To explore the scientific process and related experience of 3D laparoscopic abdominoperineal resection (APR) surgery.

A retrospective analysis was carried out of ninety patients who successfully underwent 3D laparoscopic APR from January 2016 to October 2018 in the Peace Hospital Affiliated to Changzhi Medical College. The procedure of APR was improved: (1) Perineal surgery started by freeing the posterior rectal space. (2) The period from the time when the perineum communicated with the abdomen to the complete free excision of the specimen was the same the time period as stoma incision to the completion of the step of the extraperitoneal stoma. (3) Rebuild the posterior 1/3 of the pelvic peritoneum + extraperitoneal stoma step and the suture of the perineum completed simultaneously.

There was no conversion to open surgery. The intraoperative blood loss was (120.4±41.6) ml and the operation time was (165.7±30.5) min. The first exhaust time was 2 days (1-6 days), and the hospital stay was (14.5±2.3) days. Postoperative infection occurred in three cases, intestinal adhesion in one case, para stomal hernia in one case, urinary retention in five cases, stoma slobber in one case. All the patients were cured by 3D laparoscopic APR surgery. No local recurrence or distant metastasis was found during the follow-up period of 8 (6-14) months.

It is helpful to shorten the operation time, and increase the safety to master the scientific process of 3D laparoscopic APR operation, which makes the abdomen and perineum coordinate and unify.