This technique was described by Lazahortes et al.  and combines the abdominal access with transsphincteric access according to Mason , The patient is subjected to right lateral decubitus and the left leg is raised to reach a 45° angle. Abdominal dissection is performed as before through an incision to the patient's left side.
Through an incision from the anal margin to the sacrum with coccyx resection. The external sphincter is sectioned to expose the rectum rear side, which is sectioned above the anal canal. Once the anastomosis between the apex of the cholic reservoir and the pectinate line is fashioned, the external sphincter is sutured.
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