Using laparoscopic assisted surgery in management of rectal cancer, particularly, very low rectal cancer is still complicated due to technical difficulties owing to its anatomical location in the pelvis. Moreover, the approach of laparoscopic assisted intersphincteric resection as a recent management strategy of very low rectal cancer remains a controversial issue, due to few prospective studies about such issue, advantages, benefits and contraindications of such procedure is still not reaching a consensus.