Ressec？？o anterior ultrabaixa e interesfinctérica do reto com anastomose coloanal por videolaparoscopia

the author present the laparoscopic coloanal anastomosis and intersphincteric resection technique to treat patients with very low rectal cancer. the operative steps are: 1 - patient positioning; 2 - instruments and equip positioning; 3 - insertion of the ports; 4 - preparation of the operative field; 5 - difining and dividing the inferior mesenteric artery and vein by the medial approach; 6 - mobilization of splenic flexure and sigmoid colon; 7 - rectal mobilization and total mesorectum excision by rullier technique; 8 - rectal division and coloanal anastomosis; 9 - intersphincteric resection and coloanal anastomosis by coloplasty, j pouch or latero-to-end techniques. the technique employed is safe and have presented low rate of complication and no mortality.