Very large number of patient are suffering from piles and present with complain of bleeding, burning sensation & mass coming out of anus after dedication. Novel technique of stapper hemorrhoidopexy is less painful & help patient in faster recovery. Fissure is commonly occure due to constipation and present with painful bleeding. This problem is commonly managed by medicine . 15-20% patient who don’t improve with medicine or had frequent recurrence may require surgery (sphicterotomy). Fistula in Ano present with complain of recurrent painful swelling & pus discharge from perianal skin. This patient frequently require surgery ( fistulotomy, fistulectomy or seton placement )