Minimally invasive hemorrhoid surgery 1: Automatic hemorrhoid ligation (RPH) RPH (automatic hemorrhoid ligation) is developed from the traditional ligation therapy of Chinese medicine in the motherland, this method is through a special automatic hemorrhoid ligature in the appropriate position 1.5-3cm above the tooth line to put a special rubber ring on the base of the hemorrhoid or the mucosa on the hemorrhoid, through the tightening of the rubber ring, blocking the blood supply to the hemorrhoid or reducing venous backflow, reducing the congestion of the hemorrhoid The hemorrhoids gradually fall off and the wound tissue is repaired and healed. It is one of the best treatment methods for non-surgical treatment at present. Zhang Xiling, Department of Anorectal Surgery, Shaanxi Provincial People’s Hospital Treatment principle: a. After ligation, the mucous membrane is wrinkled and the anal cushion is lifted; b. Local inflammatory reaction causes adhesion of the mucosa, submucosa and superficial muscle layer, and the anal cushion is fixed in a higher position; c. Partial shade cuts off the blood supply to hemorrhoids or reduces venous backflow, reduces congestion and hypertrophy of hemorrhoids or blood flow stasis, and makes hemorrhoids atrophy; d. Direct ligation of the base of hemorrhoids can stop bleeding immediately. Advantages: I. The whole process of lancing treatment is automated, which saves time, effort, practicality and simplicity; II. One person alone can complete the operation, which takes only 5-10 minutes; III. Disadvantages: It cannot be used for the treatment of simple external hemorrhoids, the external part of mixed hemorrhoids, anal papillary hypertrophy, rectal polyps. Indications: I. Internal hemorrhoids of all stages (best results for stages I-III); internal hemorrhoid part of mixed hemorrhoids; II. RPH can be used as supplementary treatment for hemorrhoid masses or incomplete anal cushion retraction after PPH or other therapies; III. Other: focal rectal lesions such as rectal polyps, rectal hemangiomas or vascular malformations. Contraindications: i. Simple external hemorrhoids; ii. External part of mixed hemorrhoids; iii. Anal papillary hypertrophy (special reminder: never mistake anal papillary hypertrophy for polyps or internal hemorrhoids and perform ligation); iv. Rectal polyps with suspected malignant changes. Overall evaluation: I. Among all non-surgical treatments, collar ligation has the best efficacy; II. The efficacy of collar ligation is second only to surgery; III. Collar ligation is the preferred treatment in Europe and America.