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Pure NOTES Transanal TME

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Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME)

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Abstract

We aim to describe a full transanal procedure for oncologic resection of the rectum and of its mesentery without any abdominal laparoscopic assistance. The rationale, the different steps of this technique, and the required armamentarium and indications are described and illustrated.

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References

  1. Miles WE. A method of performing abdominoperineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon. Lancet. 1908;2:1812–3.

    Article  Google Scholar 

  2. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery–the clue to pelvic recurrence? Br J Surg. 1982;69(10):613–6.

    Article  CAS  PubMed  Google Scholar 

  3. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H, Clinical Outcomes of Surgical Therapy Study Group. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg. 2007;246(4):655–62. discussion 662–4.

    Article  PubMed  Google Scholar 

  4. Heald RJ. A new solution to some old problems: transanal TME. Tech Coloproctol. 2013;17(3):257–8. https://doi.org/10.1007/s10151-013-0984-0. Epub 2013 Mar 22.

    Article  CAS  PubMed  Google Scholar 

  5. Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc. 2010;24:1205–10. https://doi.org/10.1007/s00464-010-0965-6. Epub 2010 Feb 26.

    Article  PubMed  Google Scholar 

  6. Leroy J, Barry BD, Melani A, Mutter D, Marescaux J. No-scar transanal total mesorectal excision: the last step to pure NOTES for colorectal surgery. JAMA Surg. 2013;148(3):226–30. discussion 31.

    Article  PubMed  Google Scholar 

  7. Leroy J, Cahill RA, Perretta S, Forgione A, Dallemagne B, Marescaux J. Natural orifice translumenal endoscopic surgery (NOTES) applied totally to sigmoidectomy: an original technique with survival in a porcine model. Surg Endosc. 2009;23(1):24–30. https://doi.org/10.1007/s00464-008-0102-y. Epub 2008 Sep 24. PMID: 18814015.

    Article  PubMed  Google Scholar 

  8. Leroy J, Diana M, Barry B, Mutter D, Melani AG, Wu HS, et al. Perirectal Oncologic Gateway to Retroperitoneal Endoscopic Single-Site Surgery (PROGRESSS): a feasibility study for a new NOTES approach in a swine model. Surg Innov. 2012;19(4):345–52. https://doi.org/10.1177/1553350612452346. Epub 2012 Jul 1. PMID: 22751618.

    Article  PubMed  Google Scholar 

  9. Dapri G, Marks JH, editors. Surgical Techniques in Rectal Cancer, Chapter 28, Joel Leroy, Usmaan Hameed, Ntourakis Dimitrios, and Frédéric Bretagnol. Pure Transanal Laparoscopic TME without Abdominal Laparoscopy. Springer Japan 2018. https://doi.org/10.1007/978-4-431-55579-7_28.

  10. Marks J, Mizrahi B, Dalane S, Nweze I, Marks G. Laparoscopic transanal abdominal transanal resection with sphincter preservation for rectal cancer in the distal 3 cm of the rectum after neoadjuvant therapy. Surg Endosc. 2010;24(11):2700–7. https://doi.org/10.1007/s00464-010-1028-8. Epub 2010 Apr 23.

    Article  CAS  PubMed  Google Scholar 

  11. Marks JH, Myers EA, Zeger EL, Denittis AS, Gummadi M, Marks GJ. Long-term outcomes by a transanal approach to total mesorectal excision for rectal cancer. Surg Endosc. 2017;31(12):5248–57. https://doi.org/10.1007/s00464-017-5597-7. Epub 2017 Jun 22. PMID: 28643051.

    Article  PubMed  Google Scholar 

  12. Zorron R, Phillips HN, Wynn G, Neto MP, Coelho D, Vassallo RC. “Down-to-up” transanal NOTES Total mesorectal excision for rectal cancer: preliminary series of 9 patients. J Minim Access Surg. 2014;10(3):144–50. https://doi.org/10.4103/0972-941.134878. PMID: 2501333.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Buess G, Kipfmüller K, Ibald R, Heintz A, Braunstein S, Gabbert H, Junginger T. Transanal endoscopic microsurgery in rectal cancer. Chirurg. 1989;60(12):901–4. [Article in German]. PMID: 2695299.

    CAS  PubMed  Google Scholar 

  14. Kim EK, Sheetz KH, Bonn J, DeRoo S, Lee C, Stein I, et al. A statewide colectomy experience: the role of full bowel preparation in preventing surgical site infection. Ann Surg. 2014;259:310–4.

