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We describe combined TEM excision of a rectal polyp with laparoscopic anterior resection for sigmoid cancer using transanal assistance. The patient is a 75 year-old male with a sigmoid cancer and a 1.2 cm sessile rectal polyp located 18 cm and 7 cm from the anal verge respectively. The rectal polyp was resected using TEM followed by suture closure. Following complete laparoscopic mobilization and transection of the rectosigmoid, the TEM proctoscope was inserted intraperitoneally through the open rectal stump and used to exteriorize and transect the specimen followed by placement of the Anvil for laparoscopic stapled colorectal anastomosis.