Colorectal anastomosis after laparoscopic low anterior resection with total mesorectal excision: a difficult problem made simple.

Laparoscopic anterior resection with total mesorectal excision for middle and lower third rectal cancer remains a difficult operation, in particular, in male patients with a narrow pelvis and bulky mesentery. In this type of patient, the available staplers do not allow an easy transection of the rectum close to the pelvic floor. A new approach that uses instruments (dilator, obturator, and pursestring anoscope) specifically designed for the technique of stapled hemorrhoidopexy and a common circular stapler can overcome all these issues.