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.
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
Common Questions
Frequently Asked
Not sure which treatment is right for you?
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