Transanal total mesorectal excision alone as minimally invasive surgery for metachronous rectal cancer after a Hartmann's procedure.

This is the first report of resection of rectal cancer in the rectal remnant after Hartmann's surgery using only a trans-anal procedure. The adhesions to the uterus were then dissected, revealing the staple that remained the rectal stump (white arrow) after the previous Hartman's surgery. b Final view of the dissection. 2 Intraoperative findings during trans-anal total meso-rectal resection. a The dissection line was set at 2 cm from the tumor on the anal side. [Extracted from the article]