Masaaki Ito, Yuji Nishizawa, Yuichiro Tsukada, Takeshi Sasaki. National Cancer Center Hospital East
Objective: The purpose of this study was to establish step-by-step procedures of taTME and to avoid intraoperative complications. Methods: We experienced one-hundred thirty taTME operations for low rectal cancers since 2013. We divided whole procedure to nine parts according to the surgical anatomical feature to establish step-by-step taTME.
Results: There are longitudinal fibers, deriving from the outer longitudinal muscle of the rectum, which attach to the Endopelvic fascia throughout a whole circumference. Especially, the smooth muscle fibers were recognized during surgery as the recto-urethral muscle in the anterior side and the recto-coccygeal muscle in the posterior side. So we should dissect at 1 and 11 o'clock first to identify the recto-urethral muscle clearly. This step could avoid the urethral injury. As well, we need to dissect at 5 and 7 o'clock first to identify the recto-coccygeal muscle in posterior side. We had no experiences of the urethral injury and our average operative time of taTME by two teams was 128 min.
Conclusion: The step-by-step taTME could offer safe and quick procedures according to the surgical anatomies closed to the anal ring in rectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87227
Program Number: V132
Presentation Session: Colorectal 2 Session
Presentation Type: Video
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