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Studies examining sexual function following laparoscopic and open rectal surgery give conflicting evidence for outcomes. The purpose of this study was to analyse the impact of surgical technique on sexual function following laparoscopic or open resection for rectal cancer patients in our department.Patients with rectal cancer underwent laparoscopic or open surgery between September 2006 and September 2009. Validated standardised postal questionnaires were sent to patients. This functional data was then quantified usingpreviously validated indices of sexual function.144/173 (83%) responded to the questionnaire-based study. 83 of respondence (53 men) had laparoscopic rectal resection, while 61 (38 men) had openprocedure. In Males having laparoscopic surgery, all measures of sexual function tended to be better with statistically significant variable was incidence of successful penetration (P = 0.04). However female patients in the laparoscopic group did significantly better in all aspects compared to open group with respect to sexual arousal (P = 0.005), orgasm (P = 0.04) and the incidence of dyspareunia (P = 0.02).Laparoscopic TME for rectal cancer is associated with significantly less deterioration in sexual function when compared to open surgery. Better visualisation coupled with improved technique, confers advantage in laparoscopic surgery with less risk of damage to the nerves.