Lateral subcutaneous internal sphincterotomy for anal fissure. Technic and experience with 22 cases in children.

Lateral sphincterotomy is probably the operation of choice for most cases of intractable anal fissure in children. The lower half of the sphincter is divided in the left or right lateral position through a small external incision at the anal verge. An incision in the anal canal itself is avoided, postoperative pain is minimal and the risk of secondary hemorrhage is eliminated. The operation can be done as an outpatient procedure. Only one patient developed minor anal incontinence.