Transanal mesorectal excision is a novel, ingenious approach in the dissection of the rectum which begins from the perineum and proceeds more proximally in a sort of retrograde fashion compared with more traditional dissection techniques. Its purported advantage is facilitating the dissection of the distal rectum. It remains a controversial approach and requires specific training. The adoption of this technique has been unsuccessful in Norway as this article delineates, among other experiences with more favorable results.