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Current Endoluminal Approaches: Transanal Endoscopic Microsurgery, Transanal Minimally Invasive Surgery and Transanal Total Mesorectal Excision

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Advanced Colonoscopy and Endoluminal Surgery

Abstract

Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), collectively known as transanal endoscopic surgery (TES), are current endoluminal approaches for transanal resection of rectal lesions. Transanal total mesorectal excision or taTME was recently introduced as a novel transanal endoscopic approach to traditional total mesorectal excision (TME). Recent series have demonstrated its feasibility and procedural safety profile with acceptable preliminary oncologic and short-term postoperative outcomes relative to laparoscopic TME. In this chapter, current indications and contraindications for TES and taTME will be reviewed. The essentials of preoperative preparation and staging will be discussed as well as current surgical techniques, pearls, and pitfalls associated with TES and taTME. Furthermore, review of the published outcomes for these various approaches with respect to oncologic outcomes, functional results, and morbidity and mortality will be examined.

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Authors and Affiliations

  1. Department of Surgery, Lenox Hill Hospital, 100 East 77th St, New York, NY, 10075, USA

    Cici Zhang M.D.

  2. Department of Surgery, Division of Colon and Rectal Surgery, Icahn School of Medicine at Mount Sinai Hospital, 5 East 98th Street, 1259, New York, NY, 10029, USA

    Patricia Sylla M.D., F.A.C.S., F.A.S.C.R.S.

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  1. Cici Zhang M.D.
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  2. Patricia Sylla M.D., F.A.C.S., F.A.S.C.R.S.
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Correspondence to Patricia Sylla M.D., F.A.C.S., F.A.S.C.R.S. .

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Editors and Affiliations

  1. Department of Surgery - Colon and Rectal Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA

    Sang W. Lee

  2. Division of Colon and Rectal Surgery Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA

    Howard M. Ross

  3. Department of Colon and Rectal Surgery Northwell Health, Huntington Hospital Hofstra School of Medicine, Woodbury, New York, USA

    David E. Rivadeneira

  4. Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

    Scott R. Steele

  5. Division of Colorectal Surgery Department of Surgery, Columbia University, New York, New York, USA

    Daniel L. Feingold

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Zhang, C., Sylla, P. (2017). Current Endoluminal Approaches: Transanal Endoscopic Microsurgery, Transanal Minimally Invasive Surgery and Transanal Total Mesorectal Excision. In: Lee, S., Ross, H., Rivadeneira, D., Steele, S., Feingold, D. (eds) Advanced Colonoscopy and Endoluminal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-48370-2_22

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