Rectal surgery continues to progress during the last ten years. This technical and treatment evolution give the possibility to increase survival, with local recurrence decrease, all associated with more digestive, urinary and sexual function preservation. These progressive and continues modifications make that today the surgeon was a major prognosis factor of success. Whatever the technical solution used, the function preservation that we reported here, was more and more associated with better oncological result, for the patient benefit. These improvements required mixed teams, medical and surgical, implicated in this specific cancer giving the possibility to use all the technical solutions described here.