    Article  PubMed  Google Scholar 

  15. Lange MM, Buunen M, van de Velde CJH, et al. Level of arterial ligation in rectal cancer surgery: low tie preferred over high tie. A review. Dis Colon Rectum. 2008;51(7):1139–45. https://doi.org/10.1007/s10350-008-9328-y. Epub 2008 May 16. Review. PMID: 18483828.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kanemitsu Y, Hirai T, Komor K, et al. Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery. Br J Surg. 2006;93:609–15. https://doi.org/10.1007/DCR.0b013e3181cf7609. PMID: 20389212.

    Article  CAS  PubMed  Google Scholar 

  17. Pezim ME, Nicholls RJ. Survival after high or low ligation of the inferiormesenteric artery during curative surgery for rectal cancer. Ann Surg. 1984;200(6):729–33. PMID: 6508403.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hideo Y. Laparoscopic colectomy using retroperitoneal approach method. Gastroenterol Surg. 2004;27(6):861–9.

    Google Scholar 

  19. Occelli B, Narducci F, Lanvin D, Coste E, Legoupils E, Castelain B, Querleu D. Comparison of transperitoneal versus extraperitoneal laparoscopic para-aortic lymphadenectomy: randomized experimental study. Ann Chir. 2000;125(1):9–17. [Article in French].

    Article  CAS  PubMed  Google Scholar 

  20. Narducci F, Occelli B, Lanvin D, Vinatier D, Leblanc E, Querleu D. Endoscopic para-aortic dissection by the extraperitoneal approach: clinical study of 37 patients. Gynecol Obstet Fertil. 2000;28(2):108–14. [Article in French].

    CAS  PubMed  Google Scholar 

  21. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP, TaTME Registry Collaborative. Transanal total mesorectal excision: international registry results of the first 720 cases. Ann Surg. 2017;266(1):111–7. https://doi.org/10.1097/SLA.0000000000001948. PMID: 27735827.

    Article  PubMed  Google Scholar 

  22. Tuech JJ, Karoui M, Lelong B, De Chaisemartin C, Bridoux V, Manceau G, et al. A step toward NOTES total mesorectal excision for rectal cancer: endoscopic transanal proctectomy. Ann Surg. 2015;261(2):228–33. https://doi.org/10.1097/SLA.0000000000000994.

    Article  PubMed  Google Scholar 

  23. Wolthuis AM, de Buck van Overstraeten A, D’Hoore A. Dynamic article: transanal rectal excision: a pilot study. Dis Colon Rectum. 2014;57(1):105–9. https://doi.org/10.3748/wjg.v20.i36.12981. Review. PMID: 25278692.

    Article  PubMed  Google Scholar 

  24. Velthuis S, Nieuwenhuis DH, Ruijter TE, Cuesta MA, Bonjer HJ, Sietses C. Transanal versus traditional laparoscopic total mesorectal excision for rectal carcinoma. Surg Endosc. 2014;28(12):3494–9. https://doi.org/10.1007/s00464-014-3636-1. Epub 2014 Jun 28. PMID: 24972923.

    Article  PubMed  Google Scholar 

  25. Delgado S, Fernandez M, Lacy AM. Laparoscopic-assisted total mesorectal resection through the transanal route. Cir Esp. 2014;92(Suppl 1):21–9. https://doi.org/10.1016/S0009-739X(14)70005-3. PMID: 24842688.

    Article  PubMed  Google Scholar 

  26. Atallah S, Martin-Perez B, Albert M, deBeche-Adams T, Nassif G, Hunter L, et al. 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. https://doi.org/10.1007/s10151-013-1095-7. Epub 2013 Nov 23. PMID: 24272607.

    Article  CAS  PubMed  Google Scholar 

  27. Velthuis S, van den Boezem PB, van der Peet DL, Cuesta MA, Sietses C. Feasibility study of transanal total mesorectal excision. Br J Surg 2013;100(6):828–31. discussion 31. doi: https://doi.org/10.1002/bjs.9069. Epub 2013 Feb 25. PMID: 23440708.

  28. Sylla P, Bordeianou LG, Berger D, Han KS, Lauwers GY, Sahani DV, et al. A pilot study of natural orifice transanal endoscopic total mesorectal excision with laparoscopic assistance for rectal cancer. Surg Endosc. 2013;27(9):3396–405. https://doi.org/10.1007/s00464-013-2922-7. Epub 2013 Apr 10. PMID: 23572214.

    Article  PubMed  Google Scholar 

  29. Rouanet P, Mourregot A, Azar CC, Carrere S, Gutowski M, Quenet F, et al. Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis. Dis Colon Rectum. 2013;56(4):408–15. https://doi.org/10.1097/DCR.0b013e3182756fa0. PMID: 23478607.

    Article  PubMed  Google Scholar 

  30. Lacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernandez M, Delgado S, et al. 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. https://doi.org/10.1007/s00464-013-2872-0. Epub 2013 Mar 22. PMID: 23519489.

