Historical Perspectives and Rationale for Development -- TAMIS: Indications and Contraindications -- An Algorithm for Local Excision for Early Stage Rectal Cancer -- Complete Clinical Response in Rectal Cancer after Neoadjuvant Therapy-Organ-Preservation Strategies and the Role of Surgery -- Salvage Surgery after TAMIS Excision of Early Stage Rectal Cancer -- Organ Preservation and Palliative Options for Rectal Cancer -- Operative Equipment and Insufflator Options -- Operating Theater Setup and Perioperative Considerations -- Surgical Technique for Local Excision of Rectal Neoplasia -- Pyramidal Excision for Early Rectal Cancer and Special Closure Techniques -- Closure versus Non-Closure after Excision -- Operative and Peri-Operative Outcomes -- Functional Outcomes after Local Excision of Rectal Neoplasia -- Oncologic Outcomes for Local Excision of Rectal Neoplasia -- Applications Beyond Local Excision -- The Evolution of Robotic TAMIS -- Transanal Robotic Surgery and Future Directions -- TAMIS: Current Controversies and Challenges -- Indications for Malignant Neoplasia of the Rectum -- Indications for Benign Disease of the Rectum -- Operating Theatre Setup & Two-Team Coordination -- Single-Team taTME -- Transanal Access Platform Options & Instrument Innovations -- Intra-Operative Decision Making: Converting to taTME, When and for Whom? -- Key Aspects of the Abdominal Dissection -- Zen and the Art of the Pursestring -- An Overview of Operative Steps and Surgical Technique -- Strategies for Ultra Low-Lying Rectal Cancer -- Critical Anatomical Landmarks in Transanal Total Mesorectal Excision (taTME) -- Urethral Injury: The New Challenge for taTME -- How to Avoid Urethral Injury in Males -- A Roadmap to the Pelvic Autonomic Nerves During Transanal Dissection -- Operative Vectors, Anatomic distortion, and the Inherent Effect of CO2 Dissection -- Total Hindgut Mesenteric Mobilization for taTME -- The Role for Perfusion Angiography -- Perioperative Preparation and Post-Operative Care Considerations -- Intra-Operative Morbidity TaTME -- Functional Outcomes to Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME) -- Oncologic Outcomes -- TaTME for Radical Exenteration -- taTME for Abdominoperineal Resection -- Hartmann's Reversal by a Combined Transanal-Transabdominal Approach -- Pure NOTES Transanal taTME -- Totally Robotic taTME--Experiences and Challenges to Date -- Next Generation Robots for taTME -- Video-Based Training Apps and Deferred Live Surgery -- Navigation for Transanal Total Mesorectal Excision -- Current Controversies and Challenges -- Transanal Total Mesorectal Excision: The Next Ten Years.