The concept of TME has been shown to improve both disease-free and overall survival. TME in conjunction with LAR or LAPR involves precise dissection and removal of the entire rectal mesentery, including that distal to the tumor, as an intact unit. Unlike conventional blunt dissection, which may leave residual mesorectum in the pelvis, TME involves sharp dissection under direct vision in the avascular, areolar plane. This procedure emphasizes ANP and complete homeostasis and avoids violation of the mesorectal envelope.