82 year-old female patient with history of arterial hypertension, Diabetes Mellitus, Hypothyroidism, ACV, AF in treatment with pradaxa. She consulted for rectal bleeding and a colonoscopy showed a 3 cm 0-IIa + 0 – Is lession at rectoanal junction. NBI shows a NICE type II lession and allows too delimitate better it. We have used hyaluronic acid 0.8% and methylene blue starting at the anal margin and then in retroflxexion at the distal margin.We have worked with a 185 Olympus gastroscope in retroversion. For the mucosectomy we used a 25 mm Olympus loop and a 15 mm Boston Scientific loop. Finally in the scar we put Purastat to decrease the risk of bleeding. Patient should continue taking anticoagulants.