First, a running stitch is made from the top to the bottom. The device is so designed that only the prolapsing tissue is caught by the needle.
The ends of the thread are pulled together and knotted at the top. This has the effect of lifting up the haemorrhoids that are hanging down.
With this “lifting”, the haemorrhoids are back where they belong. The tissue scars over and integrates “seamlessly” back into the anal tissue.