Transanal Total Mesorectal Excision Specialist

What is transanal total mesorectal excision?

Transanal total mesorectal excision (taTME) is an advanced surgical technique that uses a transanal access platform to remove the affected rectum and reconnect the healthy bowel through your bottom rather than through an abdominal incision.

The taTME procedure is an alternative to conventional colorectal surgery in patients who have cancer of the lower rectum.

This type of surgery uses laparoscopic principles as well as transanal minimally invasive surgery (TAMIS) to achieve better surgical outcomes compared with traditional surgery. 

What are the benefits of transanal total mesorectal excision?

There are several significant benefits to having taTME surgery compared to conventional procedures. 

First, it enables Dr. Zaghiyan to view the cancerous growth more clearly and remove it with greater precision, without having to make any large incisions in your body. This means you benefit from all the advantages of laparoscopic techniques, including:

• Less surgical pain
• Minimal tissue damage
• Reduced use of medications
• Less time spent in hospital
• Shorter recovery time
• Faster return of bowel function
• Reduced scarring

Using taTME techniques also means there’s less chance of leaving any part of the tumor behind. That’s because the most technically important part of the surgery, the part focusing on the cancer, is done through the anus, allowing for more precise cutting where it matters most.

The other chief benefit of transanal total mesorectal excision surgery is that Dr. Zaghiyan doesn’t have to remove the anus, which means you won’t need to have a permanent colostomy bag to collect fecal waste.

Am I a good candidate for transanal total mesorectal excision?

If you have a low rectal tumor, then taTME could be a better option than other forms of surgery. Some patients facing lower rectal surgery are at greater risk of having to live with a colostomy bag after surgery, particularly men, patients who have a narrow pelvis and patients who are obese.

If you’re facing the prospect of having to live with a permanent colostomy bag after lower rectal surgery, Dr. Zaghiyan can review your case and see whether you are suitable for taTME, which avoids the need for colostomy.

What happens during the taTME procedure?

Transanal total mesorectal excision takes place under general anesthetic, so you’ll be asleep during the procedure. Dr. Zaghiyan removes the tumor, affected rectum, and lymph nodes through your anus, leaving the anus undamaged and the anal sphincter mechanism intact. 

Dr. Zaghiyan then reconnects the colon to the anus with sutures or staples. Most patients need a temporary ileostomy, which is a hole on your abdomen through which a tube carries waste into a bag. This is done to allow the rectal reconnection to heal. 

Dr. Zaghiyan can close the ileostomy hole at a later date when your body heals from the surgery and you complete any chemotherapy you require.

A TaTME means you will only have a few small incisions, making your surgical recovery much easier and less painful. By saving the anal sphincter muscles, TaTME surgery also allows you to maintain normal bowel movements without a permanent bag. 

After your taTME surgery, you need to remain in the hospital for an average of three days. You can eat solid food the day after your surgery, and you should be able to start walking around.

When you’re ready to go home, apart from avoiding extreme pressure on the area such as lifting heavy weights. You can resume all normal activities. A special ostomy nurse will also help teach and guide your care of the ileostomy, until the surgical site is healed and it is time to have your reconnection.

To find out more about transanal total mesorectal excision surgery and see if you’re a good candidate for the procedure, call Karen Zaghiyan, MD today, or book an appointment using the online tool.