LAUSR

early cancerous component and make it easy to evaluate the specimen for known risk factors for cancer, such as histological grade, depth of invasion, lymphovascular invasion, tumour budding and mucin pools [4] as well as to assess deep and lateral margins. Although evidence is still accumulating, knowledge of a polyp’s characteristics helps in selecting treatment options postresection. This video (Video S1) demonstrates the excision of a nearly circumferential 12-cm polypoid lesion in the mid and upper rectum using a combined technique of transanal minimally invasive surgery (TAMIS) with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR). The case was initially referred for TAMIS and assessed to be a 4-cm lesion under conditions of poor bowel preparation.