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Innovation comes at a cost - it creates a conflict between the supporters of the tradition and those that embrace the new ideas. Total mesorectal excision, described by Dr. Heald, was one of these innovative ideas that changed the course of colorectal surgery. Several years later, the advent of minimally invasive surgery was another important step in the evolution of surgery. Laparoscopic surgery is now accepted as an approach that minimizes pain and accelerates recovery after surgery. The next step in rectal cancer treatment was the transanal approach (TaTME). This approach overcomes the difficulties of laparoscopic surgery in special situations: obese and male patients, those with a narrow pelvis and bulky tumors, and these difficulties are specially true for the distal margin section. Furthermore, the use of two simultaneous teams - the Cecil Approach - has reduced procedure time.
