Snow v Royal United Hospitals Bath NHS Foundation Trust [2023] EWHC 42 (KB) (13 January 2023) This is the trial of C’s claim for damages for clinical negligence for failing to obtain his fully-informed consent for a laparoscopic low anterior resection of rectal cancer with a trans-anal (Ta) total mesorectal excision (TME), and for negligent intra-operative care. D admits it failed to consent C adequately but causation is denied. D denies C’s allegation of negligent intra-operative care. [1] C says that if he had been adequately consented, he would have chosen to undergo a TME, and not a TaTME, and as a consequence he would not have suffered the following severe multiple injuries: i) Permanent total impotence, total inability to ejaculate and anorgasmia; ii) Urinary incontinence and urgency; iii) Faecal urgency and incontinence; iv) Exacerbation of Lower Anterior Resection Syndrome (LARS); v) Moderate prolonged adjustment disorder and depression. [2] found C to be a truthful witness and find that he has proved on the balance of probabilities that if he had been properly consented, he would have elected to undergo a laparoscopic TME [164] C has proved on the balance of probabilities that if he had undergone a laparoscopic TME, he would not have suffered total impotence, loss of ejaculatory function and anorgasmia [292] C has proved on the balance of probabilities that if he had undergone a laparoscopic TME with autonomic nerve preservation, it is unlikely that he would have suffered urinary urgency and urinary incontinence [313] C has failed to prove on the balance of probabilities that his LARS has been exacerbated or worsened in a measurable way by undergoing a TaTME. [344] C has proved on the balance of probabilities that by reason of undergoing a TaTME he has suffered a significant increase in faecal incontinence [372]