[The difficult rectal stump]

During proctectomy for rectal cancer, section and closure of the rectal stump with TA55 before stapled low colorectal anastomosis could be very difficult, especially in obese patient. In this situation, others solutions includes use of TA30 or Roticulator, closure of rectal stump by suture, use of laparoscopic endoGIA. If no device can be used, manuel colo-anal anastomosis can be performed after rectal version, instead of stapled very low colorectal anastomosis.