Transanal excision of large sessile villous adenomas using an endorectal traction flap

A technique is presented herein which allows a local transanal excision of large sessile villous adenomas with minimal morbidity and excellent preservation of specimen for complete histologic analysis. This technique is particularly applicable to elderly, poor risk patients and those patients with villous adenomas which extend so low in the rectum that anterior resection would be difficult or impossible.