In this lecture, Prof. Andre D’Hoore presents the different possibilities of reconstruction after Total Mesorectal Excision (TME) straight anastomosis, colonic J-pouch, coloplasty, and side-to-end anastomosis. He shows the benefits of the different techniques, compares the functional results and states that reservoir reconstructions offer functional benefits. Coloplasty and side-to-end anastomosis represent a valid alternative.