LIS surgery - with or without anesthesia?

Did anyone get LIS with only local?

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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LIS surgery - with or without anesthesia?

Postby Luka » 19 Dec 2015, 09:45

Hi everyone,

Has anyone here had LIS done with only local anesthesia and not any kind of sedation (like twilight anesthesia or general anesthesia)? I'm just curious how many people have had it done this way and what their experiences have been like.

I have an anxiety disorder and do not think I can undergo the procedure without any kind of sedation. I'm leaning toward general anesthesia, despite the cost and side effects, since I just cannot imagine sitting still during a surgery on my butt. The CRS I saw yesterday only does local anesthesia in her office to do LIS (and other anal surgeries). The only sedation she offers are Valium pills, which have done nothing for me in the past for procedures. Something would have to knock me completely out to get shots and cutting done in my butt! I can't be the only one who thinks this way, right?

Thank you everyone for sharing your experiences.
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: LIS surgery - with or without anesthesia?

Postby Savaici » 19 Dec 2015, 13:52

I have never heard of anyone receiving only Valium orally for this surgery.

Personally, if a CRS said that was what he/she was going to offer me, while doing surgery on my anus, I would see another surgeon.
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Re: LIS surgery - with or without anesthesia?

Postby Luka » 20 Dec 2015, 09:36

Thank you for the reply, Savaici.

I agree that I should probably see another surgeon, which I am on the 31st. It just seemed really odd to me that she does all these procedures (LIS, various hemmoroid surgeries, etc) in her office using only local anesthetic and Valium if you really need it. I would be absolutely traumatized, so I'm going to go to someone else instead. She just did not show any sympathy toward my anxiety issues. I just don't know how people can go through with this surgery that way without any deep sedation.
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: LIS surgery - with or without anesthesia?

Postby chachacha » 20 Dec 2015, 14:25

When I asked about having less sedation, before my LIS, the surgeon said that only a general anaesthetic would ensure that I wouldn't move suddenly, involuntarily or unexpectedly during the procedure. He said that it wasn't worth the risk of doing major damage, or rendering me incontinent if that did happen.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS surgery - with or without anesthesia?

Postby Luka » 21 Dec 2015, 12:32

Thank you for the reply, chachacha.

That's what I thought about the general anesthesia. Honestly, this clinic I went to was run more like a business, with lots of people coming in and out and having procedures done. This CRS is supposedly highly regarded, but does all her procedures in the office without sedation (except Valium, which I really don't count as sedation). She didn't seem to care that I was scared of the surgery and wanted to be put under for it. She told me to "get un-scared" and just get it done. She said it was quick, but I don't care. I can't even sit still very well for a shot in my arm, let alone shots and cutting in my butt!

I will be seeing another CRS (more traditional one with 40+ years experience) on the 31st. He's 15 minutes away from me and highly regarded. I really hope he's more understanding and willing to work with me to cure this, despite my lack of good medical insurance (I currently only have Medi-Cal and there are no colorectal surgeons in their system in my area... only general surgeons).

All of this is really stressing me out. I just want to feel better and end this rollercoaster ride. : (
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: LIS surgery - with or without anesthesia?

Postby chachacha » 21 Dec 2015, 13:14

Good luck at the appointment. I'm sure that the CRS will not even consider the surgery without a general anaesthetic. Keep us posted.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS surgery - with or without anesthesia?

Postby Luka » 21 Dec 2015, 14:46

Thank you, chachacha. I will keep you posted.

I just heard back from the previous CRS's office and they said they don't do IV sedation or any sedation in the office. They said they rarely do it in the surgery center downstairs and that it would cost "thousands."

So, basically, I can get the surgery done with just a Valium for $1100 in office or pay thousands of dollars just to be put out for it in a surgery center. : ( I have no idea how I'm going to afford this, no matter which CRS I decide on. *sigh*
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Luka
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