The 2006 edition of the Guidelines for the Clinical Management of Hemorrhoids states that asymptomatic hemorrhoids do not require treatment; that the aim of treatment is to eliminate and reduce symptoms; and that relieving symptoms is more meaningful than changing the size of the hemorrhoid body. With the increasing understanding of anorectal anatomy, in-depth research on the mechanism of hemorrhoids, the introduction of minimally invasive techniques and concepts, and the application of modern high technology, the treatment of hemorrhoids is constantly improving. At present, the general trend in the treatment of hemorrhoids is a combination of Chinese and Western medicine, non-surgical therapy and surgical therapy combined with minimally invasive and painless comprehensive treatment methods valued by doctors and patients. Minimally invasive medicine includes two parts: minimally invasive concept and minimally invasive technology. Minimally invasive concept runs through the whole process of disease diagnosis and treatment; minimally invasive technology implementation is guided by minimally invasive concept. The minimally invasive concept and minimally invasive technology require “the least possible or smallest possible trauma” to achieve the same good results at the least possible cost to the patient. The treatment of hemorrhoids can be seen in the following: 1. Drug therapy Drug therapy has internal and external drugs for internal hemorrhoids bleeding, internal hemorrhoids prolapse, painful thrombosed external hemorrhoids, painful inflammatory external hemorrhoids edema, etc. Drug therapy does not damage the muscle tissue, can relieve the symptoms, is the first choice of treatment for mild hemorrhoids, combined with a good daily diet, bowel habits and functional exercise can avoid the onset and development of hemorrhoids. 2.Injection therapy Injection therapy has long been a non-surgical treatment for internal hemorrhoids of degree I-II. The advantage is that the effect of treating internal hemorrhoids is comparable to surgery, less painful, and shorter treatment time. Injectable therapy can be divided into necrotizing withering method and sclerosing atrophy method according to the effect of injectable drug on the tissue. This method has a small postoperative reaction and produces less local scars, generally injected in the submucosal layer, too shallow or not much injection effect is not obvious, too deep injection or too large a dose can cause serious complications. 3.Physical therapy Physical therapy for hemorrhoids, such as freezing, laser, infrared, copper ion electrochemical therapy, etc., are mostly applicable to stage I-II internal hemorrhoids, simple operation method, short treatment time, do not require hospitalization, popular with patients. The laser therapy is short, less invasive, light postoperative reaction; the indications are wide, pregnancy, senior patients or patients with other comorbidities are not suitable for more invasive surgery by laser treatment can achieve good results, some heart disease, hypertension patients can also use this procedure. However, laser treatment has the disadvantages of obvious edema, pain, bleeding during the detachment period, and some patients cannot be operated successfully in one time. Infrared coagulation can stop bleeding, but it is not as fast as injection therapy; cryotherapy has poor results and postoperative pain, so it is rarely used now. Copper ion electrochemical therapy, through the electrodes of copper ions into the internal hemorrhoids, combined with the blood substances to form copper complexes, the complexes in the tissue to slow the microvascular blood flow, coagulation, epithelial cells of the blood vessel wall edema, aseptic inflammation, necrosis, mechanization, the number of capillaries in the hemorrhoid body to reduce the amount of stasis, hemorrhoid body atrophy become smaller, to achieve the purpose of treatment. This method is simple and easy to treat bleeding and prolapsed internal hemorrhoids of degree II, but the efficacy of this method on external hemorrhoids is not exact. 4.Ligature-Ligature therapy Ligature therapy is an old method of treating hemorrhoids, and the ligature method is a development based on the traditional ligature, which can be considered as an improved elastic ligature therapy. It is mainly applied to the internal hemorrhoid part of stage I, II, III, IV internal hemorrhoids and mixed hemorrhoids. The treatment time of this therapy is relatively long, the patient suffers a lot, and among the complications there are still bleeding, pain, swelling, edema, infection, difficulty in urination, and anal stenosis. However, there are many improvements in this method, and the ligation method combined with the peel-and-strip excision of external hemorrhoids – the external peel-and-strip procedure (Milligan Morgan procedure) is the mainstream procedure used by anorectal surgeons to treat mixed hemorrhoids, especially severe hemorrhoids, and mixed hemorrhoids with other anal diseases. With the application of minimally invasive concept and minimally invasive technology, anorectal clinicians have made a lot of efforts to preserve the anal cushion, dentate line, and skin bridge, as well as the overall appearance of the anus, which can effectively protect the anal function and reduce the occurrence of postoperative complications after treatment. Long-term clinical practice has confirmed that external peeling and internal ligation has obvious and long-lasting therapeutic effects on improving clinical symptoms and signs. 