Transanal Total Mesorectal Excision (Ta-TME)
Transanal total mesorectal excision (Ta-TME) is a modern, minimally invasive technique for the surgical management of rectal cancer, particularly in cases where pelvic anatomy makes access challenging with conventional approaches.
At Mediterraneo Hospital, Ta-TME is performed exclusively by Dr Nikos Georgopoulos, providing highly specialised and individualised care for each patient.
The method combines a transanal (bottom-up) and an abdominal (top-down) approach, ensuring precise and complete excision of the mesorectum with oncologically safe margins.
Indications and Purpose
Ta-TME is applied in patients with:
• Cancer of the mid or low rectum, where pelvic anatomy complicates standard laparoscopic or open access.
• A narrow or deep pelvis, which limits visibility and instrument manoeuvrability.
• Cases where sphincter preservation is desired without compromising oncological safety.
The technique is implemented within the context of a multidisciplinary team (MDT), involving the surgeon, oncologist, radiotherapist, and radiologist, in order to determine the most appropriate strategy for each individual patient.
The Surgical Procedure
Ta-TME is performed under general anaesthesia and may be completed laparoscopically or with robotic assistance.
The operation begins transanally, using a specialised platform available at Mediterraneo Hospital, allowing accurate dissection of the mesorectum from the lower to the upper portion under direct visual guidance.
Concurrently, the abdominal phase is completed to achieve intrapelvic anastomosis with sphincter preservation where feasible.
During the procedure, particular attention is given to:
• Maintaining the integrity of mesorectal structures, which is essential for oncological adequacy.
• Protecting the autonomic pelvic nerves, thereby reducing the risk of urinary or sexual dysfunction.
Recovery and Postoperative Follow-up
Hospital stay typically lasts 3–5 days. Diet is reintroduced gradually, from liquids to solids, and mobilisation begins within the first 24 hours.
Patients are monitored for potential complications such as anastomotic leakage, transient incontinence, or stricture, all of which are managed promptly.
Routine follow-up includes clinical and endoscopic evaluation, imaging surveillance (MRI/CT), and nutritional support.
Advantages of Ta-TME at Mediterraneo Hospital
• Exclusive performance by Dr Nikos Georgopoulos, with extensive experience in the technique.
• Specialised transanal endoscopic equipment available only at Mediterraneo.
• Improved visibility and precise excision in the narrow pelvic space.
• Potential for sphincter preservation in selected cases.
• Reduced morbidity and faster recovery compared with open procedures.
• Clear oncological safety when performed by surgeons with advanced training in the method.
Conclusion
Ta-TME at Mediterraneo Hospital represents an advanced treatment option in Greece, combining precision, minimal tissue trauma, and preservation of patient function, supported by the expertise of Dr Nikos Georgopoulos and the hospital’s multidisciplinary team.
