1.RPH automatic hemorrhoid ligation Automatic hemorrhoid ligation (RPH) Introduction Automatic hemorrhoid ligation (RPH) is developed from the traditional ligation therapy of Chinese medicine in the motherland, this method is through a special automatic hemorrhoid ligature in the appropriate position 1.5 to 3 cm above the tooth line will be specially designed. The ligature is applied to the base of the mucosa on the hemorrhoid or hemorrhoids, and through the tightening and strangulation of the ligature the blood supply to the hemorrhoid is blocked or the venous backflow is reduced, reducing the congestion and hypertrophy of the hemorrhoid or the stagnation of the blood flow, causing ischemia, atrophy and necrosis, and the ligature tissue gradually falls off and the traumatic tissue is repaired and healed. It is one of the best treatment methods for non-surgical treatment at present. (2) Local inflammatory reaction causes adhesion of mucosa, submucosa and superficial muscle layer, and the anal cushion is fixed in a higher position; (3) Partially blocking the blood supply of hemorrhoids or reducing venous backflow, reducing congestion and hypertrophy of hemorrhoids or stagnant blood flow, causing hemorrhoids to atrophy; (4) Direct ligation of the base of hemorrhoids can stop bleeding immediately. (1) The whole process of ligation treatment is automated, which saves time, effort, practicality and simplicity; (2) One person alone can complete the operation, which takes only 5-10 minutes; (3) No anesthesia is needed, no hospitalization is required, and the price is low; (4) The pain is mild and complications are rare; (5) No scar remains after the operation, which does not destroy the normal structure and appearance of the rectum and anal canal, and brings great convenience to the subsequent treatment (5) Postoperative scarring does not destroy the normal structure and appearance of the rectum and anal canal, which is very convenient for subsequent treatment. 4.Disadvantages It cannot be used for the treatment of simple external hemorrhoids, external part of mixed hemorrhoids, anal papillary hypertrophy and rectal polyps with suspected malignant changes. 5. Indications (1) Internal hemorrhoids of all stages (stage I-III is the most effective); internal hemorrhoids of mixed hemorrhoids; (2) RPH can be used as supplementary treatment for those who have incomplete retraction of hemorrhoids or anal cushions after PPH or other treatments; (3) Others: focal lesions of the rectum, such as rectal polyps, rectal hemangiomas or vascular malformations, etc. 6. Contraindications (1) Simple external hemorrhoids; (2) External hemorrhoids of mixed hemorrhoids; (3) Anal papillary hypertrophy (special reminder: do not mistake anal papillary hypertrophy for polyps or internal hemorrhoids and perform ligation); (4) Rectal polyps suspected of malignant change. 7, operation points and precautions (1) before the operation should first defecate, or induce defecation with open cork. (2) After surgery to keep the stool open; prohibit spicy, alcohol and other foods; can be used with sitz bath, topical yao cream, anal yao pessary, use antibiotics as appropriate. (3) Some patients have a feeling of swelling after surgery, which can generally be relieved by symptomatic treatment. In case of occasional postoperative bleeding, it is advisable to stop the bleeding by re-ligating or suturing under anal speculum. (1) Among all non-surgical treatments, the efficacy of collar ligation is the best; (2) The efficacy of collar ligation is second only to surgery; (3) Collar ligation is the preferred treatment in Europe and America.