Surgery involves division of a portion of the internal anal sphincter (lateral internal sphincterotomy). This can be performed as an out-patient procedure. The goal is to promote relaxation of the anal sphincter, thereby decreasing anal pain and spasm, allowing the fissure to heal. If a sentinel pile is present, it can be removed to promote healing of the fissure. Acute pain after surgery often disappears after a few days. Most patients will be able to return to work and resume daily activities in a few short days after the surgery.

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