Laser Lateral Internal Sphincterotomy
What is Laser Lateral Internal Sphincterotomy? A chronic anal fissure is a painful tear in the anal lining that fails to heal because the internal sphincter muscle is in spasm, cutting off blood flow to the tear. Typical duration at Iswarya Hospital, OMR Chennai: 15–20 mins. Recovery: 1–2 weeks.
Lateral internal sphincterotomy divides a small, controlled portion of this muscle to relieve the spasm, allowing the fissure to heal in over 95% of patients. Using a laser instead of a scalpel gives a bloodless, precise division with less tissue trauma and post-operative pain. It is offered when creams, dilators and dietary measures have failed after 6–8 weeks.
Medically reviewed by Dr. Durai Ravi, Senior Consultant – General, Advanced Laparoscopic, Laser & Robotic Surgeon · Updated 9 October 2026
How is Laser Lateral Internal Sphincterotomy performed?
- 1
Short general or spinal anaesthesia is given.
- 2
The anal canal is examined to confirm the fissure and assess sphincter tone.
- 3
A small entry point is made on the side of the anus, away from the fissure.
- 4
The lower third of the internal sphincter is divided precisely with the laser fibre.
- 5
Any skin tag or sentinel pile at the fissure is trimmed if needed.
- 6
No stitches are required; a dressing is applied and the patient goes to recovery.
What are the benefits of Laser Lateral Internal Sphincterotomy?
- ✓Heals chronic fissures in over 95% of patients
- ✓Immediate relief from sphincter spasm and pain on passing stool
- ✓Bloodless, precise division with the laser
- ✓Day-care procedure, home the same day
- ✓Low recurrence compared with medical treatment
How do you prepare for Laser Lateral Internal Sphincterotomy?
- A clinical examination confirms the fissure; a colonoscopy is arranged if there are other symptoms.
- Fast for 6 hours before the procedure.
- A small enema may be given in the morning.
- Continue fibre supplements and stool softeners up to the day of surgery.
- Stop blood thinners as instructed.
What are the risks and side effects of Laser Lateral Internal Sphincterotomy?
- Temporary difficulty controlling wind or minor soiling in a small percentage of patients
- Minor bleeding or bruising
- Small abscess or fistula at the incision site (rare)
- Recurrence of the fissure if constipation is not controlled
- Permanent incontinence is very rare with the limited laser division used today
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
What is recovery like after Laser Lateral Internal Sphincterotomy?
- Warm sitz baths after each bowel motion for 2 weeks.
- Stool softeners and a high-fibre diet to keep stools soft.
- Simple painkillers for the first few days.
- Return to work within 2–3 days for most patients.
- Review at 2 and 6 weeks to confirm the fissure has healed.
Frequently asked questions about Laser Lateral Internal Sphincterotomy
Will I lose control of my bowels after sphincterotomy?
Only a small part of the internal sphincter is divided, and the external sphincter that gives voluntary control is untouched. Minor temporary leakage of wind can occur but permanent incontinence is very rare.
Why not just keep using the cream?
Nitroglycerin or diltiazem cream heals about half of chronic fissures. If the fissure has not healed after 8 weeks of correct use, or keeps returning, sphincterotomy offers a lasting cure.
How long does the fissure take to heal after surgery?
Pain usually improves within days as the spasm is released. The tear itself heals over 2–4 weeks.
Is laser better than the conventional operation?
The principle is identical. The laser gives a bloodless field and very precise division, which many surgeons find reduces post-operative pain and bruising.
Where can you get Laser Lateral Internal Sphincterotomy in Chennai?
Iswarya Hospital's General & Laparoscopic Surgery department performs a wide range of procedures using minimally invasive (keyhole) techniques for faster recovery, less pain, and shorter hospital stays — including hernia repair, gallbladder removal, appendectomy, and piles/fistula surgery.
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ℹ️ This information is for educational purposes only and does not constitute medical advice. Individual treatment plans may vary. Always consult a qualified healthcare professional before making any medical decisions.