Related Experiment Video
Updated: Aug 20, 2026
Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
A comparative study between radiofrequency ablation with plication and Milligan-Morgan hemorrhoidectomy for grade III
1Fine Morning Hospital and Research Center, Gupta Nursing Home, Laxminagar, Nagpur, India. drpjg@yahoo.co.in
Background:
Milligan-Morgan (MM) hemorrhoidectomy is the most favored treatment for prolapsed hemorrhoids. However, it may be associated with severe postoperative pain, long periods of convalescence and other complications. In alternative, I use a procedure of radiofrequency ablation and plication (RAP) of hemorrhoids. The present study compared the two procedures in terms of surgical parameters, postoperative pain and complications.
Patients And Methods:
A total of 60 patients with grade III hemorrhoids were randomized to undergo radiofrequency ablation and plication (31 patients) or MM hemorrhoidectomy (29 patients). The patients were followed up to 2 years.
Results:
Duration of surgery was significantly longer in the MM group as was postoperative hospitalization (p<0.05). Post-defecation pain and pain at rest were much less in the RAP group (p<0.05). Wound healing period (17 vs. 38 days) and time to return to work (7 vs. 17 days) were the other significant findings favoring RAP procedure. Early complications occurred more frequently in MM group, but late complications like external skin tags (4 vs. 2 patients) were more common in RAP group. One asymptomatic recurrence was noted in RAP group.
Conclusions:
Radiofrequency ablation and plication of hemorrhoids is associated with significantly less postoperative pain, shorter hospital stay and earlier return to normal activity. It can be considered as an alternative to the Milligan-Morgan hemorrhoidectomy.
Insights
Radiofrequency ablation and plication (RAP) offers a less painful and faster recovery for prolapsed hemorrhoids compared to Milligan-Morgan (MM) hemorrhoidectomy. This RAP procedure results in shorter hospital stays and quicker return to normal activities.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Hemorrhoid Treatment
Background:
- Milligan-Morgan (MM) hemorrhoidectomy is a standard treatment for prolapsed hemorrhoids.
- MM hemorrhoidectomy can lead to severe postoperative pain, prolonged recovery, and complications.
- Radiofrequency ablation and plication (RAP) presents an alternative treatment modality.
Purpose of the Study:
- To compare the efficacy and safety of radiofrequency ablation and plication (RAP) versus Milligan-Morgan (MM) hemorrhoidectomy.
- To evaluate surgical parameters, postoperative pain, and complication rates between the two procedures.
Main Methods:
- A randomized controlled trial involving 60 patients with grade III hemorrhoids.
- Patients were allocated to either RAP (31 patients) or MM hemorrhoidectomy (29 patients).
- Follow-up extended up to 2 years post-procedure.
Main Results:
- The MM group experienced significantly longer surgery duration and hospitalization.
- The RAP group reported significantly less pain at rest and post-defecation.
- Wound healing and return to work were faster in the RAP group (17 vs. 38 days and 7 vs. 17 days, respectively).
- Early complications were more frequent in the MM group, while late complications like skin tags were more common in the RAP group.
Conclusions:
- Radiofrequency ablation and plication (RAP) is associated with reduced postoperative pain, shorter hospital stays, and earlier return to normal activities.
- RAP can be considered a viable alternative to Milligan-Morgan hemorrhoidectomy for prolapsed hemorrhoids.
Related Concept Videos
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: