Optimizing Combined Surgical Management of Chronic Stage Iii–Iv Hemorrhoids and Anal Fissure

The coexistence of chronic stage III–IV hemorrhoids with a chronic anal fissure presents a significant surgical challenge due to the complexity of treating both pathologies simultaneously. Traditional methods involving excisional hemorrhoidectomy with fissure removal are often associated with severe postoperative pain, prolonged wound healing, and increased complication risks. Therefore, the implementation of minimally invasive techniques aimed at achieving effective disease control with reduced tissue trauma is of growing clinical relevance.