Hospital Clínic de Barcelona has performed more than 500 surgeries to date using the TaTME technique, or transanal total masorectal excision, considered one of the best treatment options for rectal cancer, being the most advanced technique currently available. These surgeries have been led by Dr. Antonio de Lacy, head of the Gastrointestinal Surgery Service at Hospital Clínic and member of Top Doctors, accompanied by his team.
What does the TaTME technique consist of and what advantages does it offer the patient?
The TaTME technique is a novel and complex technique, in addition to being minimally invasive. It is a procedure that is applied in a hybrid manner, combining laparoscopic resection through the abdomen with transanal resection, thus increasing the precision of the surgery. It is a technique first used in 2009 by Dr. de Lacy.
TaTME has many advantages. The fact that it is a minimally invasive technique means that it reduces surgical time, hospital stay and complications that may arise after the operation, such as dehiscence or infection, by 50%. In addition, another important advantage is that the patient does not need to carry a bag for excrement and, if it is necessary to place it, in more than 99% of cases it can be removed after 3 or 6 months.
In which pathologies can the TaTME technique be used?
The TaTME technique can be used for both benign and malignant diseases. In the case of rectal cancer, the factors that may make this technique preferable are:
- Distance of the tumor less than 12cm from the anal margin.
- Narrow and/or deep pelvis.
- BMI (Body Mass Index) over 30.
- Visceral obesity.
- Tumor diameter greater than 4cm.
- Prostatic hypertrophy.
- Distortion of the planes due to neoadjuvant radiotherapy.
- Very low tumor location, requiring a very precise distal resection margin.
However, the current trend is to use this technique in all cases of rectal pathology. Thus, the most common diseases in which the use of TaTME is indicated are: rectal cancer, rectal stenosis, inflammatory bowel disease, complex fistulas, familial adenomatous polyposis, fecal incontinence, radiation proctitis, the need to remove the rectal stump after Hartmann’s, Hartmann’s reconstruction, complications after surgery and recurrences.
TaTME technique applied to colon and rectal cancer
Colon and rectal cancer is a tumor that appears in the large intestine. It is the third most common in men, after prostate cancer and lung cancer, and the second most frequent in women, after breast cancer. However, it is currently a tumor that can be prevented and cured, since, for many years, this tumor is a polyp that, if detected and removed immediately, will prevent it from progressing to cancer. The TaTME technique allows the removal of rectal cancer in an oncologically safe manner, which translates into a better chance of survival for the patient. As mentioned above, the fact that it is a minimally invasive technique reduces surgical trauma and, therefore, complications and infections, as well as hospitalization time.
Dr. Antonio de Lacy, head of the Gastrointestinal Surgery Service at Hospital Clínic, maintains that “with this technique, not only do we remove the malignant tumor, but we also reduce the possibilities of metastasis and minimize complications for patients after treatment. In addition, we are conducting a study to demonstrate better oncologic outcomes with the use of this technique.”