5.Anastomotic suprahemorrhoidal circumferential hemorrhoidectomy The anastomotic suprahemorrhoidal circumferential hemorrhoidectomy (referred to as PPH) is a new technique for treating hemorrhoids developed in recent years with the rise of the doctrine of inferior anal cushion migration. This procedure is aimed at eliminating symptoms. The prolapsed anal cushion is repositioned through surgery and the structure of the anal cushion is preserved as much as possible during the procedure in order to achieve the goal of not affecting or minimizing the ability of fine bowel control after surgery. The indications for the surgery are stage III and IV prolapsed internal hemorrhoids and circular mixed hemorrhoids mainly internal hemorrhoids, stage II and III hemorrhoids that have failed other surgeries, and prolapsed rectal mucosa. The advantages of this procedure compared with traditional surgery are: simple operation, short operation time, less intraoperative bleeding; effective treatment of prolapsed circumferential internal hemorrhoids and bleeding caused by hemorrhoids; light postoperative anal pain, short time, and few long-term complications; short postoperative hospital stay, and early return to normal life and work. This procedure is expensive and the long-term efficacy is uncertain, and complications and sequelae such as urinary retention, anal pain, anastomotic bleeding and stenosis, anorectal dysfunction such as urgency, postoperative infection and perforation can occur. Improper surgical operation technique is prone to recurrence after surgery. 6.Ultrasound Doppler-guided hemorrhoid artery ligation Hemorrhoid artery ligation (DG HAL) is a simple, safe, painless, effective and less invasive minimally invasive method for the treatment of II and III degree internal hemorrhoids, which is a new treatment technique integrating ultrasound exploration and suture surgery. By quickly determining the location of the hemorrhoidal artery through a specially designed proctoscope with an ultrasonic probe and suturing the hemorrhoidal artery, the blood supply to the hemorrhoid is blocked and the internal pressure in the venous plexus of the hemorrhoid is reduced, achieving rapid hemostasis and shrinkage of the hemorrhoid, which is highly effective for bleeding hemorrhoids. At the same time, the ligature effect can make the rectal mucosa and submucosal tissue adhesion fixed, prevent the anal cushion from moving down, also can achieve the purpose of eliminating the symptoms of hemorrhoid prolapse. However, this procedure has been used in the clinic for a short time, and although the recent efficacy is satisfactory, the postoperative period may be complicated by submucosal hematoma of the anal canal, edema of the external hemorrhoid tissue or formation of thrombosed external hemorrhoids, hemorrhage, pain and infection, and the long-term efficacy is yet to be observed. There is also the more publicized HCPT treatment, which uses high-frequency capacitive electric field heat generation principle to convert electrical energy into heat energy to make the treatment site tissue necrosis, dry nodules, and then fall off, and get the treatment effect. It is suitable for some simple anal diseases, such as first and second stage internal hemorrhoids, isolated thrombosed external hemorrhoids and inflammatory external hemorrhoids, anal fissure, low simple anal fistula, perianal warts and so on. However, the treatment also damages human tissues and requires a tissue repair process, with complications such as severe defects in the epithelium of the anal canal, anal or rectal stenosis, and infection of the wound. Later observation and treatment are required. There is no hemorrhoid treatment method that can be called an absolutely perfect hemorrhoid treatment method, and each method has its own indications. In the whole process of hemorrhoid treatment clinicians will follow the principle of individualized treatment under the guidance of minimally invasive concept, for different stages of hemorrhoid disease comprehensive and reasonable choice of safe, effective and economical minimally invasive treatment methods to reduce the patient’s pain and speed up the recovery time.