Robotic ultralow anterior resection combined with transanal transection and coloanal anastomosis - a video vignette.

Total mesorectal excision (TME) surgery requires accurate transection of the distal rectum distal to any tumour within the very limited space of the bony pelvis. Whilst robotic surgery may facilitate the pelvic dissection, choosing the site of rectal stapling is still a challenge especially if a purely abdominal approach is carried out. With the introduction of the transanal techniques, the transection level can be more easily controlled, as recently described by Spinelli et al.1 We present this case-video highlighting the benefits of combining abdominal and transanal approaches.