Traditionally, a rectal carcinoma would be approached from a transanal technique to perform a stapled anastomosis between the left colon to residual rectum. We have found that a maneuver such as this will necessitate inordinate movement within the operating room including gown changing, unusual opportunities to expose the patient to breaks in sterile technique and always the potential to push some contaminating material from the rectal stump into the peritoneal cavity of the patient. Our approach is to keep the operative procedure confined to the patient's abdominal cavity by reversing the end-to-end stapling instrument.