In general, the steps of rectal cancer surgery are anesthesia, toweling, incision and exploration. 1. Anesthesia: after completing endotracheal intubation and intravenous compound anesthesia, take the stone position of head-low-foot-high, and carry out routine disinfection of abdominal surgical area and perineal skin. 2. Toweling: Insert the gastric tube and urinary catheter respectively, and perform the toweling operation on the routinely sterilized abdominal surgical area and perineal skin. 3. Incision and exploration: take the lower abdomen from pubic bone to umbilicus, and perform the operation of median incision, paramedian incision or transrectus abdominis muscle incision. The incision can be extended upward according to the intraoperative situation. After incision, exploration is carried out from far to near, focusing on the peritoneum, pelvis, liver, abdominal aorta, root of the inferior mesenteric artery, ovary and other parts of the body, and finally the tumor is gently explored. Finally, the rectal mesentery and its surrounding invaded tissues are completely resected, and the surrounding lymph nodes are cleared. In general, the surgical approach must be selected based on the principle of being able to achieve complete resection of the tumor, taking into account the patient’s quality of life.