How can I understand the phenomenon of many names for hemorrhoid surgery? Although the diagnosis of hemorrhoids does not seem complicated, there are many names for their surgery, such as external incision and internal ligation, excision and suturing, segmental dentate ligation, and broken bridge suturing, etc. Some names are the first time even our specialists have heard of them. This is because some doctors tend to make some small improvements on the basis of the basic procedure and then give it a different name, which leads to a dazzling variety of names for hemorrhoid surgery. However, from the basic method of hemorrhoid surgery, external hemorrhoids are usually excised or peeled and excised combined with sutures; internal hemorrhoids are excised after ligation, or excised and sutured. For internal hemorrhoids, the method of anastomotic stapling (PPH) after excision of the supra-mucosal ring of hemorrhoids is more commonly used. The surgical approach for mixed hemorrhoids is a combination of surgical management of external and internal hemorrhoids. If you ask your doctor in detail about the basic method or principle of treatment, you will be able to roughly understand the basic procedure that corresponds to the name. The current surgical treatment of internal hemorrhoids can be divided into two main categories. The first type is the method of removing the internal hemorrhoid itself, which is mostly done by ligating or excising the internal hemorrhoid and suturing it. The other type of treatment method is not to remove the internal hemorrhoid itself, such as PPH procedure, which is a method of circumferential removal of all mucosa above the internal hemorrhoid and then anastomosis without directly removing the hemorrhoid nucleus, and ultrasound-guided hemorrhoid artery ligation, which is a method of ligating the small artery above the hemorrhoid nucleus under ultrasound Doppler guidance. What is internal hemorrhoid ligation therapy? Internal hemorrhoid ligation therapy is a method of blocking the blood supply to the nucleus of the hemorrhoid by ligating or stitching the root of the internal hemorrhoid with threads, causing ischemic necrosis and detachment. Internal hemorrhoid ligation therapy is the basic method of treating internal hemorrhoids in Chinese medicine. The thread for ligating internal hemorrhoids used to use spider silk or drug-impregnated medicinal thread, but nowadays, silk thread or chemical synthetic thread is generally used. Ligation therapy is mainly used for the surgical treatment of stage II and III internal hemorrhoids or the internal portion of mixed hemorrhoids, anal papillary fibroids, and status rectal polyps. Because ligation of external hemorrhoids can lead to more intense pain, ligation therapy is generally not used to ligate external hemorrhoids. The basic operation of internal hemorrhoid ligation therapy is that the patient is placed in a lateral or truncated position, the anorectal field is disinfected, anesthesia is prepared, a small incision is cut along the tooth line with a tissue clamp at the root of the internal hemorrhoid, a round needle with a thread is passed under the curved hemostatic clamp, and the hemorrhoid nucleus is ligated in the shape of an “8”, and after most of the hemorrhoid nucleus is cut off, the hemorrhoid nucleus is returned to the anus. The stump is returned to the anus and injected into the anus with oil or hemorrhoidal ointment and fixed with a dressing.