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Laparoscopic Left Lateral Sectionectomy: Guided by the Ligamentum Teres Hepatis and the Umbilical Fissure Vein

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Randomized trial comparing LigaSure to closed Ferguson hemorrhoidectomy.

M Fareed¹, Saleh El-Awady, H Abd-El monaem

¹Mansoura Colorectal Surgery Unit, Mansoura University Hospital, Mansoura, Egypt.

Techniques in Coloproctology

|July 25, 2009

Summary

LigaSure hemorrhoidectomy offers a new approach with reduced pain, faster healing, and higher patient satisfaction compared to the Ferguson technique. Further research is needed to confirm long-term safety and functional outcomes.

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Area of Science:

Colorectal Surgery
Surgical Techniques
Hemorrhoid Treatment

Background:

Hemorrhoidectomy using the LigaSure vessel sealing system is an emerging surgical technique.
This study compares LigaSure hemorrhoidectomy with the traditional closed Ferguson technique.

Purpose of the Study:

To evaluate the efficacy and outcomes of LigaSure hemorrhoidectomy.
To compare LigaSure hemorrhoidectomy with the closed Ferguson technique in terms of postoperative pain, recovery, and patient satisfaction.

Main Methods:

Eighty patients with grades III and IV hemorrhoids were prospectively randomized.
Comparison between LigaSure hemorrhoidectomy and closed Ferguson technique.
Primary endpoint: postoperative pain; Secondary endpoints: operative time, blood loss, morbidity, manometric assessment, analgesia use, hospital stay, wound healing, and patient satisfaction.

Main Results:

LigaSure hemorrhoidectomy demonstrated significantly reduced operative time, blood loss, and postoperative pain scores at multiple time points.
Patients undergoing LigaSure hemorrhoidectomy experienced shorter hospital stays, faster wound healing, and higher satisfaction rates.
No significant differences in postoperative complications were observed between the two groups, though Ferguson technique showed decreased manometric pressures.

Conclusions:

LigaSure hemorrhoidectomy is a viable alternative to closed hemorrhoidectomy, offering short-term advantages.
Patients benefit from reduced postoperative pain, improved wound healing, and enhanced satisfaction with LigaSure.
Long-term functional outcomes and safety require further investigation to fully establish LigaSure hemorrhoidectomy's benefits.