fig4
![Transanal minimally invasive surgery: from transanal minimally invasive surgery to pure natural orifice transluminal endoscopic surgery](https://image.oaes.cc/f691d49f-b0eb-457e-b9c3-afe95f4b7973/3286.fig.4.jpg)
Figure 4. Considerations in pure NOTES. Preoperative considerations are anal sphincter condition (A), pelvic promontory (B), distance to splenic flexure (C), operative history, etc. NOTES: natural orifice transluminal endoscopic surgery; LLQ: left low quadrant