Rectal cancer is one of the most common malignant tumors in China, and 75% of them are low rectal cancer. The traditional classical surgery – combined abdominal perineal resection (Miles) is becoming more and more difficult to be accepted by patients due to the removal of the anus, which seriously affects the postoperative quality of life. With the improvement of living standard, most patients are no longer satisfied with simple postoperative survival, but have higher requirements for normal postoperative physiological function and quality of life. With the in-depth understanding of the infiltration and metastasis rule of rectal cancer and the wide application of anastomosis technology, ultra-low rectal-anal canal anastomosis has become possible. Recently, the rate of anus-preserving surgery has been significantly increased. The reasonable choice of anus-preserving surgery for low rectal cancer does not reduce the radicality of surgery, does not increase the local recurrence rate due to anus-preserving surgery, and makes the patient’s postoperative quality of life significantly better than Miles surgery because the continuity of the intestine is restored and the ability to control defecation is preserved, which broadens the indications for anus-preserving surgery for low rectal cancer. Total mesorectal excision (TME) is recognized as the standard surgical treatment for low to mid-level rectal cancer. The application of TME technique can reduce the postoperative local recurrence rate to less than 10%. However, due to the anatomy of the pelvis, complete resection of the entire rectal mesentery is not an easy task, and in this regard laparoscopy has an unparalleled advantage over open surgery in that it allows for comfortable dissection in a small space. The magnified image allows clear visualization of the ureter, the anterior sacral space, and other important tissue structures, and allows complete removal of the entire rectal mesentery, which can be freed to a lower level, allowing for preservation of anal function.