Improving surgery for rectal cancer
Lead researcher: Miss Marta Penna
Location: Imperial College London and Oxford University Hospital
Grant award: £31,500
Dates: October 2017 to March 2019
Surgery offers the best chance of cure for patients with rectal cancer. Our first Bowel Cancer UK/Royal College of Surgeons of England Research Fellow, Marta Penna, improved training for surgeons who use a pioneering new technique for rectal cancer known as transanal total mesorectal excision (TaTME).
The challenge
Rectal surgery can be very challenging, especially when the cancer is within the lower part of the rectum. Certain elements can make the surgery even more complex, such as obesity, previous abdominal surgery and having a small pelvis. The surgeon needs to operate down a deep narrow hole where the view is limited, making accurate surgery more difficult. TaTME was developed to help surgeons operate on these more complex rectal cancers and overcome these barriers. It means surgery can be performed from both the top (abdominally) and the bottom (transanally), allowing for more accurate surgery, fewer complications and better quality of life for patients.
The science behind the project
In order to reduce chance of error and complication, Miss Penna analysed videos and reports of TaTME procedures. Her research aimed to both identify common errors, as well as useful technical tips, and develop a training tool, with guidance for surgeons learning the technique in the future.
Results
Miss Penna reviewed 100 videos of TaTME operations to highlight techniques that work well, and review how and why errors happen.
Her results have been made into a technical manual with recommendations for successful operations and reducing errors. These tips have been incorporated into the national TaTME training programme to enhance the training of surgeons learning the procedure.
If you like, you can find out more about this work by reading this key research article, published by the researchers.
What difference will this project make?
Miss Penna’s work is key to improving surgical performance. Whilst this new surgical technique has already shown promising results, understanding the technique in more detail and finding ways of avoiding errors during surgery will further improve outcomes for patients. Increasing surgical accuracy means less chance of complications, which ultimately means patients are likely to live longer with less risk of the cancer returning, and have a better quality of life with good bowel, urinary and sexual function longer term.
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