A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation: XII. Anorectal mobilization: A new surgical access to rectal lesions. Preliminary report

A new technique for the removal of inaccessible benign intrarectal lesions and malignant lower third rectal tumors with sphincter preservation is presented. The procedure was performed in eight patients, four with huge bilharzial papillomas and four with malignant lower third rectal tumors. The essential feature of the operation is preservation of the levator tunnel, which is responsible for maintaining normal, voluntary continence and defecation. The results were satisfactory. The technique provides easy access to the interior of the rectum, and it extends the indications for sphincter-saving operations to include malignant lower third rectal tumors. It is hoped that this procedure will eliminate the use of abdominoperineal excision in the treatment of rectal cancer.