{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:24:48Z","timestamp":1780568688917,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:00:00Z","timestamp":1493856000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Transanal total mesorectal excision (ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content>) has become one of the most promising technical advancements in the surgical treatment of rectal cancer, with rising numbers of surgeons seeking training. We describe our experience with human cadaveric courses for ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> delivered in two countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Four fresh human cadaveric workshops conducted in Oxford, <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>, in 2015 and two in Chicago, <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>, in 2013\u22122014, trained a total of 52 surgeons. Parameters of operative performance for each delegate were recorded. Previous surgical experience and uptake of ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> in the surgeons\u2019 clinical setting were surveyed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> cases were performed on cadaveric models. Participating surgeons had previous experience in laparoscopic <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> surgery and transanal approaches but limited ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> exposure. The purse\u2010string remained occluded throughout in 93% of <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> and 60% of <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> cases. Operative timings for key procedural steps were similar between the two countries with a mean time from start of circumferential dissection to peritoneal entry of 79.5\u00a0min (range 25\u2013155). 96% of surgeons dissected transanally to a level S2 or above. The <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> specimen quality was complete or near complete in 81%, with improvements noted between the first and second procedure performed. 81% of surgeons surveyed are currently performing ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> in their local hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fresh\u2010frozen cadavers provide excellent teaching models for complex pelvic surgery. A structured training curriculum including reading material, dry\u2010lab purse\u2010string practice and postcourse mentorship will provide surgeons with a more complete training package and ongoing support, to ultimately ensure the safe introduction of ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> in the clinical setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13525","type":"journal-article","created":{"date-parts":[[2016,9,20]],"date-time":"2016-09-20T00:16:54Z","timestamp":1474330614000},"page":"476-484","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Developing and assessing a cadaveric training model for transanal total mesorectal excision: initial experience in the <scp>UK<\/scp> and <scp>USA<\/scp>"],"prefix":"10.1111","volume":"19","author":[{"given":"M.","family":"Penna","sequence":"first","affiliation":[{"name":"Oxford University Hospital NHS Foundation Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Whiteford","sequence":"additional","affiliation":[{"name":"The Oregon Clinic Providence Cancer Center Oregon Health and Science University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hompes","sequence":"additional","affiliation":[{"name":"Oxford University Hospital NHS Foundation Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sylla","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Mount Sinai Hospital New York NY 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