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Approach With the usage of a regular transanal approach, the distal margin of the lesion is marked and raised from the interior sphincter muscle. The dissection is proceeded until above the anorectal ring, and a 5.5-cm transanal platform is introduced transanally. Insufflatiemely challenging with standard transanal approaches. See Video at http//links.lww.com/DCR/B231.Background Colonoscopy overall performance by gastroenterologists has been confirmed to be associated with reduce