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The etiology of anastomotic leaks is a multifactorial problem. Besides technical aspects, adequate bowel perfusion is the main factor in ensuring the integrity of an anastomosis. Current literature suggests that additional visualization of tissue perfusion with fluorescence imaging-indocyanine green can add relevant information to determine a well-perfused location for colorectal transections, thus leading to fewer leaks. Low/ultralow rectal anastomoses in transanal total mesorectal excisions (TaTME) have a higher risk for leak for this reason ICG should be considered a routine assessment for taTME, as a guide for the creation of a successful anastomosis. On September 15, Antonio Lacy and Ana Otero demonstrated the usefulness of perfusion assessment using the PINPOINT Endoscopic Fluorescence Imaging System ® (Novadaq) in taTME for rectal cancer by the Cecil approach.
