PMC7252201_01
Total colonoscopy revealed a lesion in the rectum below the peritoneal reflection (4 cm above the anal verge).
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F1
A total colonoscopy revealed a lesion in the rectum below the peritoneal reflection (4 cm above the anal verge) (Fig. 1).
Computed tomography images. The patient's body mass index had decreased from 41.7 kg/m2 (height: 179.8 cm; weight: 133.8 kg) to 34.3 kg/m2 (height: 177.4 cm; weight: 108.0 kg).
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F2
Preoperatively, the patient underwent nutrition management for 3 months, and his BMI decreased to 34.3 kg/m2 (height: 177.4 cm; weight: 108.0 kg) (Fig. 2).
A colonic pull-through segment of about 10 cm was left outside the anal canal without any tension and was fixed by sutures under indocyanine green fluorescence imaging.
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F3
A colonic pull-through segment of about 10 cm was left outside the anal canal without any tension and fixed by sutures under indocyanine green fluorescence imaging (ICG FI) (Fig. 3).
Final coloanal anastomosis was performed without diverting the stoma under indocyanine green fluorescence imaging.
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F4
It was sutured using 16 interrupted absorbable sutures without diverting the stoma under ICG FI (Fig. 4).