A Study Assessing Perfusion Outcomes With PINPOINT® Near Infrared Fluorescence Imaging in Low Anterior Resection

Inclusion Criteria:

* Be 18 years of age or older.
* Be undergoing open, or minimally invasive LAR for the treatment of a rectal or rectosigmoid neoplasm (Subjects with rectal or rectosigmoid neoplasm(s) may be treated with or without neoadjuvant therapy. Long-course neoadjuvant therapy must have been completed ≥6 weeks prior to LAR surgery (Day 0).
* Have a planned low circular stapled or transanally hand sewn anastomosis ≤10 cm from the anal verge.
* Have a colorectal or coloanal reconstruction with or without reservoir/pouch.
* Subjects who are women of child-bearing potential must not be pregnant or lactating, must have a negative pregnancy test at Day 0.
* Have signed an approved informed consent form for the study.
* Be willing to comply with the protocol.

Exclusion Criteria:

* Undergoing stapled anastomosis with the use of an experimental or non-FDA approved stapler.
* Undergoing ileoanal reconstruction, total colectomy or proctocolectomy, abdominoperineal resection, Hartmann's procedure, Hartmann's reversal or multiple synchronous colon resections (e.g., LAR and concomitant right colectomy).
* Has received and completed a course of pelvic radiotherapy ≥ 6 months prior to LAR surgery (Day 0).
* Has previously undergone a left sided colon resection.
* Has previously undergone a rectal resection.
* Has recurrent rectal or rectosigmoid cancer.
* Has a diagnosis of locally advanced rectal or rectosigmoid cancer undergoing extended en bloc operations.
* Has a diagnosis of Stage IV rectal or rectosigmoid cancer with any multifocal metastases or single site metastasis with tumor size of \> 2 cm (Intraoperative incidental finding or preoperative suspicion of Stage IV cancer with isolated (single site) metastasis (≤ 2 cm) or limited metastases (≤3), with largest lesion ≤ 2 cm in size, does not exclude the subject).
* Has a diagnosis of inflammatory bowel disease (IBD). Subjects with rectal or rectosigmoid cancer neoplasms and IBD are excluded.
* Has hepatic dysfunction defined as Model for End-Stage Liver Disease (MELD) Score \>12.
* Renal dysfunction defined as creatinine ≥ 2.0 mg/dL.
* Has known allergy or history of adverse reaction to ICG, iodine or iodine dyes.
* Has, in the Investigator's opinion, any medical condition that makes the subject a poor candidate for the investigational procedure, or interferes with the interpretation of study results.
* Is actively participating in another investigational clinical study which, in the Investigator's or Sponsor's opinion, would interfere in this study.