The colorectal surgeons at NewYork-Presbyterian Lawrence Hospital have extensive experience treating anorectal fistulas — small channels or connections form between the rectum and skin near the anus — and fissures (a tear in the lining of the anus). Your doctor will choose the surgical technique that is most appropriate for your care.
During fistulotomy, an anal fistula is surgically opened, flushed out, and stitched open or left as is to heal.
The surgeon places a thin silastic tube (seton) in a fistula to help drain the infection.
Advancement Rectal Flap
For anal fistulas that significantly affect the anal control muscles, the surgeon may create a flap of rectal tissue to cover the internal opening of the fistula.
For complex fistulas, the surgeon accesses the fistula between the sphincter muscles and inserts a seton widening it over time. A few weeks later, the surgeon disconnects the fistula through a small incision and closes the internal opening of the fistula.
For anal fissures that cannot be managed with other approaches, this treatment involves cutting a portion of the internal anal sphincter. This technique reduces pressure in the area and allows the fissure to heal.