近年来，直肠癌外科治疗的宗旨在强调保证根治前提下尽可能保护肛门及生殖功能，以及减少病人的创伤。随着科技的进步，成熟的3D技术改善了视觉疲劳等缺陷，并因其特有的立体感和纵深感使3D腹腔镜在结直肠外科微创手术中得到普及。正因为3D腹腔镜特有的高清的手术视野和立体的视觉效果，3D腹腔镜直肠癌根治术中对于骨盆腔及盆底结构的三维解剖认识更为清晰，术中对重要结构及解剖层次的辨析度更为精准。因此，3D腹腔镜不仅能缩短直肠癌根治术的手术时间、减少术中出血量、提高手术标本质量，还能减少术后排尿功能障碍、加速术后恢复、减少远期性功能障碍。本文将从如何减少盆腔植物神经的损伤，保护输尿管及提高标本病理学质量方面等方面探讨3D腹腔镜下直肠癌根治术中对解剖层次显露的意义。

In recent years, the aim of surgical treatment for rectal cancer is to preserve the anal and reproductive functions as much as possible, and to minimize the damage of the patients under the premise of radical treatment. With the progress of science and technology, 3D technology improves the visual fatigue, and because of its unique sense of three-dimensional and depth, the application of 3D laparoscopy in the surgical field has been popularized. 3D laparoscopy provides a high-definition surgical vision and 3D visual effect. It has a clearer understanding of the 3D anatomy of the pelvic and pelvic floor structures, and a more accurate discrimination of important structures and membrane anatomical exposure during the operation. In summary, 3D laparoscopy not only could shorten the operation time, reduce intraoperative bleeding and improve the quality of surgical specimens, but also could reduce postoperative urination dysfunction, accelerate postoperative recovery and reduce long-term sexual dysfunction. In this paper, we will discuss the clinical significance of 3D laparoscopic resection of rectal cancer in terms of how to reduce the damage of pelvic autonomic nerve, protect ureter and improve the quality of specimen.