Anal fissure surgery: what you need to know

• An anal fissure is a chronic sore in the anus that causes pain and even bleeding during bowel movements.
• There are conservative methods that can help the anal fissure to heal by itself, although in most cases surgery will be necessary.
• Anal fissure surgery is performed with an open sphincterotomy and under regional anaesthesia, with excellent results.

Anal fissures are often confused with other anal pathologies such as haemorrhoids or fistulas, although there are important differences between them. 

An anal fissure can be defined as a chronic injury in the anal area causing pain and bleeding during defecation. In some cases, the pain is so severe during and hours after defecation that the patient becomes afraid to go to the toilet.

One of the main problems with anal fissures is that, due to their location, they are easily infected, causing the symptoms mentioned above. There is some advice and conservative treatment methods that can alleviate and even cure anal fissures, but in most cases the only solution to recover the lost quality of life is anal fissure surgery with open sphincterotomy.

Anal fissure surgery by means of open sphincterotomy is performed under regional or general anaesthesia, depending on the case of each patient. 

Once the patient is under anaesthesia and is positioned on the stretcher, the surgeon proceeds to make an incision of about one centimetre inside the tissue covering the sphincter, sectioning the inner lateral part of the sphincter. 

After this, a dressing is applied and the patient is taken to the resuscitation room where he/she will remain until his/her vital signs are restored.

The duration of anal fissure surgery using the open sphincterotomy technique is between 15 and 30 minutes.

The results of anal fissure surgery are excellent in the long term and patients usually do not relapse.