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What is Anal Fissurectomy?

An anal fissurectomy is a surgical procedure to treat chronic anal fissures, which are painful tears in the lining of the anal canal that fail to heal with non-surgical treatments. The surgery removes the fissure and surrounding damaged tissue to promote healing and relieve pain. In India, anal fissurectomy is performed in specialized colorectal surgery centers, offering effective, affordable care. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.

Why do you need Anal Fissurectomy?​

Anal fissures are often caused by trauma from hard stools, chronic constipation, or prolonged diarrhea, leading to severe pain during and after bowel movements. While acute fissures may heal with conservative measures (e.g., fiber, sitz baths), chronic fissures—persisting beyond 6–8 weeks or associated with complications—require surgery. Anal fissurectomy is indicated for:

  • Chronic anal fissures: Non-healing fissures with scar tissue or sentinel tags.
  • Severe pain or bleeding: Impacting quality of life.
  • Associated complications: Anal stenosis, fistula, or hypertrophied anal papillae.
  • Failure of non-surgical treatments: Including topical medications (e.g., nitroglycerin, calcium channel blockers) or Botox injections.

In India, hospitals like Apollo, Fortis, Medanta, and Narayana Health specialize in anal fissurectomy, often combining it with procedures like lateral internal sphincterotomy to enhance outcomes.

Why Do Anal Fissurectomy Costs Vary in India?

The cost of anal fissurectomy in India ranges from ₹30,000 to ₹1.5 lakh, depending on:

  • Procedure Type: Simple fissurectomy (₹30,000–₹80,000) is cheaper than fissurectomy with sphincterotomy (₹50,000–₹1.2 lakh) or laser-assisted (₹80,000–₹1.5 lakh).
  • Hospital & Location: Top hospitals in metro cities (e.g., Apollo, Fortis) charge more; government hospitals (₹10,000–₹50,000) are cheaper but may have wait times.
  • Surgeon Expertise: Experienced colorectal surgeons charge higher fees.
  • Extra Costs: Diagnostics, anesthesia, medications, or complications (rare) increase expenses.
  • Insurance & Aid: Many insurance plans cover medically necessary fissurectomy; schemes like Ayushman Bharat offer free or subsidized treatment.

Anal Fissurectomy Procedure

The procedure is straightforward and typically performed as a day-care or short-stay surgery:

  1. Before Procedure Evaluation:
    • Diagnosis is confirmed via physical examination, including digital rectal exam or anoscopy, to assess the fissure’s location, depth, and associated features (e.g., sentinel tag, fibrosis).
    • Blood tests and ECG may be conducted for surgical fitness, especially in older patients or those with comorbidities.
    • Patients are advised to use laxatives or enemas for bowel preparation to ensure a clean surgical field.
    • Discussion with the surgeon addresses pain management and post-operative care.
  2. Surgical Technique:
    • Open Fissurectomy:
      • Performed under general, spinal, or local anesthesia with sedation, lasting 15–30 minutes.
      • The patient is positioned in the lithotomy (legs raised) or prone position.
      • The surgeon excises the fissure, including scar tissue, sentinel tags, or hypertrophied papillae, creating a clean wound to promote healing.
      • The wound is left open or partially closed to heal by secondary intention, reducing infection risk.
    • Combined with Lateral Internal Sphincterotomy (LIS):
      • Often performed concurrently to reduce anal sphincter pressure, which contributes to fissure persistence.
      • A small incision divides part of the internal anal sphincter muscle, improving blood flow and healing.
      • LIS is highly effective, with healing rates of 95–98%, but carries a small risk of incontinence.
    • Minimally Invasive Techniques:
      • Rarely, laser-assisted fissurectomy is used in select centers for precise tissue removal, though it’s costlier and less common.
    • The procedure is typically outpatient, with same-day discharge unless complications arise.
  3. After Procedure:
    • Patients are monitored for a few hours post-surgery to ensure stable recovery from anesthesia and pain control.
    • Pain medications (e.g., paracetamol, ibuprofen) and stool softeners (e.g., lactulose) are prescribed to ease bowel movements.
    • Sitz baths (warm water soaks) are recommended 2–3 times daily to promote healing and reduce discomfort.
    • Follow-up visits assess wound healing and symptom relief.

Recovery After Anal Fissurectomy

Recovery is relatively quick but requires careful adherence to post-operative care:

  1. Hospital Stay:
    • Most patients are discharged the same day (outpatient) or within 24 hours.
    • Rarely, a 1–2 day stay is needed for pain management or complications.
  2. Post-Procedure Care:
    • Pain is significant for the first 1–2 weeks, managed with oral painkillers and sitz baths.
    • Stool softeners and high-fiber diets prevent constipation and reduce strain during bowel movements.
    • Patients are advised to keep the anal area clean and dry to prevent infection.
    • Topical creams (e.g., lignocaine) may be prescribed for local pain relief.
  3. Activity and Diet:
    • Light activities (e.g., walking) resume within 1–2 days; strenuous activities (e.g., heavy lifting, sports) are avoided for 2–4 weeks.
    • A high-fiber diet (fruits, vegetables, whole grains) and adequate hydration (2–3 liters daily) promote soft stools.
    • Avoid spicy foods, alcohol, or caffeine, which may irritate the bowels.
  4. Follow-Up:
    • Follow-up visits at 1–2 weeks and 4–6 weeks assess wound healing and symptom resolution.
    • Most fissures heal within 4–8 weeks, with pain subsiding significantly by 2–3 weeks.
    • Long-term follow-ups are rare unless complications (e.g., incontinence, recurrence) occur.

