Rectal cancer affects 53,000 new cases each year. TaTME is an innovative laparoscopic technique that has many advantages compared to traditional surgery: Prof. Marco Caricato, an expert in General Surgery in Rome, explains how it is done and what its advantages are.
Incidence and treatment of rectal cancer
Colorectal cancer is one of the most widespread in Italy, in 2017 it was ranked second among women (13%) and among men (16%) by incidence and mortality: more than 53,000 new cases are diagnosed each year. This pathology is more treated with surgery, often accompanied by cycles of radiotherapy and in some cases by multiple cycles of chemotherapy.
A type of treatment that in many cases is taken into consideration because it is less demanding, is the intervention in laparoscopy: the Campus Bio-Medico in Rome specializes in this type of treatment, far exceeding the national average (49% of colon cancer and 77% of the rectum against 32.2% and 40.4% of the Italian average). In this center, in fact, the laparoscopic technique is combined with the protocol called ERAS (Ender Recovery After Surgery, or rapid post-operative recovery) and with the research, in order to offer patients a valid and always cutting-edge therapy. For all these reasons, in the field of laparoscopic surgery of rectal tumors, the Campus Bio-Medico was one of the first in Italy to apply the TaTME technique, which allows to optimize the surgical radicality and to easily identify the seat of the neoplasia.
What are the latest surgical techniques?
In recent years the techniques for the treatment of rectal cancer have improved and have given very positive oncological and functional results. Minimally invasive laparoscopic surgery has proved to be safe, effective and able to improve short-term results also in terms of visual, aesthetic and functional quality. The first step to reach the TaTME was the TME (Total Mesorectal Excision) technique, that is the total excision of the mesoretto (the fold of the peritoneum that connects the rectum to the back wall of the abdomen). With this technique it was precisely identified the tissue to be removed to eliminate the tumor and the lymph nodes potentially affected: TME has thus substantially improved the prognosis of the rectum tumor, laying the foundations for the development of TaTME.
What is TaTME?
TaTME (TransAnal Total Mesorectal Excision or Total Transaxial Mesorect Excision) is an evolution of TME, recently emerged and characterized by an innovative surgical access, attracting great interest in the world of colon-rectal surgery worldwide. During the traditional surgery, to get to the area affected by the tumor, it was accessed from the abdomen and then descend to the pelvis: with the TaTME it is accessed instead by transanal, allowing a better view of the final part of the rectum. It is a technique that requires a great experience in laparoscopic and transanal surgery, as well as a long and demanding learning period: despite this, TaTME offers numerous advantages to patients, among which:
• Low incidence of complications
• Low number of sphincter demolition interventions
• Improved compliance with anatomical planes
• Increased radicality of the intervention
Given the great interest aroused by this technique in the medical field, this year on 3 and 4 May the first Italian Congress on TaTME took place at the Rome Bio-Medical Campus, chaired by Prof. Caricato. The Italian and international Faculty, of the highest level, was composed by the most competent experts of the method, a surgical intervention by an international team was performed in direct video from the operating rooms of the Campus.