Transanal Robot-Assisted TME with Multiport Abdominal Laparoscopy



Transanal total mesorectal excision (taTME) is a “bottom-up” rather than “top-down” approach to radical proctectomy for rectal cancer. The surgical tools utilized to perform taTME continue to evolve. This chapter will review the robotic technical approach to performing taTME and summarize the published experience to date. Lastly, the perceived benefits and drawbacks associated with robotic taTME will be discussed.


Rectal cancer Total mesorectal excision Transanal TME taTME Robotic 


  1. 1.
    Marks JH, Frenkel JL, D’Andrea AP, Greenleaf CE. Maximizing rectal cancer results: TEM and TATA techniques to expand sphincter preservation. Surg Oncol Clin N Am. 2011;20(3):501–20. viii–ixCrossRefPubMedGoogle Scholar
  2. 2.
    Marks J, Nassif G, Schoonyoung H, DeNittis A, Zeger E, Mohiuddin M, et al. Sphincter-sparing surgery for adenocarcinoma of the distal 3 cm of the true rectum: results after neoadjuvant therapy and minimally invasive radical surgery or local excision. Surg Endosc. 2013;27(12):4469–77.CrossRefPubMedGoogle Scholar
  3. 3.
    Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc. 2010;24(5):1205–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Marks J, Mizrahi B, Dalane S, Nweze I, Marks G. Laparoscopic transanal transabdominal 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.CrossRefPubMedGoogle Scholar
  5. 5.
    McLemore EC, Weston LA, Coker AM, Jacobsen GR, Talamini MA, Horgan S, et al. Transanal minimally invasive surgery for benign and malignant rectal neoplasia. Am J Surg. 2014;208(3):372–81.CrossRefPubMedGoogle Scholar
  6. 6.
    Huscher CGS, Bretagnol F, Ponzano C. Robotic-assisted Transanal Total Mesorectal Excision. Ann Surg. 2015;261(5):e120–1.CrossRefPubMedGoogle Scholar
  7. 7.
    Atallah S, Nassif G, Polavarapu H, deBeche-Adams T, Ouyang J, Albert M, et al. Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol. 2013;17(4):441–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Gómez Ruiz M, Parra IM, Palazuelos CM, Martín JA, Fernández CC, Diego JC, et al. Robotic-assisted laparoscopic transanal total mesorectal excision for rectal cancer. Dis Colon Rectum. 2015;58(1):145–53.CrossRefPubMedGoogle Scholar
  9. 9.
    Verheijen PM, Consten ECJ, Broeders IAMJ. Robotic transanal total mesorectal excision for rectal cancer: experience with a first case. Int J Med Robot Comput Assist Surg. 2014;10(4):423–6.CrossRefGoogle Scholar
  10. 10.
    Atallah S, Martin-Perez B, Parra-Davila E, deBeche-Adams T, Nassif G, Albert M, et al. Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution. Tech Coloproctol. 2015;19(7):401–10.CrossRefPubMedGoogle Scholar
  11. 11.
    Hompes R. Robotics and transanal minimal invasive surgery (TAMIS): the “‘sweet spot’” for robotics in colorectal surgery? Tech Coloproctol. 2015;19(7):377–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2018

Authors and Affiliations

  1. 1.Colon and Rectal Surgery, Department of SurgeryKaiser Permanente Los Angeles Medical CenterLos AngelesUSA

Personalised recommendations