What is Transmucosal Internal Sphincterotomy (TMIS)?

TMIS is a new, less invasive surgical method used to treat Chronic Fissures which are nothing but small tears or cuts in the skin around the anus that can cause extreme pain, bleeding, pricking and discomfort while passing stool.

This technique was developed by India’s renowned Proctologist Dr. D.U. Pathak as a safer and simpler alternative to traditional surgery.

What makes TMIS the right option to treat Chronic Fissure?

Traditional surgery for anal fissures involves cutting part of the internal anal sphincter (a muscle that controls bowel movements) to reduce pressure and promote healing of the tear. While effective, these procedures can sometimes cause pain, infections, or even temporary incontinence (leakage of gas or stool).

Dr Pathak’s TMIS technique offers a modern, patient-friendly approach. Research proven benefits of TMIS include :

• Less post-operative pain - There is mild to moderate pain for a couple of days that is easily controlled with medicines, if one feels the need for them.
• Shorter surgery time
• No risk of incontinence -Some patients (<3%) have only temporary gas leakage which goes away in a few days
• Almost no chance of any post-operative infection
• Faster healing - Complete healing occurs in 6-9 weeks
• Negligible chance of recurrence

Who should opt for TMIS?

TMIS may be a good option if:

• You have a chronic anal fissure that hasn’t healed with medicine.
• You want a quicker recovery with less pain.
• You're nervous about complications from traditional surgery.
• You’re overweight or have a body shape that makes surgery more difficult. This technique can help surgeons be more precise

How Does TMIS Work?

Here’s what happens during the TMIS procedure

1. You receive anaesthesia so you don’t feel pain during the surgery.
2. The doctor gently opens the area using retractors and carefully places small stitches to expose the muscle.
3. A tiny cut is made on the muscle through the inner lining (mucosa) of the anus.
4. No stitches are needed to close the area—it heals naturally.

Is TMIS Safe?

Yes, in trained hands TMIS is way better than conventional surgery. It avoids many of the risks of traditional surgery, such as cutting too deep, forming abscesses (pockets of infection), or causing painful lumps afterward.

Are There Any Downsides?

Like any surgery, TMIS has a few minor risks. A small number of patients may have:

• Mild bleeding or discomfort
• Temporary difficulty controlling gas
• Extremely rare chance of the fissure returning

However, most patients do very well and feel much better soon after the surgery.