Recently, the Department of Gastrointestinal Surgery of the Inner Mongolia Autonomous Region People’s Hospital completed the “complete laparoscopic total colectomy with rectum and anus resection (Miles) surgery” independently. According to the test, this is the first operation completed independently since the establishment of Inner Mongolia Autonomous Region People’s Hospital, and also the first operation in the history of the development of surgery in Inner Mongolia Autonomous Region, filling the gaps in the relevant fields in the autonomous region and doing a real good thing for the people of the autonomous region! The patient was a 70-year-old male with diarrhea and blood in the stool for many years. Through colonoscopy, the whole colon and rectum were covered with countless polyps of different sizes, and pathological examination confirmed that the cecum and rectal polyps 3cm away from the anus had become malignant. The clinical diagnosis was “polyposis of the colon combined with malignant transformation of some polyps”. Wang Ju, Department of General Surgery, People’s Hospital of Inner Mongolia Autonomous Region, was diagnosed as “polyposis of the large intestine (Familial adenomatous polyposis (FAP)), which is an autosomal dominant disorder caused by mutations in the APC gene on the long arm of chromosome 5. The main pathological change is the widespread appearance of tens to hundreds of polyps of different sizes in the large intestine, initially in the rectum and distal colon, or in severe cases from the oral cavity to the recto-anal canal, and the number of polyps can reach thousands. Some people say that the rate of adenoma cancer is 100% when the patient’s life allows. Surgical resection of the entire colon and rectum is the most effective treatment. Common surgical procedures include: (1) colorectal resection + permanent ileostomy; (2) total colectomy + ileorectal anastomosis; and (3) total colectomy + ileoanal anastomosis or ileal storage pouch anastomosis. This patient’s entire colon and rectum were covered with polyps, and almost no normal intestinal mucosa could be seen, and the rectal polyp 3 cm away from the anus had become malignant, so the best surgical method was total colectomy plus rectal and anal resection. This operation is the largest operation in gastrointestinal surgery, and the whole operation is equivalent to four operations, namely “right hemicolectomy, transverse colectomy, left hemicolectomy and combined abdominal perineal rectal cancer radical surgery (i.e. Miles operation)”. The scope of surgery is large, and in the past, traditional open surgery was usually used, which required an incision of more than 30 centimeters in length from the pubic symphysis to the subxiphoid process in the abdomen (i.e., the commonly referred to as the “through-the-sky” incision), which is more traumatic, slower in postoperative recovery, and has a high incidence of postoperative intestinal obstruction and other complications. The Department of Gastrointestinal Surgery attached great importance to this case, and decided to perform a less invasive laparoscopic surgery after a consultation with the whole department. The operation was performed by Dr. Wang Ju, director of the Department of Gastrointestinal Surgery, who made 5 small keyhole-sized holes in the patient’s abdomen and inserted the laparoscope into the abdominal cavity, which immediately showed the organs in the abdominal cavity clearly on the monitor screen. The entire large intestinal tissue and anus were removed from the body through an incision in the perineum, and then a terminal ileostomy was completed at the patient’s left lower abdominal poke card. The whole operation was very smooth and anatomically clear, with only a small amount of bleeding during the operation, and the patient recovered well after the operation. Up to now, the number of laparoscopic total colectomy with rectal and anal resection is still relatively small, and only a few large hospitals and a few doctors in China can carry out this kind of surgery. The reasons for this are mainly its technical difficulty and narrow indications. Because of the large scope, high technical difficulty and long operation time, it requires great patience, strong willpower and skillful laparoscopic technique, as well as rich experience in colorectal surgery, and it also requires extremely high anesthesia technique and level in hospitals. At present, Dr. Wang has accumulated experience in 8 cases of this surgery, and all of them have achieved good surgical results. After the surgery, the patient’s abdominal incision is almost invisible, and the postoperative recovery is fast and the results are very satisfactory. Laparoscopic surgery is an emerging minimally invasive technique and an inevitable trend in the development of future surgical methods. With the rapid advancement of industrial manufacturing technology, the integration of related disciplines has laid a solid foundation for the development of new techniques and methods, which, together with the increasingly skillful operation of physicians, has led to the fact that many past open surgeries have now been replaced by intracavitary surgery, greatly increasing the chances of surgical options. Similar to an electronic gastroscope, a laparoscope is an instrument with a miniature camera, and laparoscopic surgery is surgery performed using a laparoscope and its associated instruments: a cold light source is used to provide illumination, a laparoscopic lens (3-10 mm in diameter) is inserted into the abdominal cavity, and the images captured by the laparoscopic lens are transmitted through an optical fiber to a posterior signal processing system and displayed in real time on a dedicated on a dedicated monitor. The surgeon then uses the images of the patient’s organs from different angles displayed on the monitor screen to analyze the patient’s condition and perform the surgery with special laparoscopic instruments. Laparoscopic surgery is mostly performed with 2 to 5 holes, one of which is opened on the umbilical port of the human body to avoid leaving long scars on the patient’s abdominal wall, and after recovery, only 1 to 4 linear scars of 0.5 to 1 cm are left on the abdominal wall, so it is also called “keyhole” surgery. The development of laparoscopic surgery has reduced the pain of the patient’s incision and significantly shortened the patient’s recovery period, which is a major change in surgical technology in recent years. The Department of Gastrointestinal Surgery of Inner Mongolia Autonomous Region People’s Hospital is the first specialized center for the diagnosis and treatment of gastrointestinal surgery in the region. The department features the treatment of gastrointestinal and anorectal diseases, with emphasis on gastrointestinal tumors, and focuses on the development of minimally invasive treatment techniques for gastrointestinal diseases based on traditional surgery. In 2011, the Department of Gastrointestinal Surgery carried out more than 10 new technologies, and took the lead in Inner Mongolia region to independently carry out surgeries of domestic first-class level. In 2011, the Department of Gastrointestinal Surgery carried out more than 10 new techniques, and was the first one in Inner Mongolia to carry out the first-class surgery in China, such as laparoscopic radical gastrointestinal tumor surgery, laparoscopic appendectomy, intestinal adhesion release, gastrointestinal perforation repair, etc. In addition, they have successfully performed radical surgery for various gastrointestinal tumors for more than 10 elderly people over 80 years old, the oldest of whom was 86 years old, all of whom had no serious complications and were successfully discharged from the hospital; advanced gastric cancer is a difficult treatment point, so they introduced the concept of neoadjuvant radiotherapy and carried out combined organ resection for some advanced gastric cancer, such as total gastric combined with transverse colon resection, total gastric combined with spleen and pancreatic body tail resection, etc., which improved patients’ quality of life and survival. In November last year, the complete laparoscopic esophageal hiatal hernia repair with fundoplication (Nissen surgery) was completed independently to fill the gap in Inner Mongolia, providing patients with esophageal reflux disease with a minimally invasive treatment method that avoids open-heart or open abdomen! On the whole, the overall technical strength of gastrointestinal surgery in Inner Mongolia Autonomous Region People’s Hospital, especially the minimally invasive surgery technology, is at the leading level in the region, and some fields have reached the advanced level in China.