METHOD FOR COMBINED SURGICAL TREATMENT OF CHRONIC ANAL FISSURE WITH SPASM OF THE SPHINCTER USING THE METHOD FOR EXCISION OF THE FISSURE IN COMBINATION WITH INJECTION OF BOTULINUM TOXIN TYPE A AT A DOSAGE OF 40 UNITS INTO THE INTERNAL ANAL SPHINCTER UNDER ULTRASOUND NAVIGATION Russian patent published in 2022 - IPC A61B17/00 A61B8/08 A61B8/12 C07K14/33 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely colorectal surgery. Intraoperative ultrasound examination of the anal canal is performed in B-mode using a linear endorectal ultrasound sensor with a scanning frequency of 10-12 MHz. Excision of the anal fissure with scar-altered tissues is performed within healthy tissues with the removal of the wound edges to the perianal skin 1.5-2.0 cm from the edge of the anus. Botulinum toxin type A is injected under the control of a linear endorectal ultrasound sensor located in the anal canal, visualizing the fibers of the internal sphincter, at 4 points: at 1, 5, 7 and 11 o'clock, 10 units of the drug at each point. The introduction of botulinum toxin throughout the internal anal sphincter is visually monitored when the needle is inserted to its full length and its subsequent spread to the distal edge of the sphincter.

EFFECT: method reduces the risk of intra- and postoperative complications; reduces the risk of relapses of the disease; accurate injection of the drug makes it possible to unify the method for its application, adequately eliminate the spasm of the internal anal sphincter, level the introduction of the drug and its spread to neighboring muscle structures in the anus.

1 cl, 1 ex