Total Mesorectal Excision (TME)
Gold standard oncological operation for mid and lower rectal cancer — complete mesorectal envelope excision, local recurrence under 5%.
What is Total Mesorectal Excision (TME)?
Total mesorectal excision is the gold-standard oncological operation for carcinoma of the mid and lower rectum. The rectum is excised together with its complete surrounding mesorectal envelope as an intact specimen, minimising the risk of local recurrence. TME may be performed laparoscopically, robotically, or open.
Dr. Tagore Mohan Grandhi performs TME using a minimally invasive laparoscopic approach wherever oncologically appropriate. Careful sharp dissection in the embryological tissue planes preserves the autonomic pelvic nerves, protecting bladder and sexual function while achieving complete oncological clearance.
Indicated for carcinoma of the mid and lower rectum — typically tumours within 12 cm of the anal verge — in patients fit for major colorectal resection.
How the Procedure Works
Patient Positioning
Patient placed in modified lithotomy under general anaesthesia. Laparoscopic ports inserted. Steep Trendelenburg with left lateral tilt facilitates pelvic dissection.
Vascular Ligation
Inferior mesenteric artery and vein ligated at their origin, achieving high lymphovascular clearance and adequate bowel length for anastomosis.
Mesorectal Dissection
Sharp dissection proceeds in the holy plane between the mesorectal fascia propria and the parietal pelvic fascia. Autonomic hypogastric nerves carefully identified and preserved.
Distal Transection and Specimen Removal
Rectum divided with adequate distal clearance. Intact mesorectal specimen extracted via a small Pfannenstiel or specimen extraction incision.
Anastomosis or Stoma
Stapled colorectal or coloanal anastomosis fashioned with a temporary loop ileostomy where sphincter preservation is possible. APR with permanent colostomy performed where sphincter preservation is not appropriate.
Outcomes
Who Needs This Treatment?
- →Gold standard technique — local recurrence rates below 5–8% in experienced centres
- →Intact mesorectal excision ensures complete lymph node clearance
- →Nerve-preserving sharp dissection protects bladder and sexual function
- →Laparoscopic approach achieves equivalent oncological outcomes with faster recovery
Total mesorectal excision is the cornerstone of rectal cancer surgery. Meticulous dissection in the correct embryological planes achieves the oncological clearance patients need while preserving the quality of life they deserve.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Total Mesorectal Excision (TME) Cost for Rectal Cancer in Hyderabad
The cost of Total Mesorectal Excision (TME) for Rectal Cancer in Hyderabad depends on factors such as tumour stage, surgical requirements, pre-operative evaluation, hospital care, and additional treatment needs.
For patients undergoing standard oncological rectal cancer surgery, the approximate cost of Total Mesorectal Excision ranges between ₹2,50,000 and ₹5,00,000.
| Procedure | Approximate Cost Range |
|---|---|
| Total Mesorectal Excision (TME) | ₹2,50,000 – ₹5,00,000 |
The final cost may vary depending on your individual diagnosis, surgical complexity, hospital stay, and post-operative treatment plan.
Factors That Influence TME Cost
The overall cost may depend on:
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Cancer stage and tumour characteristics: The extent of rectal cancer and surrounding tissue involvement can influence treatment planning.
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Pre-operative staging: Imaging, biopsy findings, blood tests, and multidisciplinary treatment evaluation may contribute to the overall cost.
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Surgical requirements: The complexity of rectal surgery, lymph node management, anaesthesia, hospital admission, and recovery care may affect the estimate.
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Follow-up cancer management: Some patients may require chemotherapy, radiation therapy, and regular monitoring after surgery.
Is TME Covered by Insurance?
Total Mesorectal Excision performed for rectal cancer treatment may be covered by health insurance. Coverage depends on policy benefits, insurer approval, and documentation requirements.
Our insurance support team can assist with coverage checks, required documents, and cashless approval procedures.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Tagore Grandhi
Orthopaedic & Joint Replacement Surgeon
During consultation, Dr. Tagore Mohan Grandhi, Bariatric & GI Surgeon at Lux Hospitals, will evaluate your cancer diagnosis, investigation reports, and treatment requirements to recommend the appropriate surgical plan. He will explain the procedure, recovery expectations, and provide an estimated cost based on your individual treatment needs.
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