Hemorrhoids (commonly known as hemorrhoids) are a common disease located in the anal area that can develop at any age, but the incidence gradually increases with age. In China, hemorrhoids are the most common anal disease, and there is a saying that “nine out of ten men have hemorrhoids” and “ten out of ten women have hemorrhoids”. There is an etiological theory that hemorrhoids are soft venous masses formed by the enlargement and varicosity of the venous plexus under the mucous membrane at the end of the rectum and under the skin of the anal canal. It is a part of the body that is stagnant due to poor circulation and blood flow, so there is no such thing as eradicating it, just restoring it to its original size. Peng Hui, Department of Gastroenterology and Anorectal Surgery, The Sixth Hospital of Sun Yat-sen University Anastomotic Circumferential Hemorrhoidopexy is the removal of the prolapsed rectal mucosa located above the dentate line using a special circular anastomosis (banding) —- to bring the prolapsed hemorrhoid back into place. It can significantly change the preoperative discomfort and reduce postoperative complications. The DST hemorrhoidal anastomosis is a circular anastomosis using the Directional Stapling Technology (DST), which has the advantage of “safety and precision” to reduce intraoperative bleeding and postoperative complications, especially for prolapsed III-IV mixed hemorrhoids, cricoid hemorrhoids, and some hemorrhoids with severe bleeding. The DST patent ensures that the procedure is carried out in a safe and precise manner. First, a patented DST ensures safe and reliable surgery. Compared with traditional anastomosis, the patented DST technology has improved the staple leg and anvil of the circular anastomosis, the rectangular staple leg is more robust, easier to penetrate the hypertrophic tissue and less prone to distortion; the teardrop-shaped staple anvil increases the area to receive the staple leg, which is perfectly formed at different angles and less prone to deflection. The tough staple strength and strong staple line provide excellent hemostasis! Secondly, the two staple leg heights allow for individualized surgery. 3.5mm is suitable for normal mucosal and submucosal circumcision; 4.8mm is suitable for thicker tissues such as larger hemorrhoids, multiple hemorrhoids of different sizes. Thin tissues are tightly stapled, thick tissues are closed without worry, and they can be properly stapled in all cases, making hemorrhoid circumcision truly personalized! The last three purse holes achieve quantitative resection. Different degrees of hemorrhoids require different tissues to be removed, and the DST hemorrhoid anastomosis provides three holes that can be quantified, making the procedure more scientifically accurate. The amount of tissue to be removed is evaluated according to the degree of hemorrhoid development, making the procedure more humane and avoiding a one-size-fits-all approach! Surgical operation method: (1) Preoperative bowel preparation, selection of lumbar anesthesia or intra-sacral anesthesia, prone folding position, routine disinfection of perineum and laying of towels. (2) Lubricate the dilator, gently place it into the anal canal, and then take it out. (3) Put the anal speculum components (dilator, anal speculum and winged anal rest) together and gently place them into the anal canal. (4) Remove the dilator and anal speculum and secure the winged anal support to both buttocks with sutures (fixation is an optional step). (5) Make a uniform circumferential purse in the mucosal and submucosal layers; the purse should receive the tissue desired to be stowed, and the purse should be appropriately positioned from the dentate line. (6) Place the nail anvil head into the purse, select an appropriate fixation hole in the central bar, pull the purse tightly around the central bar, and tie a knot to secure it. (7) Dock the nail anvil to the body of the instrument, close the instrument completely and fire. (8) After striking, gently withdraw the instrument and check the hemostasis of the staple line. Safety, the most important purpose of hemorrhoid circumcision, is the patented DST hemorrhoid anastomosis technique was created to effectively stop bleeding and avoid recurrence. Its performance in the clinic has constantly confirmed this, and its scientific design concept has made the operation more precise and has reduced the pain for the majority of patients.