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Concerns exist regarding laparoscopic rectal cancer surgery due to increased rates of open conversion/complications and circumferential resection margin positivity (a surrogate for local recurrence). This study reports results from a single-surgeon series.Prospective data were collected for all patients undergoing laparoscopic total mesorectal excision (TME) for rectal cancer. Records were updated at each outpatient follow-up. No patients with advanced disease or unfavourable histology were excluded.One hundred and fifty patients (91 males, mean age 65.9 years and median BMI 26) underwent laparoscopic TME over 10 years. Mean length of follow-up was 144.8 weeks. Sixteen patients (10.6%) underwent neoadjuvant radiotherapy. Six patients (4.0%) required open conversion and nine patients (6.3%) developed anastomotic leakage. Duke's stage: A (50 patients), B (46), C (47), D (7). Five patients (3.3%) had an R1 resection with one R2. Median length of post-operative stay was 6.0 days. Three patients (2.1%) died within 30 days. Median time to first post-operative oncology appointment was 3.9 weeks. Four patients (2.7%) developed local recurrence.A non-selective approach to laparoscopic surgery for rectal cancer can result in excellent short and long-term outcomes. The low rate of local recurrence may reflect an attenuated immunological surgical stress response and early oncology follow-up.