Transanal TME is an increasingly popular technique to aid in the removal of rectal tumours. It involves an abdominal and transanal approach to the removal of tumours in the lower rectum. It is most useful in obese patients where conventional techniques have always struggled to provided adequate views and access to the low pelvis. taTME combines minimally invasive abdominal surgery with transanal laparoscopic surgery. The surgery can be performed by 2 surgical teams working together. Although it is a technically challenging procedure this technique allows some patients who would otherwise need a permanent colostomy to have their bowel rejoined.