Transanal total mesorectal excision (TaTME) of a low rectal cancer using transanal minimally invasive surgery

An 18mmHg CO2 pneumo-rectum was established and the laparoscopic camera and instruments were introduced. Diathermy was used to dissect circumferentially into the submucosal plane under magnified direct vision. Diathermy and ultrasonic energy were then combined to advance the dissection through the rectal wall and into the mesorectal plane until it met with the laparoscopically dissected plane (Figure 3).