The car, a fine diet, a good meal …… These seemingly modest “pleasures” are silently providing a good opportunity for the arrival of hemorrhoids. The results of foreign epidemiological surveys show that the prevalence of hemorrhoids is as high as 4 to 55%, and the number of people who visit the clinic each year is close to 4 million. The science of healthy living and proper prevention and treatment of hemorrhoids has become urgent. For those who have been “unfortunate” enough to be caught up in hemorrhoids, it is extremely important to choose the right treatment. The common clinical treatments for hemorrhoids are conservative, instrumental, and surgical, with surgical treatment mostly used for patients for whom the first two treatments are ineffective, with priority given to hemorrhoid artery ligation for patients with moderate hemorrhoids. Hemorrhoid artery ligation is a procedure that blocks the blood supply to the hemorrhoid nucleus by ligating the arterial vessels supplying the hemorrhoid, thereby causing the hemorrhoid tissue to shrink and reducing the symptoms of hemorrhoid prolapse. This method uses a special proctoscope with a Doppler ultrasound probe to detect the arteries supplying the hemorrhoids and ligate them with sutures to achieve the treatment. Doppler ultrasound-guided hemorrhoidal artery ligation The operation is guided by an ultrasound Doppler diagnostic instrument to accurately search for and locate the arterial vessels supplying the anus, especially the hemorrhoidal nucleus area, to help determine the depth of needle entry, and to perform accurate and effective ligation and closure of the sutured vessels with the help of a thread pusher to block the blood flow and effective supply into the hemorrhoidal nucleus area. After completing the ligation of the selected hemorrhoidal artery, the anoscope is rotated again to detect the ligation effect, and if there is any unsatisfactory area it needs to be ligated again. In general, 3-5 groups of vessels can be selectively ligated in one operation. At the same time, around the ligated area, a local chronic inflammatory reaction is induced, which results in tissue fibrosis, causing adhesion and fixation of the mucosa and submucosa, resulting in gradual atrophy and disappearance of the hemorrhoidal nucleus, and ultimately a significant reduction in hemorrhoidal prolapse. Hemorrhoid artery ligation is mostly applied to stage II-III internal hemorrhoids and mixed hemorrhoids with mainly stage II-III internal hemorrhoids, especially for patients whose main symptom is bleeding. Patients are required to evacuate the bowels before the procedure, and if necessary, a cleansing enema is given with a small dose of anesthesia. Hemorrhoid artery ligation, hemorrhoid treatment into a new era of painlessness When it comes to the benefits of hemorrhoid artery ligation, the most noteworthy is that it greatly improves the comfort of the patient. Doppler-guided hemorrhoid artery ligation has the advantage of significantly reducing post-operative pain and quickly restoring the body’s condition, with a procedure that takes 19-35 minutes and is easy to perform, and can be done in an inpatient unit or on an outpatient basis. Only 0-38% of patients require analgesia after surgery, and most of the remaining patients do not require painkillers or hospitalization and can resume normal activities within a short time. This is mainly related to the fact that after successful surgical ligation of the artery, the blood supply to the hemorrhoid is reduced and the hemorrhoid starts to shrink, thus both bleeding and painful symptoms can be effectively controlled. Moreover, after the tension in the hemorrhoidal lesion is reduced, the connective tissue in it begins to regenerate, which in turn further promotes the shrinkage of the hemorrhoid and ultimately achieves the desired healing effect, greatly reducing the probability of postoperative complications, such as postoperative bleeding. Of course, hemorrhoid artery ligation is not perfect, and its disadvantage lies in the high rate of postoperative recurrence in patients with grade IV hemorrhoids. However, clinical measures are taken to help reduce the recurrence rate, such as combining mucosal fixation. Patients should also pay attention to good local hygiene and cleanliness after surgery and adhere to abstinence, appropriate activity, and regular follow-up. References [1] Committee of Colorectal and Anorectal Diseases of the Chinese Society of Integrative Medicine. Chinese guidelines for the treatment of hemorrhoids (2020) [J]. Colorectal and Anal Surgery,2020,526-527. [2]Chen Shao-Ming. Illustration of new techniques for the treatment of anorectal diseases [M]. Shenyang:Liaoning Science and Technology Press,2008:71-73.