Surgical Treatment for Polyps, Fistula, and Hemorrhoids

Multidisciplinary care from leading experts: Treatment of fissures, fistulae, and hemorrhoids requires collaborative care from medicine and surgery. The unique multidisciplinary approach coordinates complex care, providing focused support — before, during, and after your surgery. 

When you choose Weill Cornell Medicine, you have access to specialists in gastroenterology and hepatology, colon and rectal surgery, radiology, laboratory medicine and pathology, and nutrition.

In addition, our patients benefit from collaborative care with:

● The Jay Monahan Center for Gastrointestinal Health

● The Jill Roberts Center for Inflammatory Bowel Disease

Weill Cornell Medicine partners with New York-Presbyterian, one of the top hospital systems in New York City and the U.S.

Surgical Treatments for Polyps, Fistula and Hemorrhoids

Our team helps patients suffering from fissures, fistulae, and hemorrhoids.

A fissure is a small tear in the anal canal. Common causes of an anal fissure include constipation, severe diarrhea, and passing hard, large stools during a bowel movement. Anal fissures cause severe pain and minor bleeding with bowel movements. Initial treatment includes dietary modification to alleviate constipation, which is very effective in the early stages of the disease. Additional options include:

●     Topical Nitroglycerin or Diltiazem: these medications improve blood flow and decrease the spasm associated with the pain. Regular application multiple times a day is critical to achieve healing.

●     Botox injection: One-time injection of Botox injection relaxes the sphincter muscles and improves blood flow and pain.

●     Lateral internal sphincterotomy: if all the other modalities fail, partial division of the internal sphincter muscle achieves healing in up to 95% of cases.

A fistula is an abnormal connection between two body parts, such as an organ or blood vessel, and another structure. Infection or inflammation can cause a fistula to form, or it may result from surgery. Inflammatory bowel disease, such as Crohn’s disease, can also lead to fistulas between loops of intestine or other abdominal organs. Fistula repair procedures include:

●      Fistulotomy: In this procedure, the fistula tract is opened to remove diseased tissue or drain pus. This allows the fistula tract to heal from the inside out.

●      Advancement rectal flap procedure: Complex fistulas are closed by covering the internal opening with your healthy tissue. This procedure can help preserve the sphincter muscle.

●      Ligation of the intersphincteric tract (LIFT). After the tract is identified as it traverses the external into the internal sphincter it is obliterated with sutures, thus preserving the sphincter muscles.

●      Endoscopic fistula repair: If your fistula is in the upper part of your small intestine, our surgeons may be able to remove the fistula with the help of a small flexible tube passed through your mouth and esophagus (endoscope.) Learn more about endoscopy.

All people have hemorrhoidal tissue as part of their normal anatomy. For some, hemorrhoids may become enlarged or painful. Most symptomatic hemorrhoids will not require surgical management. However, surgery may be considered if you have a large external hemorrhoid, combined internal and external hemorrhoids, or a prolapsed internal hemorrhoid. The types of hemorrhoidectomy procedures include:

●      Excisional hemorrhoidectomy: In this procedure, your surgeon removes the hemorrhoidal tissue by cutting it. They may leave the wound open or close it with stitches.

●      Stapled hemorrhoidopexy: In this procedure, your surgeon removes only a portion of the hemorrhoidal tissues. The remaining hemorrhoidal tissues are lifted back up into the anal canal and stapled into place with a unique stapling device.

What to Expect During Your Surgery at Weill Cornell Medicine