Laparoscopic rectal cancer surgery is technically demanding requiring accurate pelvic dissection according to total mesorectal excision (TME) principles with autonomic nerve preservation. Inadvertent injury to the nerves has been attributed to the higher rate of male sexual dysfunction following laparoscopic surgery. The practicalities of robotic-assisted colorectal cancer surgery have been reported in small series but only two studies have concentrated on rectal cancer, and only one of these performed a randomised comparison in a small number of patients.