- Details the steps and discusses controversies, pitfalls, and future directions of taTME and TAMIS
- Provides a well-timed, must-have reference for surgeons who are performing these operations
- Written by those at the forefront of innovation
This book captures cornerstone developments in a new body of knowledge and provides an expert resource on a “hot topic” in rectal surgery. Transanal minimally invasive surgery (TAMIS) was designed for local excision of select rectal neoplasms, however soon it became realized that the TAMIS technique could be used for applications beyond local excision, most notably for transanal total mesorectal excision (taTME).
This new operative technique has revolutionized our approach to the distal rectum by allowing for improved access, especially in obese male patients with an android pelvis, and by minimizing abdominal wall access trauma. The endpoints of improved oncologic resection, as defined by mesorectal envelope completeness, negative circumferential resection margins, and negative distal margin, are assessed.
This book details controversies, pitfalls, and future directions of taTME and TAMIS. Chapters are authored by those on the forefront of innovation with TAMIS and taTME, and each is considered an authority on the topic.
Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME) is a must-have reference for surgeons who are performing this operation and fellows in training who want to completely understand the various nuances of TAMIS and taTME.
Table of Contents- Historical Perspectives and Rationale for Development
- TAMIS: Indications and Contraindications
- An Algorithm for Local Excision for Early Stage Rectal Cancer
- Complete Clinical Response in Rectal Cancer after Neoadjuvant Therapy—Organ-Preservation Strategies and the Role of Surgery
- Salvage Surgery after TAMIS Excision of Early Stage Rectal Cancer
- Organ Preservation and Palliative Options for Rectal Cancer
- Operative Equipment and Insufflator Options
- Operating Theater Setup and Perioperative Considerations
- Surgical Technique for Local Excision of Rectal Neoplasia
- Pyramidal Excision for Early Rectal Cancer and Special Closure Techniques
- Closure versus Non-Closure after Excision
- Operative and Peri-Operative Outcomes
- Functional Outcomes after Local Excision of Rectal Neoplasia
- Oncologic Outcomes for Local Excision of Rectal Neoplasia
- Applications Beyond Local Excision
- The Evolution of Robotic TAMIS
- Transanal Robotic Surgery and Future Directions
- TAMIS: Current Controversies and Challenges
- Indications for Malignant Neoplasia of the Rectum
- Indications for Benign Disease of the Rectum
- Operating Theatre Setup & Two-Team Coordination
- Single-Team taTME.- Transanal Access Platform Options & Instrument Innovations
- Intra-Operative Decision Making: Converting to taTME, When and for Whom?
- Key Aspects of the Abdominal Dissection
- Zen and the Art of the Pursestring
- An Overview of Operative Steps and Surgical Technique
- Strategies for Ultra Low-Lying Rectal Cancer
- Critical Anatomical Landmarks in Transanal Total Mesorectal Excision (taTME)
- Urethral Injury: The New Challenge for taTME
- How to Avoid Urethral Injury in Males
- A Roadmap to the Pelvic Autonomic Nerves During Transanal Dissection
- Operative Vectors, Anatomic distortion, and the Inherent Effect of CO2 Dissection
- Total Hindgut Mesenteric Mobilization for taTME
- The Role for Perfusion Angiography
- Perioperative Preparation and Post-Operative Care Considerations
- Intra-Operative Morbidity TaTME
- Functional Outcomes to Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME)
- Oncologic Outcomes
- TaTME for Radical Exenteration
- taTME for Abdominoperineal Resection
- Hartmann’s Reversal by a Combined Transanal-Transabdominal Approach
- Pure NOTES Transanal taTME
- Totally Robotic taTME--Experiences and Challenges to Date
- Next Generation Robots for taTME
- Video-Based Training Apps and Deferred Live Surgery
- Navigation for Transanal Total Mesorectal Excision
- Current Controversies and Challenges
- Transanal Total Mesorectal Excision: The Next Ten Years
