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Historical Perspectives and Rationale for Development
Pages 3-10
This book captures cornerstone developments in a new body of knowledge and provides an expert resource on a “hot topic” in rectal surgery. Transanal minimally invasive surgery (TAMIS) was designed for local excision of select rectal neoplasms, however soon it became realized that the TAMIS technique could be used for applications beyond local excision, most notably for transanal total mesorectal excision (taTME). This new operative technique has revolutionized our approach to the distal rectum by allowing for improved access, especially in obese male patients with an android pelvis, and by minimizing abdominal wall access trauma. The endpoints of improved oncologic resection, as defined by mesorectal envelope completeness, negative circumferential resection margins, and negative distal margin, are assessed. This book details controversies, pitfalls, and future directions of taTME and TAMIS. Chapters are authored by those on the forefront of innovation with TAMIS and taTME, and each is considered an authority on the topic.
Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME) is a must-have reference for surgeons who are performing this operation and fellows in training who want to completely understand the various nuances of TAMIS and taTME.
Historical Perspectives and Rationale for Development
Pages 3-10
TAMIS: Indications and Contraindications
Pages 11-16
An Algorithm for Local Excision for Early-Stage Rectal Cancer
Pages 17-30
Complete Clinical Response in Rectal Cancer After Neoadjuvant Therapy: Organ Preservation Strategies and the Role of Surgery
Pages 31-41
Salvage Surgery After TAMIS Excision of Early-Stage Rectal Cancer
Pages 43-48
Organ Preservation and Palliative Options for Rectal Cancer
Pages 49-55
Operative Equipment and Insufflator Options
Pages 57-79
Operating Theater Setup and Perioperative Considerations
Pages 81-87
Surgical Technique for Local Excision of Rectal Neoplasia
Pages 89-95
Pyramidal Excision for Early Rectal Cancer and Special Closure Techniques
Pages 97-111
Closure Versus Non-closure After Local Excision
Pages 113-116
Operative and Perioperative Outcomes
Pages 117-122
Functional Outcomes After Local Excision for Rectal Neoplasia
Pages 123-131
Oncologic Outcomes for Local Excision of Rectal Neoplasia
Pages 133-142
Applications Beyond Local Excision
Pages 143-152
The Evolution of Robotic TAMIS
Pages 153-164
Transanal Robotic Surgery and Future Directions
Pages 165-174
TAMIS: Current Controversies and Challenges
Pages 175-183
Indications for Malignant Neoplasia of the Rectum
Pages 187-196
Indications for Benign Disease of the Rectum
Pages 197-215
Operating Theater Setup and Two-Team Coordination
Pages 217-227
Single-Team taTME
Pages 229-243
Transanal Access Platform Options and Instrument Innovations
Pages 245-254
Intraoperative Decision-Making: Converting to taTME, When and for Whom?
Pages 255-261
Key Aspects of the Abdominal Dissection
Pages 263-270
Zen and the Art of the Purse-String
Pages 271-276
An Overview of Operative Steps and Surgical Technique
Pages 277-284
Strategies for Ultralow-Lying Rectal Cancer
Pages 285-297
Critical Anatomical Landmarks in Transanal Total Mesorectal Excision (taTME)
Pages 299-309
Urethral Injury: The New Challenge for taTME
Pages 311-319
How to Avoid Urethral Injury in Males
Pages 321-333
A Roadmap to the Pelvic Autonomic Nerves During Transanal Dissection
Pages 335-342
Operative Vectors, Anatomic Distortion, and the Inherent Effects of Insufflation
Pages 343-356
Total Hindgut Mesenteric Mobilization for taTME
Pages 357-372
The Role for Perfusion Angiography
Pages 373-380
Perioperative Preparation and Postoperative Care Considerations
Pages 381-389
Intraoperative Morbidity of taTME
Pages 391-397
Functional Outcomes to Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME)
Pages 399-403
Oncologic Outcomes
Pages 405-410
TaTME for Radical Exenteration
Pages 411-417
TaTME for Abdominoperineal Excision
Pages 419-427
Hartmann’s Reversal by a Combined Transanal-Transabdominal Approach
Pages 429-434
Pure NOTES Transanal TME
Pages 435-453
Totally Robotic taTME: Experiences and Challenges to Date
Pages 455-464
Next-Generation Robots for taTME
Pages 465-474
Video-Based Training Apps and Deferred Live Surgery
Pages 475-484
Navigation for Transanal Total Mesorectal Excision
Pages 485-491
Current Controversies and Challenges in Transanal Total Mesorectal Excision (taTME)
Pages 493-497
Transanal Total Mesorectal Excision: The Next 10 Years
Pages 499-508
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