Lateral Internal Sphincterotomy

Lateral internal sphincterotomy is a surgical procedure used to treat anal fissures, which are small tears in the lining of the anus. The goal of the procedure is to relieve pain and promote healing by reducing spasm and increasing blood flow to the affected area.

Indications

Lateral internal sphincterotomy is typically recommended for patients with:

• Chronic anal fissures that have not responded to conservative treatments, such as topical creams or oral medications
• Painful anal fissures that interfere with daily activities
• Fissures that are associated with spasm of the internal anal sphincter

Procedure

The procedure is usually performed under local anesthesia, and it involves making a small incision in the lateral aspect of the internal anal sphincter. This incision allows the surgeon to divide the muscle fibers of the internal sphincter, which helps to:

• Relax the spasm of the internal sphincter
• Increase blood flow to the affected area
• Promote healing of the fissure

Techniques

There are several techniques that can be used to perform a lateral internal sphincterotomy, including:

• Open technique: This involves making a small incision in the skin and muscle to access the internal sphincter
• Closed technique: This involves using a specialized instrument to divide the internal sphincter without making an incision in the skin
• Endoscopic technique: This involves using an endoscope to visualize the internal sphincter and perform the procedure

Benefits

The benefits of lateral internal sphincterotomy include:

• High success rate in treating anal fissures
• Rapid relief of pain and discomfort
• Low risk of complications, such as infection or bleeding
• Quick recovery time, with most patients able to return to normal activities within a few days

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with lateral internal sphincterotomy, including:

• Infection
• Bleeding or hemorrhage
• Fecal incontinence (loss of control over bowel movements)
• Recurrence of the fissure

Postoperative Care

After the procedure, patients are typically advised to:

• Avoid heavy lifting or straining
• Take regular baths to keep the area clean
• Use stool softeners to prevent constipation
• Avoid spicy or fatty foods that can irritate the anus

Follow-up Care

Patients are typically scheduled for follow-up appointments with their surgeon to:

• Monitor the healing process
• Assess for any potential complications
• Provide guidance on postoperative care and rehabilitation