Constipation is a common clinical symptom rather than a disease, mostly manifested as reduced frequency of bowel movements, dry and hard stools and difficulty in defecation. The incidence of constipation is high, with 22% of the population over 60 years of age in China, and over 65 years of age in Europe and the United States, with a prevalence of 26% for men and 34% for women. There are many causes of constipation, but there are two points worth noting, one is the Shanghai people’s diet is too fine, the texture of food is too fine, too little fiber intake; the other is the abuse of diet pills, many diet pills in the market contains stimulating laxatives, such as if the guide (phenolphthalein), rhubarb and senna, long-term use can stimulate the intestinal mucosa and intestinal wall plexus, may cause muscle weakness of the large intestine, resulting in ” Inert” colon, leading to or aggravating constipation. A strange phenomenon is that most patients do not consider constipation to be a disease. A British study found that only a quarter of constipated patients sought medical attention, while the vast majority took laxatives on their own. In fact, the consequences of constipation are very serious, long-term constipation can affect brain function, leading to memory loss, distraction, as well as depression, obsessive-compulsive and other psychological disorders. Female patients can cause endocrine disorders, skin pigmentation, itching, chloasma, acne and acne, etc. In the elderly and patients with cardiovascular disease, constipation is an important trigger for sudden death. Recent studies have shown that patients with constipation also have a significantly higher chance of developing colorectal cancer and benign tumors. Also, constipation can be caused by underlying diseases such as diabetes and thyroid disease, or more seriously, intestinal tumors can cause intestinal obstruction leading to constipation. Self-abuse of laxatives may delay the diagnosis. Therefore, the 2013 Chinese chronic constipation guidelines state that if constipation persists for more than 3 months, patients under 40 years of age may receive 2 to 4 weeks of formal empirical treatment, and if constipation does not improve, they must undergo colonoscopy, biochemical and other related tests, and for patients over 40 years of age with alarm signs (meaning blood in stool, anemia, wasting, fever, black stool), objective tests including colonoscopy must be done without delay. The use of laxatives is also important, and graded drug therapy should be used, with fibrin preparations as the first-line drugs, volumetric laxatives as the second-line drugs, osmotic cathartics as the third-line drugs, and stimulant cathartics and intestinal motility drugs as the fourth-line drugs. Abuse of laxatives can cause laxative dependence, intestinal dysfunction and thus aggravate constipation, and even cause colorectal melanosis. The vast majority of patients with constipation for more than 6 months, clinically known as chronic constipation, chronic constipation is divided into two kinds of organic and functional. The main clinical target of constipation treatment is patients with chronic functional constipation, also known as habitual constipation. Treatment should be individualized and comprehensive, including dietary guidance, psychotherapy, biofeedback therapy, and drug ladder therapy. The first step should be lifestyle modification, such as increasing the intake of fiber and water in the diet and drinking at least 1.5-2.0 liters of water per day. At the same time, moderate exercise and regular and orderly bowel habits should be established. Patients are advised to have a bowel movement in the morning because when a person changes from lying down to standing up after waking up, an upright reflex occurs in the colon, which can cause a strong urge to defecate. If the patient does not respond to the above treatment, then it is possible that the constipation is persistent and further consultation and treatment is needed. There are three types of functional constipation, specifically slow transmission colon, outlet obstruction, and mixed type. The main tests are colonic transmission test, fecal imaging and anorectal manometry. If the type of constipation is clearly identified, the patient’s symptoms are more severe and surgery can be considered after a period of ineffective medical treatment. Can constipation still be operated on? Many constipated patients in outpatient clinics are in pain but have a doubtful vision. In fact, surgical treatment of constipation was started as early as the Victorian era in England. However, there are several reasons for the stagnation over the years. Patients with constipation mainly come to the clinic to improve their symptoms and quality of life, and therefore have a higher demand for surgical results. Secondly, intractable constipation is mainly of mixed type, and more than 90% of domestic reports are of mixed type, so the previous surgical efficacy of using surgery for a single slow transmission or outlet obstruction is poor. In recent years, subtotal colectomy with a modified Duhamel procedure has been used to treat it. The actual procedure was originally designed to treat congenital megacolon. This procedure removes the slow transmission factor by subtotal colectomy and removes the exit obstruction factor by effectively fixing the rectum and pelvis with a large diameter rectocolonic anastomosis. The combination of the modified Duhamel procedure with subtotal colectomy corrected both slow transmission and outlet obstruction, resulting in a satisfactory clinical outcome. This procedure was done laparoscopically with minimal surgical trauma and rapid postoperative recovery.