General Surgery Procedures

Anal fissure

An anal fissure is a small tear of the skin around your back passage (anus) that can occur when you pass particularly hard stools. Constipation and childbirth can also lead to anal fissures. It can be very painful with the pain being sharp when you pass stools and then deep burning for an hour or so afterwards. You may also bleed when you pass stools.

Most often an anal fissure will heal quickly with no problems. If the tear lasts for six weeks it becomes known as a chronic anal fissure. There are many self-help recommendations and medications that may assist. However, if these don’t work then surgery may be the best option for you.

A lateral sphincterotomy is the most effective treatment for anal fissure. It’s a short and relatively simple operation that involves making a small cut to the ring of muscle surrounding your anal canal (sphincter) whilst under general anaesthetic. This helps to reduce the tension in your anal canal and allows your fissure to heal. The surgery lasts approximately 15 minutes and is normally done under general anaesthetic.

Anal fistula

An anal fistula is a small tunnel with an internal opening in the anal canal and an external opening in the skin near the anus. Most anal fistulas develop when an anal abscess doesn't heal properly after the pus has drained away.

If you have an anal fistula you’ll feel a constant throbbing pain that’s worse when you sit down, swelling, redness and skin irritation around your anus and you’ll pass puss or blood when you have a bowel movement.

Normally surgery will be required to treat an anal fistula. Surgical options are a fistulotomy (cutting open the whole length of the fistula to allow it to heal into a flat scar) and seton procedures (surgical thread called a seton is left on the fistula for several weeks to help it heal). Fibrin glue or collagen plug (to seal and close the fistula tract) are non-surgical options.


Haemorrhoids, also known as piles, cause swellings inside or around your rectum and anus due to enlarged blood vessels. They are associated with increased pressure in the blood vessels in and around your anus possibly as a result of straining on the toilet. Often you don’t notice any symptoms but sometimes haemorrhoids can be painful, itchy and bleed if they become damaged.

Dietary changes, self-care measures and medicines may initially be recommended. If these don’t work then non-surgical procedures such as banding and sclerotherapy may be recommended for haemorrhoids that are in the upper part of your anal canal.

Surgery may be required to treat your piles. There are many different types of surgery for haemorrhoids but they’ll most likely involve either removing the haemorrhoids or reducing their blood supply so that they shrink. Your general surgeon will discuss the best treatment options for you.

Hernia repairs

A hernia is a bulge or swelling that happens when an integral part of your body pushes through a weakness in your muscle or surrounding tissue wall. They can appear throughout the body but most often they develop between your chest and hips.

Common types of hernia include: inguinal hernias and femoral hernias (when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh), umbilical hernias (when fatty tissue or a part of your bowel pokes through your abdomen near your navel) and hiatus hernias (when part of your stomach pushes up into your chest by squeezing through an opening in the diaphragm).

Not all hernias require surgery but if your surgeon does recommend it, it may be keyhole or open surgery. The decision for surgery and the type of surgery will be based on the severity of your hernia and where it is located.

Lipoma removal

A lipoma is a soft, fatty, benign lump that grows under the skin due to an overgrowth of fat cells. They can grow anywhere in the body where there are fat cells and are often seen on the shoulders, neck, chest, back, bottom, thigh and arms.

Usually if they're small and painless they can be left alone. However, they can cause embarrassment and self-consciousness. The NHS do not treat lipomas for aesthetic reasons. Here at Ashtead Hospital we will treat and remove lipomas for aesthetic and medical reasons.

Removal of lumps and bumps

Benign and malignant lumps and bumps can appear in almost any part of the body. Most lumps are harmless but it’s best to get them assessed by a consultant sooner rather than later.

Moles can vary in shape, size and colour. They are often harmless but if you notice any changes in colour, shape or skin irritation then you should seek immediate medical attention.

Lumps, bumps and moles are all skin lesions and are not routinely treated on the NHS for aesthetic purposes. We offer treatment of benign skin lesions for aesthetic purposes at Ashtead Hospital as we understand they can cause emotional distress and embarrassment.

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