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  • 1854
  • 2019-11-25

Laparoscopic TME - The 6-step procedure

Epublication WebSurg.com, Nov 2019;19(11). URL:
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In this key lecture, Dr. Rullier describes a clear 6-step approach to perform a laparoscopic total mesorectal excision (TME). The first step is posterior dissection of the TME plane in the presacral space. Hereafter, a right lateral dissection is performed with sparing of the hypogastric nerves followed by anterior dissection and identification of the seminal vesicles and pelvic plexus. A left lateral dissection is then performed whereafter the planes are connected. In this procedure, the 6 essential landmarks are the following: ''the presacral space, hypogastric nerves, seminal vesicles, pelvic plexus, levator ani muscles, and Denonvilliers' fascia and the prostate.’