Transanal Total Mesorectal Excision

  • Masaaki ItoEmail author


  1. 1.

    Transanal total mesorectal excision (taTME)—a down-to-up surgery in which traditional TME that was performed from the abdominal cavity side is endoscopically performed from the perineum side—was proposed, and its safety and efficacy were shown.

  2. 2.

    taTME could offer a unique anatomical recognition different from traditional TME. Especially when dissecting the anterior wall, recognition of rectourethral muscle and Denonvilliers’ fascia is characteristic of this technique.

  3. 3.

    Though there are some issues with taTME that need to be solved, it is expected to be effective in patients with severe obesity or a huge uterine fibroid that makes expansion of the visual field and dissecting with standard laparoscopic surgery difficult.



TME Trans-anal TME Rectal cancer ISR 


  1. 1.
    Martin-Perez B, Andrade-Ribeiro GD, Hunter L, Atallah S. A systematic review of transanal minimally invasive surgery (TAMIS) from 2010 to 2013. Tech Coloproctol. 2014;18(9):775–88. Scholar
  2. 2.
    de Lacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernández M, Delgado S, Sylla P, Martínez-Palli G. Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)–short-term outcomes in the first 20 cases. Surg Endosc. 2013;27(9):3165–72. Scholar
  3. 3.
    Atallah S, Martin-Perez B, Albert M, deBeche-Adams T, Nassif G, Hunter L, Larach S. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol. 2014;18(5):473–80. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryNational Cancer Center Hospital EastKashiwaJapan

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