Rutgers Cancer Institute of New Jersey
195 Little Albany Street
New Brunswick, NJ 08903-2681
An open total mesorectal excision, or TME, is a surgical procedure to remove your rectum and some of the tissue around it.
Your rectum is the last part of your large intestine before the anal canal.
The rectum stores solid waste, called feces, until you pass it out of your body.
The mesorectum is the tissue around your rectum that contains lymph nodes.
A total mesorectal excision is performed to treat cancer in your rectum, as well as cancer that may have spread to the lymph nodes around your rectum.
An open total mesorectal excision will begin with an incision in your abdomen.
Inside your abdomen, your surgeon will separate the large intestine above your rectum from the tissue covering it.
Then, your rectum and mesorectum will be separated from the tissue in your pelvis.
Your large intestine will be divided above your rectum and closed with staples or sutures.
Your rectum will be divided above your anal canal, and removed.
Next, your surgeon will create a pouch at the end of your colon. The pouch will function like a rectum because it will store feces.
This pouch will be attached to your anal canal.
At the end of the procedure, the incision in your abdomen will be closed with staples or stitches.
At this point, your surgeon will sometimes create a different way for feces to leave your body while the new attachment heals.
To do this, your surgeon will make a separate incision in your abdomen and pull a loop of your small intestine through it.
The loop will be opened and attached to the incision. The opening is called a stoma.
A bag will be attached to the stoma to allow feces to drain into it.
Later, when your large intestine has healed, you will have another procedure to close the stoma.
This will allow feces to pass out of your body the usual way.
If you have questions about rectal removal surgery, talk to your healthcare provider.