Abstract

Management of rectal cancer has evolved over the last three decades, with a multidisciplinary strategy being the cornerstone of care. Magnetic resonance imaging (MRI), selective use of preoperative chemoradiation and detailed operative planning have facilitated appropriate radical resections. With the evolution of technology, minimally invasive options are readily available, making laparoscopic, robotic and transanal approaches valid alternatives to open total mesorectal excision (TME). The current debate is centered on which approach or combination would yield the best results to patients requiring radical resection for rectal cancer. Due to their potential benefits, a natural evolution of robotics and transanal minimally invasive surgery (TAMIS) techniques has been their combination. To date, there is scarce published data regarding the combined use of robotics and TAMIS: hybrid transabdominal robotic and transanal TME (R+taTME) or robotic-assisted transanal surgery-TME (RATS-TME). The objective of this article is to analyze the available literature, define the potential role for combined robotics and transanal TME (taTME) approaches and delineate future perspectives on this topic.