✦ RECONSTRUCTIVE FISSURE SURGERY

Advancement Flap / Anoplasty

Q: When is advancement flap preferred over sphincterotomy?

Advancement flap is preferred for resistant fissures that have failed previous treatments, fissures with associated anal stenosis, and patients where sphincter preservation is essential — such as women and patients with continence concerns.

Q: Will my continence be affected?

No. Advancement flap is specifically designed to preserve the sphincter completely. Continence is fully maintained, making it ideal for patients where sphincter protection is essential.

Q: How long is the recovery?

Most patients return to office work within 2–3 weeks. Complete healing takes 4–6 weeks. Sitz baths, dressings, dietary advice, and stool softeners support comfortable recovery.

Q: Will the fissure come back?

Recurrence is very low after well-performed advancement flap surgery. Maintaining a high-fibre diet, adequate hydration, and avoiding straining significantly reduce the risk.

Reconstructive technique for resistant fissures or anal stenosis — healthy skin or mucosa is mobilised and advanced into the area to allow proper healing without cutting the sphincter.

45–60 min PROCEDURE

Day Care – 1 Day HOSPITAL STAY

>90% SUCCESS RATE

2–3 Weeks RETURN TO WORK

What is Advancement Flap / Anoplasty?

Advancement Flap or Anoplasty is a reconstructive sphincter-sparing surgical technique for chronic, resistant anal fissures, recurrent fissures after previous treatment, or fissures associated with anal stenosis. A flap of healthy skin or mucosa is carefully mobilised and advanced into the fissure area, providing well-vascularised tissue to allow proper healing. The sphincter muscle is fully preserved. This is particularly valuable for patients in whom sphincterotomy is not preferred. As a female proctologist in Hyderabad, Dr. Tejasree Vengala performs advancement flap and anoplasty at Lux Hospitals, Hyderabad.

Suitable for chronic resistant fissures that have failed sphincterotomy or other treatments, fissures with associated anal stenosis, and patients with continence concerns where sphincter-sparing surgery is essential.

How the Procedure Works

Anaesthesia & Positioning

Surgery is performed under spinal or general anaesthesia. The patient is positioned in lithotomy or prone position.

Fissure Preparation

The chronic fissure edges, sentinel skin tag, and any hypertrophied papilla are carefully excised to create a fresh, clean base.

Flap Design

A V-Y, house, rotation, or rhomboid flap is carefully designed in the perianal skin or anal canal mucosa, ensuring good blood supply.

Flap Mobilisation & Advancement

The flap is gently mobilised and advanced into the fissure area, providing healthy, well-vascularised tissue tension-free.

Suturing & Recovery

The flap is sutured into place with absorbable sutures. Patients are usually discharged the same day or next.

Outcomes

45–60 minDURATION

Day Care – 1 DayHOSPITAL STAY

>90%SUCCESS RATE

4–6 WeeksFULL HEALING

Who Needs This Treatment?

→Complete sphincter preservation — full continence maintained
→Effective for resistant or recurrent fissures
→Treats associated anal stenosis at the same time
→Provides healthy tissue for durable healing
→Particularly valuable for women
→Discreet, sensitive care by a female proctologist

Advancement flap is a beautiful operation in proctology — when the fissure has refused to heal or the canal has become stenotic, bringing healthy skin into the area gives the body what it needs to recover. Continence is protected, the result is durable, and the patient finally feels normal again.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

When is advancement flap preferred over sphincterotomy?+

Will my continence be affected?+

How long is the recovery?+

Will the fissure come back?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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