The role of transanal total mesorectal excision in inflammatory bowel disease surgery

Abstract

The transanal approach to rectal mobilization has gained considerable popularity and utilization continues to expand, fueled by the transanal total mesorectal excision for rectal cancer. The same principles and benefits of transanal pelvic dissection may apply to transanal proctectomy for benign indications such as in the setting of inflammatory bowel disease (IBD). Applications include restorative and non-restorative procedures for Crohn's disease (CD) and ulcerative colitis (UC). A transanal approach for restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has particular advantages and its safety and feasibility has been demonstrated in small series. This paper examines the current literature exploring the use of transanal proctectomy using advanced transanal platforms for IBD.