PPH (procedure for prolapse and hemorrhoids) was reported by Pescatori in 1997 for the treatment of prolapsed rectal mucosa using a transanal anastomosis, and in 1998, Longo, an Italian scholar, used this technique for the treatment of prolapsed hemorrhoids and described the mechanism of rectal mucosal excision for the treatment of prolapsed hemorrhoids. The mechanism of circumferential resection for the treatment of prolapsed hemorrhoids was described. The surgical method has the advantages of not destroying the anal cushion, not damaging the perianal skin, light postoperative anal pain, fast recovery, and satisfactory recent results. I. Surgical steps: 1. Three points with less prolapsed hemorrhoids and less mucosal ectasia are fixed and propped up with three non-invasive forceps, so that the circular anal canal dilator (CAD33) can be introduced more easily. The introduced CAD33 partially repositioned the prolapsed hemorrhoid or mucosal prolapse of the anal canal. After removal of the internal pessary, the prolapsed mucosa falls into the sleeve of the CAD33. Since the CAD33 is transparent, we can see the dentate line through it. 2. The anoscopic suture ligature (PAS33) is introduced through the CAD33. This device obscures the prolapsed mucosa around the rectal wall at 270 degrees, so that the suture only closes the portion of the prolapsed mucosa exposed through the opening of the PSA33. The sutures must be placed at a distance of more than 3 to 4 cm from the dentate line. Of course, the exact position should be adjusted according to the degree of prolapse. By rotating the PSA33, the entire perimeter of the anal canal can be closed with a purse-string suture. 3. Rotate the circular hemorrhoidal anastomosis (HCS33) to its maximum position. Introduce the HCS33 # so that the head end is deep to the upper end of the purse string, and then knot the suture. With the help of the straps ( ST100 ), pull the trailing end of the suture out of the lateral hole of the HCS33. The suture dragged outside the anastomosis is knotted or secured by means of a clamping forceps. Introduce the head of the HCS33 completely into the anal canal, partially tightening the anastomosis during this procedure is recommended. 4. With moderate pulling of the purse-string suture, the prolapsed mucosal layer is placed into the cavity of the head of the HCS33. The anastomosis is closed, and the prolapsed mucosa in the cavity is dissected. Keep the HCS33 in a closed position for at least 30 seconds after firing to aid in hemostasis. Gently unscrew the HCS33 and remove it from the anal canal. 5. Inspect the anastomosis through the PSA33. If needed, a few stitches can be added. II. PPH surgery is suitable for severe (stage III-IV) circumferential internal hemorrhoids and mixed hemorrhoids with mainly circumferential internal hemorrhoids, anterior rectal protrusion, and incomplete rectal prolapse. Compared with traditional surgery, PPH surgery has the following advantages: simple surgery, short time, less bleeding; fine postoperative stool control ability is not affected; postoperative pain or no pain, few complications, low recurrence rate; patients can quickly return to normal life after surgery.