Confused as to how much muscle is usually cut in LIS?

Can someone please clarify?

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Confused as to how much muscle is usually cut in LIS?

Postby VictorianKnight55 » 28 Jun 2017, 14:57

I have been reading some articles recently about fissures and came across this picture of LIS:

http://dxline.info/img/new_ail/anal-sph ... tomy_2.jpg

As you can see, it shows a diagram of the ENTIRE thickness of the internal sphincter muscle being divided.

I thought the surgery involved only a small cut in the muscle instead of a full cut. Won't a full cut leave the patient incontinent? Is there such thing as a total LIS and a partial LIS? I searched and searched but have not found a definite answer to my question.
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Re: Confused as to how much muscle is usually cut in LIS?

Postby Payne4me » 20 Jul 2017, 19:25

Read a couple of my other posts...what ive been able to determine is that the best results are obtained by a complete cut and by complete I mean one that renders that involuntary muscle without any ability to heal and function again..Incontinence has been suggested as the reason for partial cuts...My surgeon said he has completed over 4,000 total LIS surgeries with no issue of incontinence....Let me ask you this. Successful surgery or recurrence of the fissure and the chance of future pain again...to be kind of gross...i'll take a little staining on my boxers in lieu of the pain...
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Re: Confused as to how much muscle is usually cut in LIS?

Postby VictorianKnight55 » 21 Jul 2017, 10:51

Thanks Payne,

Then I think it all depends on what technique the surgeon prefers? Because based on what I have read, partial division seems to be as efficient as full division.

https://www.ncbi.nlm.nih.gov/m/pubmed/7995161/

https://www.ncbi.nlm.nih.gov/labs/articles/28659668/

http://www.ijss-sn.com/uploads/2/0/1/5/ ... -_2016.pdf


One thing that confuses me is: if the risk of incontinence is not that high and if it does happen it's to gas and liquid stool (which I don't mind), why do most surgeons nowadays simply refuse to fully divide the muscle and instead partially divide it, as demonstrated here?:

https://www.researchgate.net/post/What_ ... icterotomy
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