Figure 2: Laparoscopic procedure combined with transanal rectal dissection. The gauze that was placed on the dissected plane as a landmark was able to be identified through the peritoneum on the anterior side on the rectum. It was relatively easy to dissect Denonvillier’s fascia and expose the seminal vesicles and prostate gland (a). On the posterior side of the rectum, it was possible to mobilize the lower rectum and mesorectum from the sacrum on the separated plane between the visceral and parietal endopelvic fascia through the anus (b). The lateral ligaments of the rectum were gradually divided with a harmonic scalpel from the inner limit of the inferior hypogastric nerve fibers. The rectum, including the total mesorectum, was completely removed from the pelvic floor (c, d).