Sphincterotomy with or without fissurectomy

Cirurgia Geral Home

Precision surgery for anal fissures and related diseases

A general surgery procedure aimed at treating chronic anal fissures, indicated when conservative treatments are not sufficient. It provides lasting relief and promotes proper healing.

How is this procedure performed? 

Under local or general anesthesia, the surgeon makes a small incision in the anal sphincter to reduce muscle tension and improve blood flow, facilitating fissure healing. If necessary, the fissure itself can be excised (fissurectomy). The minimally invasive nature of the procedure ensures a high success rate with minimal discomfort. 

Why is this procedure important? 

For patients suffering from chronic anal fissures, sphincterotomy provides significant pain relief and prevents other complications, such as infection or abscess formation. It offers a long-term solution for healing and improving intestinal function.

The condition

What is a chronic anal fissure

They are painful tears in the anal canal that can cause significant discomfort and bleeding. 

When they persist despite conservative treatments — creams, dietary adjustments, and bowel habits — they often require surgical intervention to heal.
Why not delay

Delaying treatment can prolong pain and increase the risk of complications, such as infection or abscess formation.

Warning signs

Signs that you may have an anal fissure

  • ✔
    Intense pain during or after bowel movements
  • ✔
    Blood in the stool or on toilet paper
  • ✔
    Burning sensation or spasm in the anal area
  • ✔
    Visible tear or small cut in the anal region
  • ✔
    Persistent discomfort that does not improve with topical treatments
  • ✔
    Recurring symptoms despite changes in diet or bowel habits
Do not wait for extreme pain

You do not need to wait for the pain to become unbearable to seek evaluation. 

If you recognize one or more of these signs, especially if they are persistent, a general surgery consultation can clarify the cause and the most appropriate treatment.

The procedure

How is sphincterotomy performed

Under local or general anesthesia, the surgeon makes a small incision in the anal sphincter, reducing muscle tension and improving blood flow in the area — which facilitates fissure healing. 

When necessary, the fissure itself can be removed (fissurectomy). 

Being a minimally invasive procedure, it presents a high success rate, with rapid recovery and reduced discomfort.
When is fissurectomy necessary

Fissurectomy is indicated when the fissure has scar tissue or irregular edges that make healing difficult with only muscle tension reduction.

Why is it important

Benefits of upper digestive endoscopy

Clinical evaluation

What is evaluated before the procedure

01

Fissure severity

Evaluation of the depth and chronicity of the lesion.

02

Muscle tension

Determination of the level of sphincter tension contributing to the fissure.

03

Healing potential

Evaluation of the area's ability to recover after the procedure.

04

Treatment follow-up

Monitoring to ensure complete resolution and patient comfort.

Frequently asked questions

Common questions about this procedure

Is sphincterotomy painful?

It is performed under local or general anesthesia, so there is no pain during the procedure. In the post-operative period, some discomfort is normal, usually much less than that caused by the chronic fissure.

How long does recovery take?

Being a minimally invasive procedure, recovery is generally quick, with significant symptom improvement in a few days and a gradual return to usual activities.

Can sphincterotomy affect intestinal control?

It is a carefully calibrated procedure to reduce sphincter tension without compromising continence function, which is an essential part of surgical evaluation.

When is fissurectomy necessary in addition to sphincterotomy?

Fissurectomy is indicated when the fissure has scar tissue or irregular edges that make healing difficult with only muscle tension reduction.

What is evaluated during the procedure?

01.

Fissure severity:

Evaluates its depth and chronicity.

02.

Muscle tension:

Determines the level of sphincter tension contributing to the fissure.

03.

Healing potential:

Evaluates the area's ability to heal after the procedure.

04.

Treatment follow-up:

Monitoring to ensure complete resolution and patient comfort.

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