Lateral internal sphincterotomy for chronic anal fissure under perianal anaesthetic infiltration – video vignette

: There are a large number of treatment options for chronic anal fissure and choice of the most appropriate treatment may be difficult. Lateral sphincterotomy (LS) was described more than 60 years ago and has been widely adopted by surgeons worldwide [1]. Although this procedure gives good results, with healing of the fissure and so high patient satisfaction, the risk of incontinence should be always be kept in mind [2]. LS should be the next step in treating chronic fissures when the medical treatment is unsuccessful.