Novel technique with the IRIS U kit to prevent urethral injury in patients undergoing transanal total mesorectal excision

BACKGROUND: Low anterior resection of the rectum with total mesorectal excision (TME) has been the gold standard for the surgical treatment of rectal cancer as it has the lowest recurrence rates. The key issue while performing transanal TME (TaTME) is avoiding iatrogenic urethral injury. We introduce our surgical technique for TaTME. SURGICAL TECHNIQUE: Intraurethral indocyanine green injection using the IRIS U kit with subsequent visualization under NIR was safely utilized during the TaTME. We were able to easily detect and visualize the IRIS urethral kit. The prostatic segment of the urethra can be identified in real-time using the infrared illumination system urethral kit (IRIS U kit). BENEFITS: The prostatic segment of the urethra was easily and quickly identified by the green fluorescence during TaTME. CONCLUSION: Our TaTME technique is an easy and feasible approach that provides real-time urethral images.