From TATA to single port robotic (SPr) taTME: approaches to distal rectal cancer

The surgical management of rectal cancers located in the distal rectum presents a unique challenge for surgeons as it is anatomically unfavorable and technically difficult to access. Over the course of the 20th century, novel techniques contributed to the improvement of rectal cancer management and led to improved quality of life for patients following surgical resection. In this article, we explore the background of rectal surgery techniques, which have progressed from abdominal perineal resection to transanal abdominal transanal proctosigmoidectomy, transanal total mesorectal excision (taTME), and ultimately minimally invasive transanal sphincter preserving techniques utilizing single port robotic technology (SPr taTME). In the first clinical experience with the DaVinci SP robot in the United States, we are finding many advantages of this new platform in transanal surgery. The SP offers superior image quality with 3D view, wristed instruments facilitating ergonomics, and superior surgical precision