Sphincterotomy, lateral

Measure used to treat chronic anal fissures based on the weakening of the M. sphincter ani internus.

Procedure: With the anal canal open (Park's retractor), the sphincter ani internus muscle on the left side (3 o'clock in supine position) is injected with an adrenalin saline solution. This is followed by a lateral incision at the level of the linea anocutanea with subsequent visualization and preparation of the internal sphincter up to the level of the linea dentata. The inner sphincter is split up to the level of the dentate line. The small skin incision is sutured again. After completion, the sphincterotomy can be palpated through the anal skin as a wedge-shaped defect. Based on the experience and critical evaluation of the literature based on the criteria of anal continence, recurrence rate, treatment duration and ability to work, the lateral sphincterotomy achieves the best long-term results.