Hi, Thanks for posting in HCM. I understand your concern. Anal fissures and piles when becomes symptomatic needs surgical intervention as it cannot be managed conservatively. The operation what the doctor has suggested you to undergo is called sphincterotomy . This can be done by means of cryosurgery or laser surgery, which involves partial cutting of internal anal sphincter so as to release pressure inside, which gives a chance for piles and fissures to regress back to normal. This operation is usually done under local anaesthesia, but might require short acting general anaesthesia in some cases. Hence, it is necessary to take physical fitness from Physician, so that operation could be planned and done accordingly. Hope the information provided would be helpful. All the best.