There is not much good evidence about how well this procedure works or how safe it is. It should only be used if extra care is taken to explain the risks and extra steps are put in place to record and review what happens.
Transanal total mesorectal excision of the rectum should only be done by surgeons with special expertise and training in the procedure.
More research on this procedure is needed and NICE may look at it again if more evidence is published.
NICE is asking health professionals to send information about everyone who has the procedure and what happens to them afterwards to a database at the transanal total mesorectal excision registry so that the safety of the procedure and how well it works can be checked over time.
Your health professional should fully explain what is involved in having this procedure and discuss the possible benefits and risks with you. In particular, they should explain the uncertainty about the evidence on how likely it is to improve your symptoms and possible complications. You should also be told how to find more information about the procedure. You should only be asked if you want to agree to this procedure after having this discussion. Your health professional should ask you if details of your procedure can be collected.