesorectal excision (taTME) is known to be a novel surgical approach for patients who are difficult to resolve with the traditional trans-abdominal approach. However, most of the colorectal surgeons are unfamiliar with the technique, which can lead to serious complications such as urethral injury. Hence, training through the fresh frozen cadaver has been gradually included in the formal taTME training course. The authors trained the taTME procedure with two cadavers in 2016. Two surgeons who were experts in trans-anal minimally invasive surgery and had minimal experiences in taTME performed the procedure. The total procedure time from the purse string suture to the anterior communication took about 65 minutes. The procedure proceeded well without any inadvertent injury to anatomic structures. The usefulness of the cadaveric model in training taTME was confirmed and the experience of single port surgery and trans-anal operation before the cadaveric training is considered to be important.