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CC BY 4.0 · Journal of Coloproctology 2025; 45(03): s00451810621
DOI: 10.1055/s-0045-1810621
Technical Note

Modified Two-Team Approach to Laparoscopically Assisted Transanal Total Mesorectal Excision (TaTME) Suitable to Lower Resource Hospitals

Authors

  • Victor Bochkarev 

    1   Department of Surgery, Hilo Benioff Medical Center, Hilo, Hawaii, United States

Funding The author(s) received no financial support for the research.
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Abstract

Objectives

Transanal total mesorectal excision (TaTME) in the management of patients with low rectal cancer have been increasingly adopted. Laparoscopically assisted two-team TaTME has been utilized by the majority to reduce operative time. As the procedure requires several operators working simultaneously, it remains mainly in the scope of practice of large colo-rectal centers. We propose a modified two-team approach with a reduced number of surgeons and assistants to be suitable for lower resource facilities, such as community hospitals.

Methods

A modified two team approach to laparoscopically assisted TaTME was utilized in eight patients with stage II and III rectal cancer treated by multidisciplinary team at our community hospital from 2023 to 2025.

Results

TaTME were successfully completed in all eight patients. The mean operative (OR) time was 325.5 minutes. The median length of hospital stay (LOS) was 2 days. R0 resection with intact mesorectal envelop and adequate resection margin distance was achieved in all patients. Three patients had complete pathological response. One patient had presacral absence managed endoscopically. All patients underwent ileostomy reversal and reported good functional outcomes.

Conclusion

Modified two team approaches to laparoscopically assisted TaTME could be safe and feasible for utilization in lower resource facilities. The early results of this short series are encouraging, yet longer case series will be needed to confirm wider applicability of this method.

Keywords

rectal cancer - TaTME - community hospital

Data Availability Statement

The data that support the findings of this study are available from the authors upon reasonable request.


ORCID ID

Victor Bochkarev – https://orcid.org/0009-0000-7359-942X




Publication History

Received: 07 April 2025

Accepted: 16 July 2025

Article published online:
09 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Victor Bochkarev. Modified Two-Team Approach to Laparoscopically Assisted Transanal Total Mesorectal Excision (TaTME) Suitable to Lower Resource Hospitals. Journal of Coloproctology 2025; 45: s00451810621.
DOI: 10.1055/s-0045-1810621