Sphinterotomy (Anal Fissure)

A sphincterotomy is a procedure performed to treat anal fissure.
The procedure is performed under a general anaesthetic administered by the specialist anaesthetist. Dr Morris will also use local anaesthetic to try to numb the area for up to 24 hours after your surgery (called a pudendal nerve block). The procedure may take up to 30-45 minutes.

As a thorough examination may not have been possible in the clinic due to the painful fissure, the first step is an ‘examination under anaesthesia’ to confirm the diagnosis and make note of any other findings.

The fissure is gently debrided, removing tags and chronic scarring – we aim to return the fissure to a ‘fresh’ wound so that it can then heal. A small incision is made next to the anus on the left hand side. A small incision is made in the lower part of the internal anal sphincter to release band of tension. The wound is closed very loosely, usually with a single stitch. This allows the drainage of any fluid or blood to occur whilst the wound is healing. The stitch will dissolve in time, and does not need removal.

A soft pack is placed in the anal canal, you may notice this when you pass your first bowel motion, and is normal. It will appear soft, squishy and perhaps blood stained.
This procedure is usually done as a day case.