Prevention and treatment of peripheral organ injury during transanal total mesorectal excision        YAO Hong-wei, WEI Peng-yu, LI Yang, et al. Department of General Surgery,Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases,  Clinical Practice and Research Center for Colorectal Neoplasm, Capital Medical University, Beijing 100050, China
Corresponding author: ZHANG Zhong-tao, E-mail：zhangzht@
ccmu.edu.cn
Abstract    Compared to conventional laparoscopic total mesorectal excision (TME) surgery, transanal total mesorectal excision(taTME) can provide a better surgical field of the pelvic floor and more open operating space, especially for patients with a "difficult pelvis" such as male, obesity, prostate hypertrophy, and pelvic stenosis , which allows for more accurate pelvic floor operation. However, as a new surgical method, taTME has a uniquely bottom-up perspective which requires the surgeon to re-understand the anatomy of the pelvic. In addition, the adjacent relationship of the operating plane is so complex that it is easy to cause damage to the surrounding organs due to misoperation. The urethra and neurovascular bundle (NVB) are organs and tissues that are easy to be injured during taTME. Other injuries of organ such as ureter, bladder, prostate, and vagina, are generally reported as early individual cases. Once the peripheral organ injury occurs during the operation, different measures should be taken according to the degree of injury and the recommendations of specialists to reduce the adverse effects as much as possible. It is suggested that colorectal surgeons who plan to perform taTME surgery should receive structured training to shorten the learning curve of taTME surgery and reduce the incidence of intraoperative and postoperative complications.