The definition of colo-anal anastomosis is still under debate. This argument is caused by the difference between the surgical anal canal (included between the anal margin and the levator plane) and the anatomic anal canal (between the anal margin and the dentate line). According to some surgeons, therefore, the excision of the rectum up to the leva-tor plane with anastomosis performed on the surgical anal canal or immediately above it is considered colo-anal anastomosis. Others prefer a more rigorous definition, considering as colo-anal anastomosis a suture at the dentate line and referring to the former as a low or ultra-low colorectal anastomosis [1, 2].

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