[Transanal total mesorectal excision: the operative platform and potential issues]

In recent 20 years, the most important advancement of rectal cancer surgery is the total mesorectal excision(TME) and laparoscopic minimal invasive surgery. However, visualization of the distal rectum is still troublesome because of narrow pelvic, bulky tumor, and especially obese male patients. A possible solution for this situation is distal rectal mobilization by transanal minimally invasive surgery (TAMIS), or even pure transanal total mesorectal excision (taTME). When people applaud a new era of rectal cancer surgery is coming, we must also concern about the patients selection, the long-term follow up results and even the operative safety.