PPH (procedureforprolapseandhemorrhoids), which is an anastomotic mucosal circumferential hemorrhoidectomy, is the latest international surgical method for hemorrhoids, especially the epoch-making revolution in the treatment of severe hemorrhoids. This procedure has been widely carried out in China since 2000. PPH is a new procedure performed under the guidance of the modern concept of hemorrhoids, i.e., the theory of submigration of the anal cushion, which uses special surgical instruments and anastomosis to circumferentially excise the rectal mucosa and submucosal tissue about 2cm wide above the dentate line, and then anastomoses the rectal mucosa so that the prolapsed anal cushion is suspended upward and restored, restoring the local anatomical relationship between the anal canal mucosa and the anal sphincter. The symptoms of prolapsed hemorrhoids are cleared and the effect of “suspension” is played; at the same time, the end branches of the subrectal arteries and veins are removed and ligated so that the blood supply to the hemorrhoids is reduced and the hemorrhoids gradually atrophy, removing the bleeding hemorrhoids and playing the role of “cutting off the flow”. The second hospital of Jilin University, colorectal and anal surgery Fan Enxue II. Indications 1. Severe circumferential prolapsed internal hemorrhoids (Ⅲ-Ⅳ degree mixed hemorrhoids). 2.Progressive grade II internal hemorrhoids. 3.Internal prolapse of rectal mucosa. 4.Inset hemorrhoids. 5.Anterior rectal protrusion. Advantages and disadvantages of PPH surgery compared with traditional surgery: Advantages: The biggest advantages of PPH surgery are: (1) Because the hemorrhoid tissue is not removed, the perianal skin and the pain-sensitive area around the dentate line are not damaged, so the postoperative pain is significantly reduced compared with traditional surgery. (2) Because the surgical procedure solves the root cause of hemorrhoids, the immediate and long-term results are ideal and will not recur. (3) Since there is no invasive surface in the anal canal area, the postoperative anal appearance is beautiful and does not affect the patient’s fine defecation function. (4) Less postoperative complications and significantly shorter time to return to work, generally 3 days to normal work. Disadvantages: PPH instruments are expensive. Currently commonly used in the United States Johnson & Johnson PPH anastomosis, reliable quality, but more expensive, the current price between more than 4,000 yuan each, the price of domestic anastomosis from reusable more than a thousand yuan to more than 3,000 yuan for single-use, but the stability is slightly different.