Where is the optimal plane to mobilize the anterior rectal wall in female patients undergoing total mesorectal excision?

Figure 1 The procedure of the experimental group. A: The peritoneum was cut at the lowest point of the peritoneal reflection to enter the anterior rectal space; B: After the incision of the peritoneal reflection, a space can be seen, in which can we easily free the anterior rectal wall. This space is considered the rectovaginal space; C: No other fascial structure was present between the fascia propria of the rectum and the adventitia of the vagina, and these two fascial structures could be pushed away from each other by an ultrasonic knife through blunt separation. ADV: Adventitia of the vagina; FPR: Fascia propria of the rectum; MR: Mesorectum; PR: Peritoneal reflection; R: Rectum; V: Vagina; ARS: Anterior rectal space.