A rectal polyp reaching the dentate line (RPDL) is challenging to resect. Traditionally, such polyps are referred for surgery, and patients are offered either major abdominoperineal resection (with a high rate of adverse events) or minimally invasive transanal endoscopic microsurgery (TEMS). Endoscopic submucosal dissection can also be technically challenging, with a steep learning curve and rates of adverse events of 2% for bleeding, 4% for perforation, and 4% for recurrence.1 EMR of an RPDL is technically difficult, although it results in fewer adverse events than does TEMS, but it has a higher recurrence rate (32% vs 10%).