Fissurectomy and fissure dilatation

Fissurectomy and fissure dilatation are surgical procedures performed to treat anal fissures, which are small tears in the lining of the anus. These procedures aim to relieve pain and promote healing by removing or stretching the scar tissue that forms around the fissure. They are typically performed as minimally invasive laparoscopic surgeries.

Who Needs Fissurectomy and Fissure Dilatation

Fissurectomy and fissure dilatation may be recommended for individuals who have persistent or recurrent anal fissures that do not respond to conservative treatments such as dietary changes, topical medications, or lifestyle modifications. The procedure is considered when the fissures cause severe pain, bleeding, or impaired quality of life.

When to See a Specialist

If you experience symptoms of an anal fissure, such as rectal pain, bleeding, itching, or discomfort during bowel movements, it is important to consult with a specialist, such as a colorectal surgeon. They can evaluate your condition, perform a thorough examination, and determine if fissurectomy and fissure dilatation are appropriate treatment options for you.

Procedure

• Anesthesia: You will be given anesthesia, either general or local with sedation, to ensure you are comfortable during the procedure.

• Positioning: You will be placed in the appropriate position for the surgery, typically lying on your back with your legs elevated or in a lithotomy position.

• Incision or dilation: The surgeon will either make a small incision at the base of the fissure to remove the scar tissue (fissurectomy) or insert specialized instruments to gently stretch the fissure (fissure dilatation).

• Hemostasis and closure: Any bleeding vessels will be cauterized or sutured to achieve hemostasis. The incision, if made, may be closed with absorbable sutures.

• Dressing and recovery: A sterile dressing will be applied to the surgical site, and you will be monitored in the recovery area until you are awake and stable.

   

Road to Recovery

Recovery after fissurectomy and fissure dilatation is typically faster compared to traditional open surgery. You may experience some discomfort, swelling, or mild bleeding in the anal area for a few days. Your healthcare team will provide instructions on pain management, wound care, and dietary modifications to promote healing and prevent constipation.

Risk Management

Although fissurectomy and fissure dilatation are generally safe procedures, there are some potential risks and complications, including:

• Infection

• Bleeding

• Anal sphincter injury

• Recurrence of the fissure

• Rare complications such as urinary retention or fecal incontinence

Benefits of Fissurectomy and Fissure Dilatation

• Pain relief: These procedures aim to relieve the pain associated with anal fissures, allowing for improved comfort during bowel movements.

• Healing promotion: By removing or stretching the scar tissue, fissurectomy and fissure dilatation help promote the healing process and reduce the risk of recurrent fissures.

• Minimally invasive: Laparoscopic techniques used in fissurectomy and fissure dilatation result in smaller incisions, less postoperative pain, and shorter recovery time compared to open surgery.

Frequently Asked Questions

1. Will fissurectomy or fissure dilatation cure my anal fissures?

   Fissurectomy and fissure dilatation aim to relieve symptoms and promote healing. However, the success and long-term outcomes vary depending on factors such as the severity of the fissure, underlying conditions, and individual healing response.

2. Is fissurectomy or fissure dilatation a painful procedure?

   You will be under anesthesia during the procedure, so you should not feel any pain. After the surgery, there may be some discomfort or soreness in the anal area, which can be managed with pain medications and other conservative measures.

3. How long does it take to recover from fissurectomy or fissure dilatation?

   Recovery time varies for each individual, but most people can resume their normal activities within a few days to a couple of weeks. Your healthcare team will provide specific postoperative instructions and monitor your progress during follow-up visits.

4. Can fissures recur after the procedure?

   While fissurectomy and fissure dilatation have a high success rate, there is still a small possibility of fissure recurrence. Following proper postoperative care, maintaining good anal hygiene, and adopting lifestyle changes can help reduce the risk of recurrence.

5. Are there any dietary restrictions after fissurectomy or fissure dilatation?

   Your healthcare team may recommend dietary modifications to prevent constipation and promote soft, easy-to-pass stools. This can include increasing fiber intake, staying hydrated, and avoiding certain foods that can worsen constipation.