A comparison of different hemorrhoidectomy procedures.

Area of Science:

• Surgical Innovation
• Colorectal Surgery
• Minimally Invasive Techniques

Background:

• Hemorrhoidectomy is a common surgical procedure for advanced hemorrhoids.
• Traditional hemorrhoidectomy techniques can be associated with significant postoperative pain and complications.
• The harmonic scalpel (HS) offers a potential alternative for tissue dissection and hemostasis.

Purpose of the Study:

• To compare the efficacy and safety of harmonic scalpel (HS) hemorrhoidectomy with classical methods.
• To evaluate postoperative pain, analgesic consumption, operation time, and bleeding.
• To assess early complications associated with different hemorrhoidectomy techniques.

Main Methods:

• A randomized study involving 87 patients with grade III-IV hemorrhoids.
• Patients were divided into four groups: open HS, closed HS, Milligan Morgan, and Ferguson hemorrhoidectomy.
• Outcomes measured included postoperative pain, painkiller consumption, bleeding volume, and operation duration.

Main Results:

• HS groups (open and closed) showed significantly reduced bleeding (p<0.001).
• Open HS hemorrhoidectomy had a significantly shorter operation time (p<0.001).
• Postoperative pain and analgesic consumption were significantly lower in HS groups compared to classical methods (p<0.001).

Conclusions:

• Harmonic scalpel hemorrhoidectomy is an effective, comfortable, and safe procedure.
• HS use in hemorrhoidectomy leads to reduced postoperative pain, analgesic needs, operation time, and bleeding.
• Suture use in traditional hemorrhoidectomy appears to be a primary contributor to postoperative pain.