Laparoscopic TATA (transanal abdominal transanal) low anterior resection for rectal cancer

Splenic flexure mobilization is technically challenging. However, it is necessary to achieve a tension-free anastomosis for any low rectal cancer resections or for a shortened sigmoid colon. In this live interactive surgical video, Dr. Armando Melani (Brazil) demonstrates a medial-to-lateral approach to splenic flexure mobilization for laparoscopic low anterior resection. He defines the main points of his procedure in a stepwise approach and provides technical tips to facilitate exposure and prevent any potential risks of splenic or vascular injuries.

Total mesorectal excision (TME) offers the lowest reported rates of local recurrence and the best survival results in patients with rectal cancer. This video shows a laparoscopic TME 10 weeks after radiochemotherapy for T3N+ rectal cancer.

In this live interactive video recorded during an IRCAD colorectal course, Dr. Armando Melani briefly demonstrates the key steps and technical aspects of abdominoperineal stoma surgery in a 65-year-old female patient with rectal adenocarcinoma attached to the lower third of the vagina. Dr. Melani highlights the main principles of vascular dissection, mobilization, dissection and transection of colon for colostomy, and perineal dissection.

Randomized clinical trials such as COLOR II, COREAN and CLASICC, have shown better results for laparoscopic total mesorectal excision (TME), in terms of short-term and long-term outcomes, when compared with open TME.
Laparoscopic TME presents some limitations such as low rectal cancer which has a high risk of leaving a positive circumferential resection margin (CRM) and a narrow pelvis. Conversion to open procedures remains unsatisfactory.
Transanal TME (taTME) has been proposed to give a new option in cases where laparoscopic TME is difficult.
In this video, we present the case of a transanal approach with the TEO™ platform for low rectal cancer.

This video of a live surgery performed by Professor Chen (Associate Professor, China Medical University Taichung, Taiwan) during an IRCAD Taiwan course very clearly demonstrates the stepwise execution of a laparoscopic total mesorectal excision (TME) with all its tips and tricks.
This is the case of a 65-year-old woman, with a low rectal tumor (4cm) is operated on after a short chemoradiation course (2 weeks before) for a stage IIA cancer (cT3N0M0).
Professor Chen’s surgical skills and experience and the beauty of the procedure, associated with a dynamic Q&A and expert comments coming from the auditorium, make of this video a must see.