Total mesorectal excision (TME) is an operation for rectal cancer in which the affected part of the rectum is removed with the surrounding fatty tissue and lymph nodes, inside their natural envelope. The aim is to remove the tumour as completely and safely as possible. The treating team decides the plan for each patient, and a cure cannot be promised.
It is performed under general anaesthesia, either laparoscopically through small incisions, or with robotic assistance controlled by the surgeon, which may offer better vision in the narrow pelvis. Afterwards the bowel is reconnected when possible, and a temporary or permanent stoma may be needed, depending on the tumour's location.
Surgery usually takes three to six hours, followed by a few days in hospital and several weeks of gradual recovery. Chemotherapy or radiotherapy may follow, depending on the pathology report. Functional results become clearer over several months with regular follow-up.
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It aims to remove rectal cancer together with the surrounding tissue and lymph nodes in a systematic way, in order to control the disease locally. A cure cannot be promised, and the treating team determines the plan.
It is usually suitable for a patient diagnosed with rectal cancer after endoscopy, biopsy and MRI or CT imaging. An oncology and surgery team, meeting with the relevant specialties, decides whether it is appropriate and whether chemotherapy or radiotherapy should come first.
Blood tests, imaging, and heart and anaesthesia assessments are carried out, bowel preparation and dietary changes may be advised, and the possibility of a stoma is discussed beforehand. Never stop any medicine, including blood thinners, on your own; that decision belongs to your doctor.
Both are done through small incisions and aim for the same resection. In the robotic approach the surgeon controls mechanical arms with a magnified three-dimensional view. Either may be converted to open surgery if safety requires it.
Under general anaesthesia, the surgeon carefully separates the rectum and its mesorectum from the surrounding tissues, preserving the nerves as far as possible, and then removes the affected part. The bowel is then reconnected when possible; otherwise a stoma is created.
The hospital stay usually lasts a few days, during which the patient gradually returns to eating and moving. Full recovery often takes several weeks and may include additional treatment and regular check-ups.
The pathology report after surgery shows how completely the tumour was removed and whether further treatment is needed. Follow-up continues for years with examinations, imaging and endoscopy to detect any recurrence early.
They include bleeding, infection, leakage from the bowel join, disturbances of bowel, urinary and sexual function, bowel obstruction and leg blood clots. Some of these problems may require an additional procedure.
A temporary stoma may be created to protect the join while it heals, and a permanent one is needed less often, depending on how close the tumour is to the anus and on the patient's condition. The surgeon discusses this possibility with you before surgery.
Staying at least two weeks after surgery is often needed, and longer depending on recovery and the pathology report. The treating doctor confirms the appropriate time to travel.
