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Transanal Laparoscopic TME with Robot-Assisted Abdominal Laparoscopy

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Surgical Techniques in Rectal Cancer

Abstract

Transanal total mesorectal excision (taTME) exists as an excellent new technique for sphincter-preserving surgery in the distal rectum. Convergence of this with a minimally invasive approach from above, albeit laparoscopically or robotically, allows for an extension of sphincter preservation and represents the ultimate application of a minimally invasive approach. In this chapter, we will describe a taTME approach using laparoscopy from below. The abdominal portion of the procedure including release of splenic flexure, high ligation of the inferior mesenteric artery and inferior mesenteric vein (IMV), mobilization of the colon, and completion of the TME dissection from above will be described using a robotic technique. Anatomic and technical approaches will be highlighted demonstrating the evolving field of rectal cancer surgery.

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References

  1. Marks G, Mohiuddin M, Goldstein SD. Sphincter preservation for cancer of the distal rectum using high dose preoperative radiation. Int J Radiat Oncol Biol Phys. 1988;15:1065–8.

    Article  CAS  PubMed  Google Scholar 

  2. Marks G, Bannon J, Marks J. Transanal-abdominal transanal radical proctosigmoidectomy with coloanal anastomosis for distal rectal cancer. In: Baker R, Fisher J, Nyhus L, editors. Mastery of surgery. 3rd ed. Boston, MA: Little, Brown and Company Inc.; 1996. p. 1524–34.

    Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. Nicholson G, Knol J, Houben B, et al. Optimal dissection for transanal total mesorectal excision using modified CO2 insufflation and smoke extraction. Colorectal Dis. 2015;17(11):265–7.

    Article  Google Scholar 

  5. Marks JH, Lopez-Acevedo N, Krishnan B, Johnson MN, Montenegro GA, Marks G. 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.

    Article  PubMed  Google Scholar 

  6. 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; https://doi.org/10.1007/s00464-017-5597-7.

  7. Marks JH, Salem JF, Valsdottir EB, Yarandi SS, Marks GJ. Quality of life and functional outcome after transanal abdominal transanal proctectomy for low rectal cancer. Dis Colon Rectum. 2017;60(3):258–65.

    Google Scholar 

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Authors and Affiliations

  1. Division of Colorectal Surgery, Lankenau Medical Center, Wynnewood, PA, 19096, USA

    Jean Salem

  2. Department of Colorectal Surgery, Lankenau Medical Center, Main Line Healthcare, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA

    John H Marks

Authors
  1. Jean Salem
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  2. John H Marks
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Corresponding author

Correspondence to John H Marks .

Editor information

Editors and Affiliations

  1. Saint-Pierre University Hospital, Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Brussels, Belgium

    Giovanni Dapri

  2. Minimally Invasive Colorectal Surgery, Lankenau Medical Center, Main Line Healthcare, Wynnewood, Pennsylvania, USA

    John H Marks

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Salem, J., Marks, J.H. (2018). Transanal Laparoscopic TME with Robot-Assisted Abdominal Laparoscopy. In: Dapri, G., Marks, J. (eds) Surgical Techniques in Rectal Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55579-7_27

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  • DOI: https://doi.org/10.1007/978-4-431-55579-7_27

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55578-0

  • Online ISBN: 978-4-431-55579-7

  • eBook Packages: MedicineMedicine (R0)

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