The need for postoperative anal dilation used to be an indispensable part of the rehabilitation process after surgery for megacolon. Because of megacolon surgery process need to sew the colon and anus together, known as “anastomosis”; anastomosis healing process is accompanied by fibrous tissue proliferation, scar fibrosis, there is the possibility of narrowing, so the need to use a metal rod (which is often referred to as the “anal dilator”) to expand the anastomosis. Therefore, it is necessary to expand the anastomosis with a metal rod (also commonly known as “anal dilator”), and the size of the anal dilator ranges from thin to thick, increasing by one model in about 1-2 weeks. In the previous surgical approach, each child required routine anal dilation up to about 3 months after surgery, and in some cases up to 6 months after surgery. The benefits of anal dilation are clear: it prevents anal stenosis, as well as the recurrence of difficult bowel movements and constipation caused by anal stenosis. In addition, anal dilation keeps the bowels clear, relieves bloating, and reduces the incidence of enteritis. The disadvantages of anal dilatation, in a way, are the same as its benefits: repeated dilatation can easily cause anastomotic mucous membrane tearing, accompanied by anastomotic bleeding, according to statistics, more than 90% of the children in the dilatation of the anus accompanied by anal bleeding, and in multiple dilatation recurrence. In the alternation of tearing and healing, chronic inflammatory reaction of the anastomosis gradually develops, which affects the ability to sense and control the stool, and causes perianal pain and defecation pain. Rectal mucosal prolapse that occurs in some children after surgery may also be related to repeated anal dilatation. In addition, the most direct and headache caused by anal dilatation is the poor cooperation of the child, crying, pain, fear, family members to see in the eyes of the very heartbreaking, causing double psychological shadow of the child and his family. The family’s intolerance, resulting in the expansion of the anus is not in place, thus causing anal stenosis and constipation recurrence, which occurs from time to time in the clinic. From the discussion of many parents of children with megacolon in qq group, it can be seen that postoperative anal dilatation after megacolon is a very painful memory for the family and the child. Our response was to improve the surgical approach by performing a laparoscopic Duhamel procedure for megacolon. This surgical procedure first originated in Europe. Since Dr. Duhamel, a French surgeon, introduced this new surgical technique and applied it to the treatment of congenital megacolon in infants in 1956, this surgical procedure has been gradually learned and accepted, and has been highly respected by pediatric surgeons in Europe, and according to the results of a recent survey conducted by the British Association for Pediatric Surgery, 62% of physicians in Europe preferred to perform Duhamel. According to a recent survey conducted by the British Pediatric Surgical Association, 62% of physicians in Europe prefer the Duhamel procedure for the treatment of congenital megacolon. What is the situation in my country? In China, there is a similar surgical procedure for treating constipation in adults, called the “Jinling operation”, which is in essence the Duhamel procedure, pioneered by the General Hospital of the Nanjing Military Command and popularized throughout the military and the country, with proven efficacy. However, in pediatrics, the Soave procedure is the most widely used surgical procedure for congenital megacolon. In contrast, although the open Duhamel procedure in pediatrics has also been performed for decades, the sample size is small. The minimally invasive laparoscopic Duhamel procedure was first reported in China by Prof. Tang Shaotao of the Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Prof. Tang modified the traditional laparoscopic Duhamel procedure to make it more suitable for pediatric patients. The current Duhamel procedure performed by the team led by Prof. Tang is also careful and rigorous in patient selection. For children with long segmental megacolon or intractable constipation, the advantages of the Duhamel procedure over the traditional Soave procedure are very clear and are supported by a lot of follow-up information and evidence. They have modified an important step of this procedure, dissecting the colon, from an intra-abdominal to an extra-anal operation, resulting in less trauma to the abdominal cavity and a more definitive, easier and more accurate resection process that largely avoids complications, as well as significantly less trauma to the abdominal wall. Prof. Shao-Tao Tang has a strong reputation in the diagnosis and management of megacolon, and has performed this surgical procedure at many national meetings in pediatric surgery, as well as being invited to many international meetings to report our surgical experience and skills in the world of academic pediatric surgery. This reputation has its origins. The team led by Prof. Tang was the first to develop minimally invasive treatment of megacolon in China, which was supported by the fund of the Ministry of Health as well as the Union Medical College Hospital, and its research results were awarded the First Prize of Scientific and Technological Advancement of Hubei Province as early as 2005. Prof. Tang has been devoted to the treatment of megacolon for more than 30 years, and minimally invasive surgical treatment for 14 years, which has accumulated a lot of experience and skills, and more valuable is that his team has a lot of experience and skills. What is more valuable is that his team has a large amount of information on case follow-up and review, and the results and prognosis information of patients who have been under long-term observation for several years, more than ten years, or even decades after the operation, which is of great importance and significance in guiding the treatment of patients. According to Prof. Tang’s research results, the advantages of Duhamel anastomosis are not only that it does not require anal dilatation, but also that it prevents anal stenosis fundamentally, and none of the children who have undergone this surgical procedure have developed anastomotic fistulae, which are greatly superior to the Soave procedure. The Duhamel procedure also reduces the incidence of enterocolitis, which is well documented in the case-follow-up data. More directly, the families of the children were highly satisfied with the results of the surgery and the recovery of bowel function, which also laid the foundation for the development and promotion of this procedure. Minimally invasive megacolon surgery without anal dilatation, the laparoscopic Duhamel procedure, not only improves the patient’s experience, but also greatly improves functional recovery, resulting in fewer complications, more health, and focuses not only on the “minimally invasive physical”, but also on the “minimally invasive psychological”, and “minimally invasive functional”. “Functional minimization. Laparoscopic megacolon surgery is carried out in many hospitals, although it is a few “small holes” on the belly, but the learning inside the belly is very different.