    Article  PubMed  Google Scholar 

  31. Chouillard E, Chahine E, Khoury G, Vinson-Bonnet B, Gumbs A, Azoulay D, et al. NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surg Endosc. 2014;28(11):3150–7. https://doi.org/10.1007/s00464-014-3573-z. Epub 2014 May 31. PMID: 24879139.

    Article  CAS  PubMed  Google Scholar 

  32. Zhang H, Zhang YS, Jin XW, Li MZ, Fan JS, Yang ZH. Transanal single-port laparoscopic total mesorectal excision in the treatment of rectal cancer. Tech Coloproctol. 2013;17(1):117–23. https://doi.org/10.1007/s10151-012-0882-x. Epub 2012 Aug 31. PMID: 22936590.

    Article  CAS  PubMed  Google Scholar 

  33. Park SJ, Sohn DK, Chang TY, Jung Y, Kim HJ, Kim YI, Chun HK, Korea Natural Orifice Transluminal Endoscopic Surgery (K-NOTES) Study Group. Transanal natural orifice transluminal endoscopic surgery total mesorectal excision in animal models: endoscopic inferior mesenteric artery dissection made easier by a retroperitoneal approach. Ann Surg Treat Res. 2014;87(1):1–4.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Marks JH, Lopez-Acevedo N, Krishnan B, Johnson MN, Montenegro GA, Marks GJ. True NOTES TME resection with splenic flexure release, high ligation of IMA, and side-to-end hand-sewn coloanal anastomosis. Surg Endosc. 2016;30(10):4626–31. https://doi.org/10.1007/s00464-015-4731-7. Epub 2016 Jan 28. PMID: 26823054.

    Article  PubMed  Google Scholar 

  35. Atallah SB, DuBose AC, Burke JP, Nassif G, deBeche-Adams T, Frering T, Albert MR, Monson JRT. Uptake of transanal total mesorectal excision in North America: initial assessment of a structured training program and the experience of delegate surgeons. Dis Colon Rectum. 2017;60(10):1023–31. https://doi.org/10.1097/DCR.0000000000000823.

    Article  PubMed  Google Scholar 

  36. Penna M, Whiteford M, Hompes R, Sylla P. Developing and assessing a cadaveric training model for transanal total mesorectal excision: initial experience in the UK and USA. Color Dis. 2017;19(5):476–84. https://doi.org/10.1111/codi.13525. PMID: 27647728.

    Article  CAS  Google Scholar 

  37. Francis N, Penna M, Mackenzie H, Carter F, Hompes R, International TaTME Educational Collaborative Group. Consensus on structured training curriculum for transanal total mesorectal excision (TaTME). Surg Endosc. 2017;31(7):2711–9. https://doi.org/10.1007/s00464-017-5562-5. Epub 2017 May 1. PMID: 28462478.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Hanoi High Tech & Digestive Center, St Paul Hospital, Digestive Colorectal Department of Minimally Invasive Surgery, Hanoi, Vietnam

    Joel Leroy, Hoa Nguyen Hoang & Chuc Phan Ngoc

  2. Digestive Surgery—University Louis Mourier Hospital (APHP), Paris, France

    Frédéric Bretagnol

  3. Hanoi High Tech & Digestive Center, St Paul Hospital, Hanoi, Vietnam

    Nguyen Ngoc Dan

  4. Thai Binh Medical University, Thai Binh, Vietnam

    Hoa Nguyen Hoang

  5. Hanoi Medical University, Hanoi, Vietnam

    Truc Vu Trung & Chuc Phan Ngoc

  6. St Paul Hospital, Digestive Colorectal Department of Minimally Invasive Surgery, Hanoi, Vietnam

    Truc Vu Trung

Authors
  1. Joel Leroy
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  2. Frédéric Bretagnol
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  3. Nguyen Ngoc Dan
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  4. Hoa Nguyen Hoang
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  5. Truc Vu Trung
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  6. Chuc Phan Ngoc
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Editor information

Editors and Affiliations

  1. AdventHealth Orlando, Oviedo Medical Center, and University of Central Florida College of Medicine, Orlando, FL, USA

    Sam Atallah

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Leroy, J., Bretagnol, F., Dan, N.N., Hoang, H.N., Trung, T.V., Ngoc, C.P. (2019). Pure NOTES Transanal TME. In: Atallah, S. (eds) Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME). Springer, Cham. https://doi.org/10.1007/978-3-030-11572-2_43

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  • DOI: https://doi.org/10.1007/978-3-030-11572-2_43

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-11571-5

  • Online ISBN: 978-3-030-11572-2

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