Open vs Closed Sphincterotomy - Recommendations?

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Open vs Closed Sphincterotomy - Recommendations?

Postby zig123 » 28 Jun 2013, 08:36

I have had a fissure off and on for almost a year. I had to go on blood thinners because of heart procedure and since I started them, the fissure has gotten real bad and does not want to heal.  I have decided to pursure surgery and wondering if I should find a Dr. that does the closed procedure as I have read there is less bleeding and fewer complications?  Your feedback would be appreciated.
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Re: Open vs Closed Sphincterotomy - Recommendations?

Postby aimonaali » 28 Jun 2013, 15:10

This might be a stupid question but which one is which? Is closed the one where the cut is made outside the anus and the wound is stiched shut? And open is the one where they just cut inside the rectum?
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Re: Open vs Closed Sphincterotomy - Recommendations?

Postby Savaici » 28 Jun 2013, 19:18


Welcome to the forum, zig123  
The closed does seem to have less complications as far as I am aware. Less chance of incontinence.  It also results in a smaller wound. I would imagine that most CRS would use this method, and would want to know why if the surgeon was considering the open method.  
(The open technique involves making an incision across the intersphincteric groove, separating the internal sphincter from the anal mucosa by blunt dissection, and dividing the internal sphincter using scissors.
The closed technique or subcutaneous technique involves making a small incision at the intersphincteric groove, inserting a scalpel with the blade parallel to the internal sphincter and advancing it along the intersphincteric groove, and then rotating the scalpel towards the internal sphincter and dividing it.)
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Re: Open vs Closed Sphincterotomy - Recommendations?

Postby torninhell » 29 Jun 2013, 10:02

Savaici wrote:Welcome to the forum, zig123  
The closed does seem to have less complications as far as I am aware. Less chance of incontinence.  It also results in a smaller wound. I would imagine that most CRS would use this method, and would want to know why if the surgeon was considering the open method.  
(The open technique involves making an incision across the intersphincteric groove, separating the internal sphincter from the anal mucosa by blunt dissection, and dividing the internal sphincter using scissors.
The closed technique or subcutaneous technique involves making a small incision at the intersphincteric groove, inserting a scalpel with the blade parallel to the internal sphincter and advancing it along the intersphincteric groove, and then rotating the scalpel towards the internal sphincter and dividing it.)

That was a lot of info I'm not sure I could understand, but I didn't even know there were 2 ways to do it! :O Thank you for the education, I really hope my CRS did a closed one on me!
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Re: Open vs Closed Sphincterotomy - Recommendations?

Postby zig123 » 29 Jun 2013, 10:03

Thanks for the feedback....similar to what I have read. Have made some calls to CRS around here and all do open. Just wondering if its that big of a deal to pursue it further or to just get it done.
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