Lateral Internal Anal Sphincterotomy
OPERATION: Lateral Internal Anal Sphincterotomy
ANAESTHETIC: General / spinal / local anaesthesia with sedation
POSITION: Lithotomy
INDICATION:
Chronic anal fissure refractory to conservative measures and topical pharmacological therapy (glyceryl trinitrate / diltiazem / botulinum toxin). [Position: posterior midline]. Anal manometry [if performed] confirming hypertonia. [Sentinel pile and hypertrophied anal papilla present].
PROCEDURE: