Advancement Flap / Anoplasty
A flap of healthy perianal skin is advanced to cover the chronic fissure defect - the preferred surgical option when LIS is contraindicated due to low sphincter pressure or prior sphincter surgery.
What is Advancement Flap / Anoplasty?
Advancement Flap Anoplasty for anal fissure involves rotating or advancing a well-vascularised flap of healthy perianal skin to cover the chronic fissure defect. The fibrotic fissure tissue is excised (fissurectomy) and the healthy flap is sutured in place - bringing fresh blood supply and new tissue to an area that failed to heal on its own.
Dr. Samhitha Reddy, one of the most experienced proctologists in Hyderabad, performs Advancement Flap / Anoplasty at Lux Hospitals for chronic anal fissure patients where LIS is contraindicated - particularly those with low baseline resting sphincter pressure, anterior fissures in women with obstetric sphincter damage, and patients who have already undergone sphincterotomy without success.
Advancement flap is specifically indicated when LIS is not safe - low resting pressure, prior sphincterotomy, or Crohn's fissure. Anorectal manometry guides this decision. It is not a first-line treatment for typical chronic fissures.
How the Procedure Works
Anorectal Manometry Assessment
Resting anal pressure is measured. Advancement flap is selected when pressure is low and sphincterotomy would risk incontinence.
Fissure Excision
The chronic fissure edges, hypertrophied papilla, and sentinel tag are excised - creating a clean wound bed for flap adherence.
Flap Design
A V-Y or rotational advancement flap of perianal skin is designed with adequate base width to ensure reliable blood supply to the flap tip.
Flap Advancement
The flap is elevated and advanced to cover the fissure defect without tension. The donor site is closed primarily.
Suturing & Recovery
The flap is sutured in place with absorbable sutures. Sitz baths and stool softeners prescribed. Full healing in 4–6 weeks.
Outcomes
Who Needs This Treatment?
- →Sphincter completely preserved - appropriate for patients who cannot safely undergo sphincter division
- →Brings well-vascularised healthy tissue to a chronically ischaemic fissure area
- →Suitable for anterior fissures in women with low sphincter pressure
- →Option for patients who have already undergone LIS without resolution
- →Avoids the small but real incontinence risk associated with sphincterotomy
- →Achieves >85% healing rates in properly selected cases at Lux Hospitals, Hyderabad
Anoplasty for chronic fissure is a beautiful solution to an otherwise intractable problem. When we cannot safely divide the sphincter, bringing fresh, healthy, well-vascularised skin to cover the fissure defect provides the healing environment the tissue simply cannot create on its own.
— Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Advancement Flap / Anoplasty Surgery Cost in Hyderabad
The cost of advancement flap or anoplasty surgery in Hyderabad depends on the type of anal fissure, complexity of the condition, previous treatments or surgeries, investigations required, and the care needed before and after surgery.
For patients with low-pressure fissure or those who have undergone previous fissure surgery, the approximate cost of advancement flap or anoplasty ranges between ₹45,000 and ₹85,000.
| Procedure | Approximate Cost Range |
|---|---|
| Advancement Flap / Anoplasty | ₹45,000 – ₹85,000 |
The final cost may vary depending on your individual condition, findings during evaluation, and whether any additional procedures are required.
Factors That Influence Advancement Flap / Anoplasty Cost
The overall cost may depend on:
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Type and complexity of fissure: The location, severity, chronicity of the fissure, and reduced healing capacity may influence the treatment approach and surgical planning.
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Pre-operative evaluation: Required investigations, clinical examination, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as removal of scar tissue, fissurectomy, or treatment of associated anal conditions are required along with advancement flap or anoplasty, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, medicines, wound care, and follow-up requirements may influence the final estimate.
Is Advancement Flap / Anoplasty Covered by Insurance?
Advancement flap or anoplasty may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr Samhitha Reddy, Proctologist and Colorectal Specialist in Hyderabad, will evaluate your symptoms, medical history, and investigation reports to determine whether an advancement flap or anoplasty is suitable for you. She will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.