Familial adenomatous polyposis (FAP) is an autosomal dominant disease, mainly caused by mutations in the APC gene on the long arm of chromosome 5. The main pathologic change is the widespread appearance of dozens to hundreds of polyps of various sizes in the large intestine, initially distributed in the rectum and distal colon, and in severe cases, polyps can occur from the oral cavity all the way to the rectal-anal tube, and the number of polyps can be up to thousands. The polyps range from the size of a soybean to several centimeters in diameter, and are often densely arranged, sometimes in strings or clusters. Patients are born without colonic or rectal polyps. The first appearance of intestinal adenomas can be below the age of 10 years. there are many symptomatic patients between the ages of 10 and 12 years. The number of polyps is small at the beginning and increases with age.The cancer rate of FAP is very high, if not treated in time after the onset of the disease, the cancer rate is 10% after 5 years, and 50% of patients become cancerous after 20 years. It has been said that the cancer rate of adenomas is 100% when the patient’s life permits. There are no obvious symptoms in the early stage of the disease, but with the increase of polyps, patients may have rectal bleeding, diarrhea, mucus loose stool, increased frequency of stool, and occasional abdominal pain. The diagnosis is confirmed by the detection of multiple polyps and a family history. Familial colonic polyposis is considered an obvious precancerous state, and surgical removal of the entire colon and rectum is the most effective treatment. Common surgical procedures include: 1, colorectal resection + plus permanent ileostomy; 2, total colectomy + ileorectal anastomosis; 3, total colectomy + ileoanal anastomosis or ileal reservoir pouch anal anastomosis. Total colectomy is a large operation, the scope of the operation is large, in the past, the general use of traditional laparotomy, must be in the abdomen to open a long more than 30 centimeters long incision can be completed (usually referred to as through the mouth), trauma, postoperative recovery is slower, postoperative intestinal obstruction and other complications occurring at a high rate. While laparoscopic minimally invasive surgery only needs to play a few small holes in the patient’s abdominal wall, compared with the previous open surgery, laparoscopic surgery patients with small incisions, light systemic reaction, mild pain, postoperative intestinal adhesions, intestinal obstruction and other incidence of low. After more than 10 years of development, laparoscopy has been able to carry out right hemicolectomy, left hemicolectomy, sigmoid resection, rectal resection (Miles surgery, Dixon surgery) and other colorectal surgery, but the number of laparoscopic total colectomy is still relatively small, has not yet been popularized, mainly because of its technical difficulties and narrow indications. Laparoscopic total colectomy can be divided into three categories: 1, complete laparoscopic total colectomy; 2, laparoscopic-assisted total colectomy; 3, hand-assisted laparoscopic total colectomy. Due to the large scope of laparoscopic total colectomy, high technical difficulty, and long operation time, the operator is required to have great patience and skillful laparoscopic techniques, as well as sufficient experience in colorectal surgery. We carried out laparoscopic total colorectal resection for familial polyposis at a very early stage, and after the operation, the patient’s abdomen was free from the traditional abdominal “through and through” opening, and the postoperative recovery was rapid and the result was very satisfactory.