I. Indications of PPH 1. Circumferential prolapse of internal hemorrhoids of degree Ⅲ or Ⅳ, and internal hemorrhoids of degree Ⅱ that bleed repeatedly. 2, cause functional outlet obstruction type constipation anterior rectal dilatation, internal rectal prolapse. Second, PPH preoperative preparation 1, routine testing of blood routine, coagulation function, if necessary, do electrocardiogram. 2, preoperative day and night oral medication cleansing enema, or enema on the morning of the operation. (The night before the operation and the morning of the operation were injected into the anus 1 (20 ml) of Keserol). 3, the use of intrathecal anesthesia or general anesthesia is prohibited from eating and drinking on the morning of the operation. PPH intraoperative operation 1, the use of local anesthesia, intrathecal anesthesia or general anesthesia. Take the folding knife position, truncated position or lateral position. 2.Use round anal tube expander to expand the anus, insert transparent anal mirror under the guidance of the expander and fix it. If the prolapsed hemorrhoidal tissue is too much, it is appropriate to use non-invasive forceps to pull the anal canal outside to facilitate the placement, and after fixation, the pulled out tissue will be reset. The mucosa over the hemorrhoids should be fully exposed. 3.According to the lesion, under the exposure of the anoscopic stapler, a purse-string suture is made at 2,5~4,5cm on the dentate line. Possible single purse-string suture or double purse-string suture, if double purse-string suture, its spacing should be about 1,0 ~ 1,5cm. The purse-string suture should be all submerged in the submucosa and kept at the same level, and the purse-string suture needle should be inserted as far as possible from the point of needle emergence in situ, generally 3-7 stitches are appropriate. 4. Rotate the round anastomosis to the maximum position, introduce the nail drill bit and place it on top of the purse-string, tighten the purse-string and tie the knot. Pull the end of the purse string out of the lateral hole of the anastomosis with a wire banding device. 5. Pull the purse string moderately while tightening the anastomosis, and feed the round anastomosis into the anus up to the 4-cm mark. Female patients should be careful to prevent accidental injury to the posterior vaginal wall. 6.Strike the anastomosis, release the handle, and wait for 30 s. Rotate the anastomosis 1/2 to 3/4 circle and remove it to check the integrity of the resected mucosa. 7.Check the anastomosis carefully, in case of active bleeding site must use absorbable suture to stop bleeding. Fourth, PPH postoperative treatment 1, observe whether there is bleeding (including early and delayed bleeding). 2, can be placed in the rectal mucosal protective agent, to facilitate wound healing and defecation. 3.Treat urinary retention and pain accordingly. 4.It is appropriate to give appropriate prophylactic antimicrobial drugs. 5.After recovery from anesthesia, food can be eaten, and stimulating food should be avoided.