Sphincterotomy (Scarless)

Sphincterotomy is a procedure done to treat Anal fissures, which involves a crack in the anal canal lining.

0hrs : 20min



Anal fissure

 An Anal fissure is a crack in the anal canal. It results from increased pressure within the anal canal, which can be due to constipation, passing large hard stools or frequent loose stools. It develops with equal frequency in both males and females. Usually younger and middle aged people are affected the most.

Fissures are of two types, primary or secondary. If the cause of the anal fissure cannot be identified, it is known as a Primary fissure. If the anal fissure is due to an underlying cause like an infection, it’s a Secondary fissure.

Understanding Sphincterotomy

Sphincterotomy is the surgical treatment of anal fissures. The muscle that controls the passing of stools is called the internal anal sphincter and it is under constant tension. By “sphincterotomy” we mean “cut into”(-otomy) the anal sphincter.  Doing this, helps release the pressure within the anal canal, which in turn helps in the spontaneous healing of the fissure. The procedure has been shown to be very effective. In 96% of patients, the fissures closes completely in 3 weeks time.

How is Sphincterotomy Performed

A small incision is made over the anal skin.

The surgeon inserts an instrument to keep the anal canal open during the procedure.

He locates the internal anal sphincter and makes a tiny cut over this muscle.

This  releases the existing tension within the anal canal.

The cut area is left open.

This closes in 2-3 weeks time, and along with it, the anal crack heals too.

Lateral internal sphincterotomy

treatment window

Chronic anal fissure results in spasm of the internal sphincter leading to constipation. This procedure is as simple as cutting a ribbon, so it’s better to undergo this procedure and get relieved of the symptom.

Life after sphincterotomy

  • Use a donut ring while sitting.
  • Sitz bath in the evening. A sitz bath is a shallow bath filled with warm water and helps keep the area clean and decreases pain.
  • Eat high fibre food.
  • Drink lots of water.

Sphincterotomy FAQ’s

You got the fissures possibly because of constipation, insufficient fiber in your diet, etc.
The bleed is because of contact between the hard stools and the wall of the bowel.
It usually takes only 15-20 minutes, and it is a precise and bloodless surgery.
Although it is true that the earlier treatment of fissure used to involve an uncontrolled stretching of the anus, resulting in incontinence in a small percentage of people, by and large, the carefully controlled sphincterotomy that we perform gives our patients almost no incontinence. When followed up, in 4500 patients we found incontinence in none giving rise to one of the most successful series in the world.

Yes, even on the same day if you are upto it but certainly the next day. There will undoubtedly be a tiny bit of pain when you pass motion but overall you will be back to normal in three or four days time.

Sphincterotomy specialists

Dr. J. S. Rajkumar


M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)

Dr. Prabhakaran Raju

Consultant Surgical Gastroenterolgy