The oncological efficiency of the perineal phase of the operation and its safety directly depend on the professional skills of the surgeon performing it. Thus, this factor must play an important role when assembling the team of surgeons. Usually, the proper position of the patient on the table ensures good exposure from the perineal side. However, if heavy buttocks or a deep anal canal make visualisation difficult, one can suture the buttocks laterally. The per-
ineal operator should first irrigate the now mobilised rectum until clear from secretions, blood and loose bits of tumour. Next the perineal is reprepped and the anal canal pursestring suture of heavy silk is placed and tied.
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