Male: 30 years old. Anal mass prolapsed for more than 5 years, had intermittent post-poo bleeding in the past, and the mass could retract on its own at the beginning of the prolapsed period after defecation, and was subsequently returned by hand for about a year. Diagnosis: multiple mixed hemorrhoids. Mixed hemorrhoids stage 3. Surgery: after conventional anesthesia poo towel. Mixed hemorrhoids truncated position 3 points 11 points. Do external stripping and internal ligation separately. First treat 3 points and then observe no bleeding and cut off the stump. Then deal with 11 points, and finally 11 points suture and stop bleeding after cutting off the stump. After finishing, routine finger probing was done and it was found that the two ligature points were in the same plane and there was resistance to enter one finger. After repeated finger probing several times, I finally withdrew my finger and found a large amount of blood gushing out from the anus. Instantly, I panicked. Because of the retraction of the ligature point, coupled with the tightness of the anus. Could not be exposed. The bleeding was even worse. As a result, during insertion, the ligature thread slipped out of the ligature point at the original 3 points because of the large caliber of the semilunar anoscope. The anus was loosened, and I was instantly devastated by the bleeding from both areas. When I pressed on one side, the other side still came out. Because the surgery was done with the operating room nurse. The nurse panicked and so did I because it was the first time I encountered bleeding from two bleeding sites together. In the panic, I exposed the 3 points of bleeding first, and ligated the superior hemorrhoidal artery with a deep stitch in the rectal mucosa above the upper part of the bleeding point where the sutures came off. The blood then arrived. Then 11 points of bleeding were treated. Because of the fear that the caliber of the pph semilunar anoscope is too large and that the original suture site will be propped up again, it is discarded and local pressure is applied to the bleeding point. After relieving emotion. Switch to bilobed anoscope with small caliber to protrude the 11-point bleeding, observe the bleeding site, find the bleeding point, and ligate it with sutures. The bleeding was stopped. Postoperative haemostatic drug application. Oil gauze filled. Experience one, intraoperative bleeding needs to be stopped, do not use a large caliber anoscope, easy to protrude the original suture ligation site. To use a flexible bilobed mirror of small caliber to prop up the exposure. Experience two, must be calm. Experience three, deal with multiple points of bleeding, one by one, the most effective way to stop bleeding, bleeding site above both hemorrhoids on the mucosal suture ligation, suture ligation site can be slightly deeper. Experience four, multiple mixed hemorrhoids after removing one, the appropriate amount of dry gauze trauma filling compression, and then do another. If secondary bleeding occurs, it is also convenient to observe. Experience five, the stump must be retained slightly more to prevent the silk thread from slipping out. Experience six, ligature point as far as possible not in the same plane, if really in the same plane, feel slightly tight, it does not matter, after the operation can mostly improve on their own. Experience seven, the assistant is very important, a good assistant, know how to effectively help you exposed. The surgery will go smoothly.