The history of transanal surgery

Transanal excision is an important approach in the management of diseases of the rectum. Most notably, advances in transanal excision technique have evolved with efforts to safely excise rectal tumors. There have been many important advancements over the past several thousand years to reach this frontier. In this article, we review the interesting history behind transanal surgery. We begin with the ancient Egyptians and Greeks who performed transanal surgery with high mortality, and end with contemporary approaches, which minimize patient morbidity. Transanal surgery is now an accepted approach in selected patients as a result of overcoming three obstacles: 1) the ability to perform these operations safely; 2) the importance of performing an oncologically sound resection; and 3) technical advances in surgical exposure. What has resulted is a rapidly evolving new era in transanal surgery.