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TaTME Transanal Total Mesorectal Excision

Bottom-up approach for low rectal cancer

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is TaTME Transanal Total Mesorectal Excision?

Transanal Total Mesorectal Excision (TaTME) is a combined transanal-transabdominal approach developed to secure adequate distal resection margins in low rectal tumours and to facilitate bottom-up mesorectal dissection.

The two-team strategy performs abdominal (laparoscopic/robotic) and transanal (via TAMIS port) dissection simultaneously. Midline rendezvous typically occurs at the anterior sacral plane.

It offers technical advantages in obese patients, narrow male pelvises and very low rectal tumours (<5 cm); direct visualisation of the distal margin enhances sphincter-preserving surgery rates.

Symptoms

Low rectal tumours (<5 cm from the anodermal border)
Rectal cancer in obese patients (BMI >30)
Narrow male pelvis
Locally advanced tumour after neoadjuvant therapy
Proctocolectomy for inflammatory bowel disease
Surgical need after TEM/TAMIS resection
Patients without sphincter-preserving alternatives

Risk Factors

Urethral injury (in men)
Anastomotic leak (high rate)
Local recurrence (steep learning curve)
Pelvic autonomic nerve damage
Post-TaTME synchronous events (anterior resection)
Urinary and sexual dysfunction
Conversion (uncommon but possible)
Anastomotic stricture (late)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Drainage from the perineal wound
  • Bloody mucoid discharge
  • Difficulty urinating
  • Severe rectal pain
  • Fever and signs of systemic infection

Treatment Methods

01
Two-team setup: abdominal (laparoscopic/robotic) + transanal (TAMIS)
02
Rectal lumen pressure 12-15 mmHg via TAMIS port
03
Purse-string suture closing distal lumen below the tumour
04
Full-thickness circumferential incision below the distal margin
05
Bottom-up retrorectal mesorectal dissection
06
Midline rendezvous with the abdominal team
07
Specimen extraction and rectal/sigmoid resection
08
Distal anastomosis (manual or circular stapler) and protective ileostomy

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.