The incidence of hemorrhoids is very high and plagues many patients, and traditional hemorrhoid surgery increases the pain of hemorrhoid patients due to the large trauma and slow recovery. However, the improvement of modern medical technology has greatly reduced the pain of patients, especially the emerging PPH surgery for hemorrhoids in recent years. The basic process of PPH hemorrhoid surgery is explained to the patients: the patient takes the lithotomy position, after the anesthesia takes effect, routine surgical disinfection, laying sterile towels, disinfection of the anorectum, the finger or the inner core of the special ring anal canal dilator to dilate the anus and then start the surgery. 1.First, use three non-traumatic forceps to clamp the skin at the anal verge of each of the three largest hemorrhoids (avoid clamping the hemorrhoid mass to avoid bleeding), so that the internal hemorrhoid mass is mildly exsanguinated. 2.Insert the dilator into the anus together with the matching inner core, remove the inner core of the dilator, fix the dilator with 4 stitches at 1, 4, 7 and 11 points, introduce the anoscopic suture, and according to the degree of prolapse, sew a loop in the subrectal mucosa 3-4.5 cm above the dentate line, this step is called “making a purse”. 3. Open the special PPH anastomosis to the maximum, insert the head end of it into the top of the purse-string suture via the anal canal dilator, tighten the sutures one by one and tie them tightly. 4.Pull out the sutures through the side holes of the anastomosis with the matching thread holder, pull the ligature thread hard in the direction of the handle, pull the mucosa and submucosa tissues to be sutured and ligated into the central rod of the anastomosis, tighten the anastomosis and strike, because there are sharp blades in the stapler as well as the suture system, so the moment of striking is completed the excision and suture of the mucosa and submucosa tissues above the internal hemorrhoid at the same time, after the anastomosis strikes After the anastomosis is fired, it is kept in the closed state for about 20 seconds. 5, the anastomosis will be completely loosened and gently pulled out, carefully check whether there is bleeding at the anastomosis site, if there is bleeding whether it is small artery active bleeding or bleeding, should be promptly performed 8-shaped seal to completely stop bleeding, withdraw the anal canal dilator, insert Vaseline oil gauze, the operation is over. For anorectal surgeons, the operation process of PPH is not complicated and can be said to be relatively simple, but each step of the operation will directly affect the effect of the operation, so it should not be taken lightly. Each step of the operation must be operated carefully and carefully, and the skills must be carefully understood and mastered in order to achieve perfect results.