The Czech Republic is a country with the highest incidence of colorectal cancer in the world. Therefore, rectal cancer surgeries are among the most frequently performed operations at our facilities. Until recently, there was only one solution for low-lying rectal tumors - abdominoperineal resection of the rectum. In conceiving this manual, the author drew on nearly a decade of experience in treating rectal diseases, including malignancies, using the minimally invasive technique of transanal endoscopic microsurgery (T.E.M.). The aim is to present the principles of the T.E.M. surgical technique and to further introduce a sphincter-preserving operation that utilizes the transanal endoscopic microsurgery technique and is safely and routinely applicable for performing continent operations for low-lying rectal cancer, that is, cancer that reaches macroscopically its aboral margin at most 1.5 cm from the linea dentata.
