In this EHTG/ESCP lecture Professor Antonio Spinelli from Humanitas Research Hospital in Milano explains the pros and cons of performing a "near to TME" dissection when performing a pouch for FAP. Despite the fact TME dissection has been considered as the gold standard in these cases, there are some advantages when dissection is performed close to the rectal wall. Some studies indicate that "near to TME " dissection could be related to a lower pelvic complication rate as well as better functional outcome due to autonomic nerve preservation. Moreover, possible pitfalls and complications regarding anatomical issues and oncological outcome are also discussed.
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