Lateral Sphincterotomy ( Open Method )

Lateral Sphincterotomy ( Open Method) for Chronic Fissure –In -Ano

Surgical Division of External Anal Sphincter is called Lateral Sphincterotomy.  It is the treatment option for Chronic Fissure in Ano, not responding to  Conservative line of management.

The conservative line of management of Anal Fissure includes

• Application of a Local anesthetic Gel ( Lignocaine )
• Sitz Bath ( Sitting on Luke warm water, dipping the peri anal region)
• Laxatives or stool softeners.
• Dietary modifications like avoiding spicy and low fiber foods etc

Most common site of External Anal Fissure is Posterior Midline. Rarely anal fissure can also occur in the anteroior midline of the anal canal.

The characteristic clinical feature of Anal Fissure is Increased Sphincteric  Spasm appreciated while doing a Digital Examination of Rectum ( Per Rectal Examination).

One can also elicit tenderness along the site of the fissure. Quite often one can feel the fissure with a gloved finger, as a longitudinal furrow.

If the sphincteric spasm is more one should not attempt a Proctoscopic examination using an Anal Speculum.

Acute anal fissure is a cause for Acute Anus (  Pain around the Anus especially while passing stools)

Another manifestation of Fissure in Ano is bleeding. In Fissure in Ano the bleeding is streak like and is ofetn associated with pain.

The type of bleeding in Haemorrhoids (Piles)  is painless fresh bleeding seen as splashes.