If you're dealing with a chronic anal fissure that hasn't responded to previous treatments, or if your symptoms are severe, your doctor may suggest surgery.
Lateral Internal Sphincterotomy (LIS):
To alleviate spasms and promote healing, fissure specialists often perform a lateral internal sphincterotomy. This procedure involves making a small incision in the anal sphincter muscle. Studies indicate that fissure surgery is the most effective treatment for persistent anal fissures.
Open Fissure Surgery:
Anorectal surgeons perform open surgery by making a small incision in the anal sphincter to relax the anal muscle. Once the muscle is released, the fissure can heal. However, one of the most common risks associated with open anal fissure surgery is persistent incontinence, making it a popular yet potentially risky option.
Laser Fissure Surgery:
Before the procedure, patients receive either local or general anaesthesia. During laser fissure surgery, the surgeon uses a laser probe to deliver infrared radiation or laser beams directly to the site of the anal fissure. The high-energy laser beams enhance blood flow to the area, promoting rapid and effective healing. This method involves cutting the sphincter muscle with a precisely targeted laser beam, reducing tension on the fissure and facilitating recovery. Laser surgery is known for its ease of use and effective healing, with lateral sphincterotomy being the most recommended option due to its minimally invasive and virtually painless nature.