Transanal Total Mesorectal Excision - Safe Introduction of a New Technique

Abstract

As a new and evolving technology, much attention has been placed on the safe introduction of the Transanal Total Mesorectal Excision (taTME) procedure. This “bottom-up” approach to the total mesorectal excision (TME) uses different anatomic views and pattern recognition compared to the gold standard traditional abdominal approach (TME), which require step-wise proctored learning for safe, successful implementation. A structured training pathway, focusing on both psychomotor and cognitive skills training, meets these needs. In addition, technologic tools such as color graded instructional videos, a focused teaching app, and use of Deferred Live surgery have the potential to improve deliberate practice and the learning process.

The goal of this work is to describe the technical procedural components of taTME, perform a comparative analysis to the abdominal TME, detail the procedure-specific risks, technical tips on how to avoid them, and the structured training model with complementary tools for efficient and effective learning.