Twelve advanced minimally invasive colorectal surgeons, experts who treat rectal cancer, convened to participate in the first Transanal Total Mesorectal Excision (taTME) training course in the United States this past weekend to learn how to safely incorporate this novel technical approach into their practice. This innovative technique is likely to further advance the current practice for the surgical management of rectal cancer by facilitating improved surgeon visibility, further reducing operative times, and improving patient cosmesis.
Transanal Minimally Invasive Surgery (TAMIS) was first developed in 2009 at the Center for Colon and Rectal Surgery at Florida Hospital in Winter Park, Florida by Sam Atallah, MD, FACS, FASCRS, Matthew Albert, MD, FACS, FASCRS, and Sergio Larach, MD, FACS, FASCRS. This innovative approach, combined with other variations of surgical treatment for rectal cancer, led to the introduction of taTME. The taTME technique was thoroughly researched and performed by surgical thought leaders, Antonio Lacy, MD, PhD of University of Barcelona and Patricia Sylla, MD, FACS, FASCRS of Massachusetts General Hospital, Harvard Medical School. A total mesorectal excision (TME) involves the removal of the rectum together with the surrounding envelope of lymph nodes.
In an editorial by R. J. Heald, OBE, MChir, FRCS, in Hampshire, United Kingdom published in 2013, Heald notes that this new combined approach will “revolutionize the practice of rectal cancer surgery.” According to the Center for Colon and Rectal Surgery at Florida Hospital, around the world there are currently “very few centers with expertise in the taTME approach, which has particular advantage over more conventional approaches to proctectomy, especially in morbidly obese patients where access to the pelvis is difficult (www.floridahospital.com).”
Recognizing the need for greater training and awareness in the US, this inaugural TAMIS taTME course was initiated under the leadership of colorectal surgeon and course director, Elisabeth McLemore, MD, FACS, FASCRS. Mclemore, recently recruited to serve as Chief, Colorectal Surgery and Director, Minimally Invasive Surgery Center at Kaiser Los Angeles Medical Center, the teaching and tertiary referral center for the Southern California Kaiser Permanente Medical Group, wanted to initiate TAMIS taTME training in the US. “I am honored to be working with such a fine group of faculty and skilled colleagues. While a transanal approach to total mesorectal excision is not a completely new concept, I believe taTME, which blends traditional techniques with innovative technologies, is the future of surgical treatment and care of patients with rectal cancer. I am inspired by the surgical philosophy of Sidney R. Garfield, MD, co-founder of Kaiser Permanente, "Keep your arms on each other's shoulders and keep your eyes on the stars for innovation and change for the future."
The course, which took place on Saturday at the University of California San Diego’s Center for the Future of Surgery, a state of the art training facility designed and conceived of by Santiago Horgan, MD, was also led by renowned faculty including Sam Atallah, MD, FACS, FASCRS of Florida Hospital, Alessio Pigazzi, MD, PhD, FACS, FASCRS of University of California Irvine, and Patricia Sylla, MD, FACS, FASCRS of Massachusetts General Hospital, Harvard Medical School.
The course was made possible with the support of industry contributors and innovative technologies from companies including, but not limited to Applied Medical (Rancho Santa Margarita, CA), Novadaq (Bonita Springs, FL), NovaTract Surgical, Inc. (Madison, CT), and Stryker(Kalamazoo, MI).