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The abdominal extraction incision continues to be major source of increased morbidity after laparoscopic colectomy, such as wound infection, incisional hernia formation, and wound dehiscence.The major advantage of natural orifice specimen extraction (NOSE) is to avoid the additional abdominal incision and reduce the access trauma.Here, we describe a novel technique in which the entire colon is extracted transanally to eliminate the abdominal extraction incision in a patient with Lynch syndrome who need total colectomy.This innovative surgical approach is feasible and effective, which may be available for patients who require total colectomy in the future.