The “anal pad”, also known as the haemorrhoidal zone, is the anatomical and physiological basis of the modern concept of hemorrhoids. In Chinese, it is translated as anal lining and vascular lining of the anal canal, usually called anal pad. Since the 1970s, the study of hemorrhoids has made breakthroughs, and anatomical, histological and physiological discoveries have given the modern concept of hemorrhoids. The pathological hypertrophy of the anal cushions is known as hemorrhoid disease”. This new concept has been supported by many famous scholars and has been gradually recognized in China’s anorectal surgery community in the past 10 years. The new concept of hemorrhoids has been widely adopted in the newly published monographs and textbooks on anorectology at home and abroad. Most scholars have now confirmed that the anal cushion is the locally thickened mucous membrane and submucous tissue in the anal canal. It is a block of tissue made up of relatively concentrated rectal columns (6-14). The 3-lobed state of the anal cushion is an inherent morphological pattern of the human anal canal mucosa and is not pathological. It is well known that the basic structure of the intestinal wall can be divided into 4 layers, which extend down to the recto-anal region with some morphological changes, namely: the mucosal layer is replaced by the atz epithelium from the rectal type epithelium, the circular muscle layer is thickened and named the internal sphincter, and the longitudinal muscle layer merges with the anal raphe fibers and is called the joint longitudinal muscle; unfortunately, only the submucosal layer has been ignored by clinical anatomists for a long time. Numerous studies have confirmed that the anal cushion is a normal human anatomical structure that is present in everyone regardless of age, sex, and race. The submucosal spongy vascular tissue of the anal canal, with abundant arteriovenous anastomoses, is spongy in structure. The special shape of the blood vessels in the spongy space is essentially the result of direct anastomotic traffic between the arteries and veins, which is called the rectal spongiosa. The rectal cavernous body is composed of blood vessels, smooth muscle (treitz muscle), elastic fibers, and connective tissue. Comparing the 25 autopsy specimens with the resected hemorrhoids, it was found that the resected hemorrhoid tissue was basically the same morphology as the anal pad tissue, i.e., composed of varicose blood vessels, Treitz muscle, elastic fibers, and connective tissue. In 25 adult and 10 infant specimens, it was found that the Treitz muscle forms a network-like structure that wraps around the hemorrhoidal plexus, forming a supportive framework that holds the anal cushion above the internal sphincter, and its main function is to prevent slippage of the anal cushion. In young people, the Treitz muscle fibers are finely arranged, parallel to each other, with a fine structure and more elastic fibers. After 30 years of age, the Treitz muscle begins to degenerate, with fractures, distortions and laxity, and fewer elastic fibers. In old age, degeneration occurs and the anal cushion has a tendency to protrude into the anal canal lumen. If the Treitz muscle breaks, the supporting tissue relaxes and the anal cushion becomes retracted, moving down from its original position in the internal sphincter. In addition to genetic factors such as congenital Treitz muscle dysplasia, constipation, diarrhea, poor defecation habits and sphincter power disorders can increase the vertical pressure on the downward pushing anal cushion, causing the Treitz muscle to overstretch and rupture, resulting in the downward shift of the anal cushion. In addition, the anal cushion is indispensable to assist the internal and external sphincter muscles to ensure normal closure of the anal station, maintain the structure of anal self-control, and avoid anal incontinence. The blood vessels in the anal cushion can constitute 15%-20% of the resting pressure of the anal canal in the filled state, indicating the important role of the anal cushion in anal restraint. When defecating, the muscle fiber tissue in the anal cushion contracts, the filled blood is obviously reduced, the volume is reduced, and the resistance decreases, which helps the excretion of feces. After defecation, the anal cushion regains blood filling and closes the anal canal again. It can be considered that the anal cushion plays a fine-tuning role in the functional anal control, and the soft and elastic muscle fiber tissue supports the functional activity, as well as suspends the anal cushion and keeps its position stable, perfecting the function of the anal canal. The ATZ epithelium (rectal anal canal migrating epithelium) is a highly specialized sensory nerve terminal zone, which is very sensitive and is the sensory center for evoking defecation. When the stool reaches the anal canal from the rectum, the ATZ is stimulated and reaches the brain through the sensory nerves to produce the urge to defecate. In summary, the epithelium of the anal cushion has fine discriminative sensation and a variety of chemical and mechanical receptors, which are extremely important for maintaining normal defecation activity.