BPG is committed to discovery and dissemination of knowledge
Letter to the Editor
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2025; 31(48): 114738
Published online Dec 28, 2025. doi: 10.3748/wjg.v31.i48.114738
Transverse incision with longitudinal ligation procedure: Innovation, pitfalls, and clinical perspectives
Hong-Wei Hua, Jiong Wu
Hong-Wei Hua, Jiong Wu, Department of Coloproctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Author contributions: Hua HW wrote the original draft; Wu J contributed to conceptualization, writing, reviewing and editing; Hua HW and Wu J participated in drafting the manuscript; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Jiong Wu, MD, Chief Physician, Professor, Department of Coloproctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110 Ganhe Road, Hongkou District, Shanghai 200437, China. tcmoctober9@163.com
Received: September 27, 2025
Revised: November 3, 2025
Accepted: November 13, 2025
Published online: December 28, 2025
Processing time: 91 Days and 14 Hours
Core Tip

Core Tip: This commentary underscores the transverse incision with longitudinal ligation (TILL) procedure as an innovative approach for addressing circumferential prolapsed hemorrhoids. The primary innovation of TILL resides in its "tension modulation", achieved through a specific incision and ligation design that adeptly balances the radical excision of hemorrhoids with the preservation of anal structure and function. This method offers distinct advantages over the Milligan-Morgan hemorrhoidectomy, particularly in minimizing postoperative pain, edema, and the risk of stenosis. Consequently, TILL emerges as a promising complementary technique within the spectrum of contemporary hemorrhoid treatments, although further validation is necessary.