Hemorrhoids are common in anorectology, and as the saying goes, “nine out of ten people have hemorrhoids”. Many outpatients ask, “Is there minimally invasive surgery?” “The advertisements of the xxx clinic or xxx hospital claim that minimally invasive surgery is painless, quick recovery, and has no after-effects.” In the age of information, medical advertisements for the treatment of hemorrhoids are everywhere in the media, making it difficult to distinguish the truth from the falsehood. Is there really a “minimally invasive” surgery for hemorrhoids? What is minimally invasive? As the name implies, it is a tiny incision, trauma. It is a technique that causes only minimal trauma to the patient during the surgical treatment and leaves only a tiny incision after the surgery, which is a technological achievement compared to traditional surgery. Minimally invasive, there is no precise definition. However, many surgeons believe that minimally invasive should be relative to traditional surgery and has four main characteristics: small incision, less trauma, faster recovery and less pain. Minimally invasive surgery is a medical revolution brought by high technology. For example, various types of lumpectomy. First, let’s understand “what are hemorrhoids”? There are two views: one is that hemorrhoids are bulging veins in the lower rectum or the anal canal that are formed by varicose veins at the end of the rectum. Based on this theory, hemorrhoid ligation, injection therapy (sclerotherapy), withered hemorrhoid therapy, rubber banding therapy, laser microwave ultrasonic knife excision, ultrasound-guided superior hemorrhoid artery ligation, HCPT hemorrhoid ablation, and so on, have been created. Another new theory is that hemorrhoids are a special tissue structure called the “anal cushion”, which is formed in the fetus and its function is to assist in the normal closure of the anus and to control defecation, just like the role of a faucet washer. Based on this theory, the PPH procedure (suprahemorrhoidal mucosal circumcision) was created. After the formation of hemorrhoids, not everyone will have symptoms, and symptomatic hemorrhoids are called hemorrhoids. The usual term hemorrhoids actually refers to hemorrhoid disease. Therefore, not all hemorrhoids require surgical treatment. Laser removal, microwave treatment, ultrasonic knife removal, HCPT ablation (high frequency capacitive field treatment) are the so-called “minimally invasive surgeries” that are currently advertised by the major online media to capture the psychology of the patients, exaggerating and even abusing the concept of minimally invasive. These procedures are still the same kind of surgery as ligation surgery. The only thing is that laser, microwave, ultrasonic knife, and high frequency capacitive field are used instead of ordinary scalpel. There is no advantage compared to ligation in terms of healing time and wound size, and some even far exceed the healing time of ligation. Pain or no pain depends on the surgeon’s surgical technique, the patient’s tolerance of pain, and the patient’s psychology. The PPH procedure is based on the theory of inferior displacement of the anal cushion, and is a circular excision of the prolapsed rectal mucosa above the hemorrhoid using an anastomosis, which is more effective for patients with prolapsed cricoid internal hemorrhoids. Again, because the procedure has strict indications (for cricoid prolapsed 3°-4° internal hemorrhoids), it is not applicable to all hemorrhoids and can only be a supplement to traditional hemorrhoid surgery, and is far from being able to overturn it. Hemorrhoids are a common condition and the various treatments can be overwhelming, and we advise against believing the false and exaggerated medical advertisements in the media that mislead patients so as not to cause unnecessary and serious post-operative complications. So what is the best method of treatment? We advocate that the most appropriate method for the individual condition is the best choice. No one treatment or procedure is suitable for all patients.