A tissue removal system is provided which enables optimally performing a full-thickness resection of a hollow organ while minimizing invasiveness. In this tissue removal system, a tissue pressing tool which has a tissue contacting part and which is guided into the abdominal cavity, and a resection and anastomosis device work together. The resection and anastomosis device resects and performs anastomosis of tissue positioned between a main body and an anvil part, and, when pressing the tissue to be cut to the cutting position of the resection and anastomosis device by means of the tissue contacting part, the tissue contacting part is pressed against two abutment parts of the resection and anastomosis device.