Transanal total mesorectal resection (taTME) has come a long way since it was first used in the clinic in 2010.The learning curve of this procedure is long due to different surgical approaches, different perspectives and different anatomical positions. Many surgeons experience complications during this procedure. Although the advantages and problems of this procedure have been reported in much literature, the anatomy and operation methods of taTME introduced in literatures and training centers are too complicated, which makes many surgeons encounter difficulties in carrying out taTME surgery. According to the author's experience in learning and carrying out this operation, spatial expansion process of ultralow rectal cancer was divided into three stages. At each stage, according to different pulling forces, three different schemes of triangular stability mechanics model were adopted for separation. From point to line, from line to plane, the model can protect the safety of peripheral blood vessels and nerves while ensuring total mesorectal excision . This model simplifies the complex surgical process and is convenient for beginners to master taTME surgical separation skills.
经肛全直肠系膜切除术（taTME）自2010年首次应用于临床以来，已经得到了很大发展。由于手术入路不同，视角差异及解剖位置不同，使得该术式学习曲线较长，很多术者开展此术式过程中出现了并发症。虽然已有不少文献报道了该术式的优势及存在的问题，但是文献及培训中心介绍的taTME解剖及操作方法过于复杂，使得很多术者在开展taTME手术时遇阻。笔者依据学习和开展此手术的经验，将超低位直肠癌行taTME时的间隙拓展过程分为3个阶段，每个阶段根据牵拉力不同，采取三角稳定力学模型的3种不同方案进行分离，由点到线，由线到面，在保障系膜完整切除的前提下，保护周围血管和神经的安全。该模型将复杂手术过程简单化，便于初学者掌握taTME手术层面分离技巧。.