Layer by Layer: The Anatomical ‘Onion Peel’ Approach to Surgery Beyond Total Mesorectal Excision | Synapse
April 10, 2026Open Access
Layer by Layer: The Anatomical ‘Onion Peel’ Approach to Surgery Beyond Total Mesorectal Excision
Key Points
To offer colorectal surgeons innovative insights into the anatomy of the mesorectal envelope and operative techniques.
Overview of mesorectal anatomy
Introduction of dissection planes beyond total mesorectal excision
Operative strategies presented for safe dissection
Novel insights into mesorectal anatomy provided
New techniques to enhance dissection safety identified
Potential for improved surgical outcomes emphasized
Abstract
This paper provides colorectal surgeons with a novel overview of the anatomy surrounding the mesorectal envelope along with simple operative strategies to enter and safely dissect planes beyond TME.