Anal fissure surgery is usually carried out when other treatments such as diltiazem cream or botulinum toxin A injections have been unsuccessful. The procedure involves your surgeon making a small cut in the ring of muscle that holds your anus closed (internal sphincter muscle) to stop it from going into spasm.n this procedure your anal fissure is removed completely, leaving an open wound to heal naturally. This surgery can be used alone, with lateral internal sphincterotomy, or with medicines such as glyceryl trinitrate or botulinum A toxin injections.
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