Low anterior resection removes rectal cancer together with its surrounding fatty envelope (total mesorectal excision – TME), preserving the sphincter and restoring continuity. It is performed laparoscopically or robotically, often with a temporary protective stoma.
What is the operation?
It is the resection of the rectum for cancer, following the principle of total mesorectal excision (TME) — removing the rectum with its surrounding fatty/nodal envelope intact, which determines the oncological outcome. The sphincter is preserved whenever oncologically safe.
When is it needed?
It is indicated for rectal cancer, especially of the middle and upper thirds. The ability to preserve the sphincter depends on the position and extent of the tumour and is decided after staging.
Preparation
Precise pelvic MRI staging, endoscopy and CT are required. The strategy — including possible neoadjuvant chemoradiotherapy — is decided at a tumour board.
How it's done
Through small incisions, the rectum is mobilised along the optimal anatomical planes (TME) and removed with the tumour. Continuity is restored with a low anastomosis, often with a temporary protective stoma to protect it.
Robotic
The robotic approach offers excellent access and precision in the narrow pelvis — ideal for TME.
Laparoscopic
Resection through small incisions with oncological adequacy and faster recovery.
Diverting stoma
A temporary stoma that protects the low anastomosis and is closed at a second stage.
Recovery
With ERAS protocols mobilisation is early; discharge is usually in 5–7 days. The temporary stoma, where present, is closed at a second stage after healing.
Risks & outcomes
A demanding operation with very good oncological and functional results in specialist hands. Possible complications: anastomotic leak, bowel-function disturbance (anterior resection syndrome), urinary/sexual dysfunction.
Frequently asked questions
Will my sphincter be preserved?
The aim is to preserve the sphincter whenever oncologically safe. It depends on the position and extent of the tumour and is decided after precise staging.
Why might I need a temporary stoma?
In low anastomoses, a temporary diverting stoma protects the anastomosis while it heals and is usually closed at a second stage.
Will I need radiotherapy or chemotherapy?
In many rectal cancers, neoadjuvant therapy comes first. The decision is made at the tumour board based on staging.
What is TME?
It is total mesorectal excision — removing the rectum with its surrounding envelope intact, a decisive factor in the oncological outcome.