Human Reliability Analysis of transanal Total Mesorectal Excision
Research type
Research Study
Full title
Human Reliability Analysis of transanal Total Mesorectal Excision and implementation of a training tool
IRAS ID
199881
Contact name
George Bushra Hanna
Contact email
Sponsor organisation
Imperial College London, St.Mary's Hospital
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Bowel cancer is the third most common cancer in the UK with >41,000 new diagnoses made annually. Surgical removal of the cancer is currently the only option offering potential cure. A third of cancers occur in the lower part of the large bowel called the rectum; the most difficult area of the bowel to operate on. Traditionally, this operation has been done through a large cut in the tummy wall. More recently, techniques such as keyhole surgery have been developed which allow faster recovery with smaller scars. Both methods can be difficult when operating low down in the pelvis, as the view the surgeon has can be limited. Previous studies showed that the poor view increased the risk of injuring surrounding structures including nerves that control bowel, urinary and sexual function, as well as obtaining an incomplete cancer specimen, which increases the risk of the cancer recurring. A more advanced approach has been adopted called a transanal approach or taTME (Transanal Total Mesorectal Excision). In this technique, surgical tools are introduced through the anus (back passage) and used to free the rectum with better views whilst protecting surrounding structures.
TaTME requires advanced surgical skills and training to perform the operation safely. A detailed analysis of the surgical technique by an approved systematic method called Human Reliability Analysis (HRA) is important in order to identify high-risk areas where errors have been committed and describe ways they can be avoided. 200 anonymised videos of the procedure from surgeons worldwide will be imported via a secure link and analysed using HRA principles over 2-year period. The findings will also allow development of a training tool to be used in taTME workshops and as educational resource. This will consequently help to obtain intact cancer specimens and improve patients’ outcomes and quality of life.REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
16/EE/0242
Date of REC Opinion
8 Jun 2016
REC opinion
Further Information Favourable Opinion