Internal sphincterotomy using a self-illuminating forked scalpel

Abstract

The aim of lateral internal sphincterotomy when treating fissure in ano is to divide the distal one-third of the internal anal sphincter (IAS). This section is sufficient to allow the anal fissure to heal, and to guarantee good continence. The incidence of fecal incontinence after internal anal sphincterotomy, particularly in women, suggests that particular attention is needed in the surgical therapy of fissures in women to avoid an excessive section of the IAS.

Recently, a self-illuminating forked scalpel has been put on the market which seems well applicable to sphincterotomy. In fact, this device facilitates the choice of portions of sphincter to cut or to safe, before cutting. The particular conformation of the device protects the cutaneous and mucous planes from accidental lacerations. This device, the technique of sphincterotomy and the results from a first series of patients are herein described.