External peeling and internal ligation is a traditional and classic procedure for treating mixed hemorrhoids, and almost all of them can be treated using external peeling and internal ligation. External peeling is the process of peeling off the external hemorrhoids, peeling them clean, keeping them about 0.3cm above the inverse dentate line, and ligating the internal hemorrhoids. After dealing with the mixed hemorrhoids, if there are hemorrhoid nuclei elsewhere, they can be dealt with at the same time. This is a traditional and classic procedure for treating mixed hemorrhoids. Mixed hemorrhoids require surgery if they are severe, and most of them are formed after a certain degree of severity, and need to be treated with the external peel and tie knife procedure.