A point on the sigmoid is selected for division, and the mesenteric border is meticulously cleared for a distance of approximately 2 cm (Figure 3). Active pulsations must be present in the mesentery, and the cleared area must be free of diverticuli. A total mesorectal excision (Plate 70) is carried out to at least 2 cm, preferably 5 cm, below the tumor. A linear stapler is fired across the rectum at that level (Figure 4) and the mesorectum is divided. Some staplers close both sides while cutting between the staple lines, while others fire only one line of staples and hence require a clamp on the proximal (“specimen”) side. The rectosigmoid specimen is then lifted out of the pelvis.