Trans-anal total mesorectal excision : reflections on the introduction of a new procedure

Introduction: The introduction of novel surgical techniques in the hope of improving overall patient care is currently under increasing scrutiny, for whilst such techniques may appear to lead towards greater efficacy they may also introduce a range of complications not normally associated with standard care. In Australia, there are clear guidelines to ensure that new operations or technologies are introduced safely into surgical practice. These are embodied in the Royal Australasian College of Surgeons ASERNIP-S programme and follow the UK IDEAL Collaboration recommendations. The guidelines are applicable to the procedure of transanal total mesorectal excision (TaTME) which was introduced in 2010 as a means of facilitating laparoscopic dissection of low rectal cancers.