Robotic and Advanced Endoscopic Approaches to Transanal Surgery

Transanal approaches are an important modality for the diagnosis and treatment of rectal neoplasia while allowing for organ preservation. Choosing the appropriate surgical approach based on anatomy, pathology, platform capabilities and surgical skill is paramount to success. In this article we review preoperative considerations, the present options for transanal approach and the relative advantages and disadvantages they each offer. We will focus on advanced transanal options including robotic-assisted approaches and endoscopic submucosal resection.