Anal fissures are a small problem with a big impact. A tiny tear in the lining of the anal canal may sound minor, but the pain, bleeding, and discomfort it brings can be unbearable. Many people describe the experience as “passing broken glass” during a bowel movement, followed by hours of burning pain and irritation.

While some fissures heal on their own with simple remedies, others become chronic, lasting for weeks or months, and constantly disrupting daily life. At this point, doctors often recommend surgical treatment

Understanding Anal Fissures

Before comparing surgeries, it’s important to understand fissures better.

An anal fissure is a small tear or cut in the delicate tissue of the anus. It often occurs when passing hard stools, but there can be other causes as well.

Common causes of fissures include:

Passing hard or bulky stools
Pain too much during bowel movements

Injury to the anal canal
Poor blood circulation in the rectal tissues

Typical symptoms are hard to ignore:

Severe pain during or after bowel movements
Streaks of bright red blood on the stool or toilet paper
Burning, itching, or irritation around the anus
A small tear or crack visible on inspection
A skin tag near the fissure in chronic cases

Most acute fissures (short-term tears) heal with lifestyle changes like increasing fiber intake, drinking more water, and using topical creams. However, chronic fissures that persist beyond six to eight weeks usually need surgical intervention.

Why Surgery Is Sometimes Necessary

Fissures can severely reduce quality of life. When home remedies, medicines, or non-surgical treatments such as sitz baths and ointments fail, surgery becomes the best solution.

Surgery works by relieving pressure in the anal muscles, improving blood flow, and allowing the fissure to heal completely. Without surgery, many patients remain stuck in a cycle of recurring pain, constipation, and bleeding.

But surgery doesn’t just mean one thing anymore. You now have two main options:

Traditional fissure surgery
Laser fissure surgery

Traditional Fissure Surgery – What You Should Know

Traditional surgery for fissures has been around for decades and has helped millions of patients. The two most common methods are:

Lateral Internal Sphincterotomy (LIS):
The surgeon makes a small incision in the internal anal sphincter muscle. This reduces tension, increases blood flow, and helps the fissure heal naturally.
Fissurectomy:
In this procedure, the fissure and surrounding unhealthy tissue are surgically removed. Sometimes, it is combined with sphincterotomy for better results.

Why people choose traditional surgery:

It is widely available in most hospitals and clinics
It has a long history of proven success
Costs are generally lower than laser procedures
Effective for deep or complex fissures

However, there are drawbacks too:

Pain after surgery is common due to cuts and stitches
Healing can take 6–8 weeks, sometimes longer
There may be visible scars or discomfort from stitches
A small but real risk of infection or bleeding exists
Rarely, patients may face complications like sphincter weakness or incontinence

Laser Fissure Surgery – A Modern Alternative

Laser fissure surgery is a newer, advanced technique that has become popular in recent years. Instead of using a surgical blade, the surgeon uses a high-energy laser beam to treat the fissure.

Depending on the case, doctors may perform:

Laser Sphincterotomy: A precise laser cut is made to release pressure in the sphincter muscle.
Laser Fissurectomy: The fissure is cleaned and treated with laser energy, sealing blood vessels and reducing bleeding.

Why many patients prefer laser surgery:

Minimally invasive - no big cuts or deep incisions
Almost painless compared to traditional methods
No stitches required, which means faster healing
Minimal bleeding because the laser seals blood vessels instantly
Very low risk of infection
Shorter procedure time (15–30 minutes)
Usually performed as a day-care surgery (go home the same day)
Much quicker return to normal activities

Comparing Laser and Traditional Surgery

When deciding which option is better, it helps to compare them side by side in real-life terms.

Pain Levels

Traditional Surgery: Post-surgery pain is common and may last for weeks.
Laser Surgery: Minimal discomfort, with many patients reporting significant relief soon after.

Bleeding and Infection

Traditional Surgery: More chances of bleeding and infection due to open cuts and stitches.
Laser Surgery: Negligible bleeding and lower infection risk because the laser seals tissues.

Hospital Stay

Traditional Surgery: May require 1–2 days of hospital stay.
Laser Surgery: Mostly day-care; patients go home the same day.

Recovery Time

Traditional Surgery: 6–8 weeks for complete healing.
Laser Surgery: 1–2 weeks, with most patients resuming daily routines within days.

Risk of Complications

Traditional Surgery: Small chance of complications like incontinence due to muscle damage.
Laser Surgery: Very rare, since the sphincter muscle is preserved more effectively.

What Happens Before, During, and After Surgery?

Whether you choose traditional or laser, the process follows a similar outline.

Before surgery:

Fasting for 6–8 hours may be required
An enema may be given to cleanse the bowel
Routine blood tests and medical checks are performed

During surgery:

Local or general anesthesia is used
The fissure is treated with either traditional instruments or laser
Laser procedures are usually quicker and bloodless

After surgery:

Patients are observed for a few hours (longer for traditional surgery)
Pain relief medicines and stool softeners are prescribed
Instructions for diet, hygiene, and activity are given

Recovery and Aftercare

The real journey begins after surgery. Recovery depends on how well you follow aftercare instructions.

Essential aftercare tips:

Eat a high-fiber diet with plenty of fruits, vegetables, and whole grains
Drink 8–10 glasses of water daily
Take sitz baths regularly to soothe the anal area
Keep the area clean and dry to prevent infection
Avoid straining during bowel movements
Resume physical activity gradually, avoiding heavy lifting until cleared by your doctor

Conclusion

Anal fissures can be devastating, but surgery provides lasting relief. Both traditional and laser fissure surgeries are effective, but the experience for patients is very different.

Traditional surgery is reliable, cost-effective, and widely available. However, it comes with more pain, longer recovery, and higher risk of complications.
Laser fissure surgery is minimally invasive, less painful, and allows quicker recovery, making it the preferred choice for most patients today.

Ultimately, the best option depends on your health condition, access to facilities, and personal preferences. For many, laser fissure surgery is the future combining effectiveness with patient comfort.

Laser Fissure Surgery vs. Traditional Surgery – Which is Better for You?