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Advanced Application of TaTME Platform For a T4 Anterior Rectal Tumor

Baker, Emily J. BAppSc, BAppSc(Hons), MBBS; Waters, Peadar S. MB, BcH, BAO, MD, FRCS; Peacock, Oliver BMBS, BMEDsci, PhD, FRCS; McCormick, Jacob J. MBBS, FRACS; Heriot, Alexander G. MD, MBA, FRACS, FRCS; Warrier, Satish K. MS, MBBS, FRACS

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: August 2019 - Volume 29 - Issue 4 - p e45–e49
doi: 10.1097/SLE.0000000000000668
Online Articles: Technical Reports

Transanal total mesorectal excision (TaTME) is a rapidly progressing technique in the management of both benign and malignant rectal disease. It is a technical advance to the current gold-standard approach to rectal cancer, the transabdominal total mesorectal excision. Until now, T4 stage cancers have been considered a relative contraindication to TaTME due to the perceived technical difficulty and increased complication rate. This case describes the TaTME operative technique for a T4b locally advanced, mid rectal anterior tumor in a young male postneoadjuvant chemoradiation. Employing a dual team hybrid TaTME (Cecil approach) with laparoscopic abdominal assistance, this case highlights the ability of TaTME to be successfully utilized in more advanced malignancy and technically difficult patients without an increase in complications, operative time, or hospital length of stay.

Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia

E.J.B. and P.S.W. are co-first authors.

Consent from the patient is obtained.

The author declares no conflicts of interest.

Reprints: Peadar S. Waters, MB, BcH, BAO, MD, FRCS, Colorectal Surgery Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Vic. 3000, Australia (e-mail:

Received March 24, 2019

Accepted April 8, 2019

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