Benign Disease of the Anus and Rectum

Surgery for Hemorrhoids

In most cases, hemorrhoids can be treated with painless outpatient procedures performed in the doctor’s office. Your doctor may recommend surgery if you have hemorrhoids that fall outside the rectum, are complicated by another disorder, or if they are not improving with medication or self care. In severe cases, Mount Sinai colon and rectal surgeons may perform what is called an excisional hemorrhoidectomy, in which a speculum is inserted into the anus to cut out the hemorrhoid and close the remaining wound with a suture that can be absorbed into the tissue.

Your surgeon might also recommend a circular stapled hemorrhoidopexy, in which the tissue above the hemorrhoids is removed, pulling the hemorrhoids back up into place. Removing a thrombus, or a blood clot, is a common surgical procedure that may be recommended to relieve pain, when appropriate.

Anal Fistula Surgery

An anal fistula forms when an anal abscess that has been drained does not heal completely. An anal fistula has an internal opening in the anal canal and an external opening in the skin near the anus.

Your surgeon must first find the fistula’s internal opening. Once it is found, the standard procedure involves opening the tract, cleaning out its contents and then stitching its sides. If there is a significant amount of sphincter muscle affected, or the entire tract cannot be located, your surgeon may perform this operation in more than one stage.

Mount Sinai colon and rectal surgeons have great experience with several fistula procedures that do not cut away sphincter muscle, including a fistula plug, advancement flap, fibrin glue, and LIFT.

Other procedures such as a seton placement, where your surgeon will use a silk string to either create scar tissue to reduce the amount of sphincter affected or to help the fistula drain. Your surgeon may also use a plasma based protein glue (fibrin glue) to heal the fistula.

Anal Fissure Surgery

Most anal fissures can be healed without surgery. If topical medications fail, the fissure can be injected with botox. As a last resort, your doctor may recommend surgery. Colon and Rectal Surgeons at Mount Sinai may perform a lateral internal sphincterotomy, which involves creating an incision at the side of the anus, so as to relax the muscle and allow the fissure to heal. In rare cases, the fissure may be surgically removed if scar tissue has formed.


Schedule an Appointment

The Division of Colon and Rectal Surgery
5 East 98th Street, 14th Floor
New York, NY 10029
Tel: 212-241-3547
Fax: 212-534-2654