Transanal Total Mesorectal Excision (TaTME) is a novel access technique which has attracted substantial interest amongst colorectal surgeons throughout the world. Suggested benefits include better short- and long-term outcomes for selected patients with mid- and/or low rectal cancer.
The ACPGBI is keen that the introduction of this procedure should be carefully planned and that surgeons should be well trained and confident to optimize patient outcomes. An initial pilot training programme, funded by Applied Medical, ConMed, Lawmed, Stryker, Medtronic and supported by the Oxford Colorectal Cancer Trust (OCCTOPUS), commenced in September 2017.
Clinical Lead: Roel Hompes, Consultant Colorectal Surgeon, University Medical Centre, Amsterdam
Educational Lead: Nader Francis, Consultant Colorectal Surgeon at Yeovil and Honorary Professor, University of Bath Academic Advisor: George Hanna, Professor of Surgical Science, Imperial College London
Five NHS colorectal teams were initially selected to undertake this pilot training programme, which included:
- Completion of the in-depth modules of the iLapp surgery TATME teaching tool
- Attendance at a cadaveric workshop on 13th-14th October 2017
- Clinical mentorship through the initial cases
- Inclusion of assessment data and clinical outcomes in the TATME registry
- Final objective assessment of performance for each colorectal team
The following teams were selected based on previous experience and skill in laparoscopic rectal resection, evidence of appropriate case volume and senior management support at each NHS trust:
- Heartlands Hospital (Lead Surgeon: David McArthur)
- Dorset County Hospital (Lead Surgeon: Anjay Talwar)
- St Helens & Knowsley Teaching Hospitals (Lead Surgeon: Michael Chadwick)
- York Teaching Hospital (Lead Surgeon: Dib Bandyopadhyay)
- Derriford Hospital (Lead Surgeon: Mark Coleman)
The project has now delivered 24 out of the 25 mentored TATME cases and the clinical and educational outcomes are being analysed for publication in a peer-reviewed journal and presentation at the next ACPGBI conference. It is anticipated that all of the pilot sites will complete the training initiative within the next six months.
The steering group for this training initiative is currently awaiting confirmation of funding for an extension, to allow TATME training for an additional five colorectal teams in the UK.
If you wish to express interest in participating in the extension of this training initiative, please contact the Project Manager, Dr Fiona Carter.
Follow the initiative on twitter @TATMEtrainingUK
Steering Board: Roel Hompes, Nader Francis, Neil Mortensen, George Hanna, ACPGBI President, Nick West, TATME Tutors, Marta Penna, Lian Lee, Fiona Carter, Stephanie Wood, Jaap Doeve, John Black, Ivan Theobald, Matt Conduit
TATME Tutors: Roel Hompes, Tony Miles, Henk Wegstapel, Gregg Wynn, Steve Arnold, Danilo Miskovic, Ken Campbell, Mark Katory, Dorin Ziayie, Stephen Dalton, Deborah Nicol