The concept of transanal Total Mesorectal Excision (TATME) or “bottom-up” TME has been gaining momentum, both in the UK and worldwide. TATME is proposed in highly selected cases as an alternative to laparoscopic, robotic or open dissection of the rectum via the abdominal approach. The technique allows dissection of the most difficult part of the TME plane deep down in the pelvis (particularly in male patients or patients with visceral obesity) using a flexible or rigid transanal platform. The perceived benefits of this technique may include ease of procedure due to better views, decreased operative time, better quality anastomosis and reduction in conversion rates. This appears to be a feasible and safe procedure on preliminary analysis of the current data however larger series are awaited.
In order to continue with the development of this technique an online secure registry has been created. This will be hosted on the LOREC website in a similar way to the perineal wound healing registry and surgeons can register free of charge. Participating centres will be able to download their own data as required.