Short term outcomes of taTME are comparable to those of laTME.27, 28, 29, 30, 31, 32, 33, 34Notably, a recent randomized trial demonstrated a significant lower conversion rate in taTME, with 20% conversion in the laTME group versus 2% in the taTME group.35 TaTME is also associated with an increased rate of sphincter preservation. Hol & colleagues found that centers utilizing taTME had an 84.3 % sphincter-preservation rate compared to 66.7% in other centers.36 The procedural safety of taTME was