Recently, the Department of General Surgery of our hospital successfully performed a modified Duhemal operation (radical megacolon surgery) for a 33-year-old male patient with congenital megacolon, who recovered well after the operation and had a clear stool, with a long-awaited smile on his face. The patient is a farmer in Yonghe Township, Anyang County, and although he is already an adult, he looks much thinner compared with his siblings, and his nutrition and development are poor. The patient was found to have difficulty in defecating after birth, and could only defecate once a week or so, but due to the poor family circumstances at the time, there has been no condition to seek treatment in a large hospital, more than 30 years of the disease will be tormented by the patient’s suffering. As the disease worsened with age, the patient’s health deteriorated, and he spent his days holding his hands in a drum-like swollen and hard stomach, relying on cathartics and laxatives to pass stools, and his stomach would swell like a drum if he didn’t have a bowel movement for a few days, so he couldn’t eat, and he suffered unbearably. Although the patient has also seen several large hospitals as an adult, have not been able to diagnose what is the disease, the money spent a lot, but the treatment effect is very poor. It was not until January that the patient sought out a specialist. After a careful examination of the patient, a specialist did colonography and other tests for the patient and soon made a clear diagnosis that this was a rare case of congenital megacolon in adults. This type of disease is very difficult to treat, the surgical method is very complex, and the postoperative results are uncertain. Leveraging years of research on colorectal diseases and deep sympathy for the patient, a specialist decided to admit the patient to the hospital for surgery. Congenital megacolon is a malformation of intestinal development caused by congenital absence or reduction of ganglion cells in the intermuscular plexus of the colonic wall, mostly seen in newborns and children, while congenital megacolon in adults is very rare. In the literature, there are very few reports in this area, and it is difficult to have experience in treating this disease. For this reason, Dr. Jia repeatedly studied the condition, designed the surgical plan, organized several consultations and discussions with relevant specialists in general surgery, pediatric surgery and anesthesiology, developed a thorough preoperative preparation plan for the patient’s characteristics, and repeatedly discussed the surgical approach. Preoperative preparation for this type of surgery is crucial, and if the intestine is not adequately prepared, there is a risk of surgical failure. It was found that the patient’s colorectum had been in a nearly non-functional state for more than 30 years, and the intestinal canal was severely dilated, with a large amount of stored stool in the intestinal cavity above the stenosis, making the preoperative bowel preparation extremely difficult. It takes three to four hours per day for colonic irrigation alone, and nearly 10,000 ml of saline is needed for irrigation every day. A specialist visited the ward every day to carefully check the patient’s enema situation. The doctors and nurses of the Department of General Surgery were patient and thoughtful in observing the changes in the condition and carefully making all the preoperative preparations.