Ann Coloproctol.  2022 Aug;38(4):283-289. 10.3393/ac.2022.00374.0053.

Transanal total mesorectal excision for rectal cancer: it’s come a long way and here to stay

  • 11Department of Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore
  • 2Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Centre, Taipei, Taiwan
  • 3College of Medicine, National Yang-Ming University, Taipei, Taiwan


Transanal total mesorectal excision (TaTME) was introduced as a novel technique to deal with rectal cancers. Its transanal approach offered the shortest distance to approach a challenging location, allowing an excellent visualization of the distal resection margin. Since its introduction in 2010, a significant amount of research has been put in to measure its development. In this review, we look at its ancestry, the genesis for its introduction and continued evolution as well as some of the important outcomes in its journey thus far. The importance of a structured and proctored learning journey is also stressed to enable the safe application and development of this technique. Beyond this, the TaTME movement has progressed relentlessly and its utility has been expanded to the management of benign conditions such as inflammatory bowel disease, Hartman reversals, and anastomotic strictures. We believe that the continued development and adoption of TaTME worldwide is here to stay.


Transanal endoscopic surgery; Rectal excision; Rectal neoplasms; Minimally invasive surgical procedures
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