Most patients resume normal activities within 1–3 weeks, with 95–98% achieving complete healing when combined with sphincterotomy. Quality of life improves significantly, with minimal recurrence if lifestyle changes are maintained.

Risks and Complications

Anal fissurectomy is a low-risk procedure but carries potential complications:

  1. Surgical Risks:
    • Bleeding or infection at the surgical site, requiring antibiotics or drainage.
    • Painful wound healing, particularly if hygiene is poor.
  2. Sphincterotomy-Related Risks:
    • Fecal incontinence (gas or minor leakage) in 1–5% of patients, usually temporary but rarely permanent.
    • Incomplete sphincter relaxation, leading to fissure recurrence (2–5%).
  3. General Risks:
    • Adverse reactions to anesthesia.
    • Delayed healing in patients with comorbidities (e.g., diabetes, Crohn’s disease).
  4. Long-Term Issues:
    • Anal stenosis (narrowing), requiring dilatation or further surgery.
    • Rarely, fistula formation or chronic pain.

Prompt reporting of symptoms like excessive bleeding, fever, or incontinence ensures timely management.

Frequently Asked Questions (FAQs)

What causes chronic anal fissures?

Chronic fissures result from repeated trauma (e.g., constipation, hard stools), poor blood flow, or high anal sphincter pressure.

Can anal fissures heal without surgery?

Acute fissures often heal with fiber, sitz baths, or medications, but chronic fissures (>6–8 weeks) usually require surgery like fissurectomy.

Is fissurectomy better than lateral internal sphincterotomy alone?

Fissurectomy removes damaged tissue for better healing, while sphincterotomy reduces sphincter pressure. Combining both is often most effective.

How soon can I resume normal activities?

Most patients resume light activities in 1–2 days and normal routines (work, driving) in 1–3 weeks.

Is anal fissurectomy covered by insurance in India?

Most insurance plans cover fissurectomy for chronic or symptomatic fissures. Confirm with your provider.

What are the signs of complications post-fissurectomy?

Excessive bleeding, fever, severe pain, or difficulty controlling bowel movements require immediate medical attention.

Can anal fissures recur after fissurectomy?

Recurrence is rare (2–5%) with proper surgery and lifestyle changes (e.g., high-fiber diet, avoiding constipation).

What lifestyle changes are needed post-fissurectomy?

Maintain a high-fiber diet, stay hydrated, avoid straining during bowel movements, and practice good anal hygiene.

Conclusion

Anal fissurectomy is a highly effective procedure for treating chronic anal fissures, relieving pain and promoting healing with minimal downtime. With expertise in hospitals like Apollo, Fortis, and AIIMS, India offers affordable, high-quality colorectal care. By understanding the procedure, cost variations, recovery, risks, and FAQs, patients can approach fissurectomy with confidence. For personalized guidance, consult a colorectal surgeon at a reputed hospital to ensure timely and successful treatment.

Looking for Best Hospitals for Anal Fissurectomy

Note: we are not promoting any hospitals

we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₹) Maximum Price (₹)
Agra
30,000
90,000
Ahmedabad
35,000
1,00,000
Ajmer
30,000
90,000
Aligarh
30,000
90,000
Allahabad
30,000
90,000
Amritsar
32,000
95,000
Aurangabad
32,000
95,000
Bangalore
35,000
1,00,000
Bareilly
30,000
90,000
Belgaum
32,000
95,000
Bhopal
32,000
95,000
Bhubaneswar
32,000
95,000
Bikaner
30,000
90,000
Chandigarh
35,000
1,00,000
Chennai
35,000
1,00,000
Coimbatore
35,000
1,00,000
Dehradun
32,000
95,000
Delhi
35,000
1,00,000
Dhanbad
30,000
90,000
Durgapur
30,000
90,000
Faridabad
35,000
1,00,000
Ghaziabad
35,000
1,00,000
Gorakhpur
30,000
90,000
Guntur
32,000
95,000
Gurgaon
35,000
1,00,000
Guwahati
32,000
95,000
Gwalior
30,000
90,000
Hyderabad
35,000
1,00,000
Indore
32,000
95,000
Jabalpur
30,000
90,000
Jaipur
35,000
1,00,000
Jalandhar
32,000
95,000
Jamshedpur
32,000
95,000
Jodhpur
30,000
90,000
Kanpur
30,000
90,000
Kochi
35,000
1,00,000
Kolkata
35,000
1,00,000
Kollam
32,000
95,000
Lucknow
32,000
95,000
Ludhiana
35,000
1,00,000
Madurai
32,000
95,000
Mangalore
32,000
95,000
Meerut
30,000
90,000
Moradabad
30,000
90,000
Mumbai
35,000
1,00,000
Mysore
35,000
1,00,000
Nagpur
32,000
95,000
Nashik
32,000
95,000
Navi Mumbai
35,000
1,00,000
Noida
35,000
1,00,000
Patna
30,000
90,000
Pune
35,000
1,00,000
Raipur
32,000
95,000
Rajkot
32,000
95,000
Ranchi
30,000
90,000
Surat
35,000
1,00,000
Thane
35,000
1,00,000
Vadodara
32,000
95,000
Varanasi
30,000
90,000
Visakhapatnam
32,000
95,000

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

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