Appearance of the transanal ileus drainage system (Transanal Ileus Tube®; Create Medic Co., Ltd., Yokohama, Japan). The transanal drainage system we used included a guide wire (white arrow, through-the-scope thin dilator, white arrowhead), and thick dilator (black arrow). The through-the-scope thin dilator had a blunt tip, white arrowhead). The guide wire, which was included in the system we used, had a soft flexible tip. By contrast, the tail of the guide wire was firm and can give a considerable penetrative force when thrust. Therefore, we inserted the guide wire backward into the through-the-scope thin dilator in order to reinforce the hardness of the through-the-scope thin dilator for moderate penetrative force.