To introduce the experience of using the TEM apparatus integrating the plastic protective sleeve to take out specimen through the anus in the laparoscopic radical resection of rectal cancer (natural orifice specimen extraction surgery, NOSES), and expounds the key technical points and controversial issues.

A retrospective analysis was performed on 7 patients with advanced rectal cancer treated in our hospital from September 2017 to January 2018. The size of the tumor (maximum diameter), the operative duration, the amount of bleeding, the number of lymph nodes harvested, postoperative first time to return of flatus, and so on were recored.

All the 7 patients in this group successfully completed the operation of NOSES by using the TEM apparatus integrating plastic protective sleeve to take out the specimen through the anus, the diameter of the tumor was 5~6.5 cm, the operative duration was 120~150 min, the amount of bleeding 50~100 ml, the number of lymph nodes harvested were 15~27, and the postoperative first time to return of flatus was 2~4 d, after the operation. The time of taking liquid was 3 d, and no complications occurred after operation.

The TEM apparatus integrating plastic protective sleeve can take out large rectal cancer specimens through anus, reduce the difficulty of removing specimens, and achieve good short-term curative effect.