Surgery for Anal Fissure Periprocedural Care

Updated: Sep 01, 2016
  • Author: Vassiliki Liana Tsikitis, MD, MCR, FACS, FASCRS; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care

Preprocedural Planning

Proctosigmoidoscopy may be performed prior to the procedure to fully inspect the colon, rectum, and anus to rule out concomitant pathology. It should be kept in mind that the fissure itself does not necessarily require treatment.



Equipment employed in anal fissure surgery includes the following:

  • Anoscope
  • Pratt bivalve speculum
  • Scalpel
  • Dissecting scissors
  • Hemostat clamps
  • Electrocautery
  • Suture, 3-0 chromic catgut

Patient Preparation

The procedure is typically done with local anesthesia using 0.5% bupivacaine with epinephrine 1:100,000. General anesthesia may be required for difficult cases or for anxious or uncooperative patients.

The patient is placed in a prone jack-knife position with the buttocks strapped apart.