Techniques in Coloproctology

, Volume 21, Issue 3, pp 233–235 | Cite as

Combined transanal total mesorectal excision (taTME) with laparoscopic instruments and abdominal robotic surgery in rectal cancer

  • R. BravoEmail author
  • J.-S. Trépanier
  • M. C. Arroyave
  • M. Fernández-Hevia
  • A. Pigazzi
  • A. M. Lacy
Multimedia Article


Laparoscopic surgery for rectal cancer can be technically challenging. We describe a hybrid technique combining abdominal robotic dissection and transanal total mesorectal excision. This procedure was performed in a 50-year-old man with rectal adenocarcinoma at 5 cm from the dentate lane. Preoperative staging was T2N0M0. Surgery went well without complications, and estimated blood loss was less than 50 mL. Robotic surgical time was 90 min, and total operative time was 160 min. The patient was discharged on postoperative day 3. Pathology analysis revealed an intact mesorectum (TME grade 3) and a T2N0 tumor with negative margins. Hybrid surgery with pelvic robotic dissection and transanal total mesorectal excision was feasible, quick and safe in this patient and may be a method that can be developed further.


Robotic surgery Transanal total mesorectal excision Transanal TME Rectal cancer Laparoscopy 



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Compliance with ethical standards

Conflict of interest

Raquel Bravo, Jean-Sébastien Trépanier, Maria Clara Arroyave and A.M. Lacy have no conflict of interest to disclose. María Fernandez-Hevia has received a grant from Covidien and from the private research foundation Cellex in the last 2 years. Alessio Pigazzi has been a consultant for Intuitive Surgical, Cook, Ethicon, Covidien, Cubist.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study formal consent is not required.

Supplementary material

Supplementary material 1 (MP4 199823 kb)


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • R. Bravo
    • 1
    Email author
  • J.-S. Trépanier
    • 1
    • 2
  • M. C. Arroyave
    • 1
    • 3
  • M. Fernández-Hevia
    • 1
  • A. Pigazzi
    • 4
  • A. M. Lacy
    • 1
  1. 1.Hospital Clínic de BarcelonaBarcelonaSpain
  2. 2.Hôpital Maisonneuve-RosemontMontrealCanada
  3. 3.Clínica SomerRionegroColombia
  4. 4.Irvine Medical CenterUniversity of CaliforniaOrangeUSA

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