Anal Sphincterotomy - Internal
- The patient is brought to the operating room and general, spinal, or monitored anesthesia care (MAC) is induced. Local anesthesia is frequently used with a pudendal nerve block administered by the surgeon.
- The patient is usually placed in a prone jackknife position for the procedure.
- The key steps of a LIS include
- Dilate the anus gently with an anoscope and locate the intersphincteric groove between the internal and external sphincter muscles.
- Closed Insert the scalpel into the intersphincteric groove, then turn the scalpel medially to break the fibers of the internal sphincter.
- Open radial skin incision distal to the dentate line to expose the intersphincteric groove. The internal sphincter is then identified, elevated, and divided. The wound is closed primarily.