Ligasure versus voyant hemorrhoidectomy: comparison of 30-day postoperative complications

Radiofrequency (RF) hemorrhoidectomy features shorter operating times, less intraoperative bleeding, less postoperative pain, and a quicker return to work compared to conventional hemorrhoidectomy. Numerous RF devices are available at varying costs. The purpose of our study was to compare the 30-day postoperative outcomes of LigaSure hemorrhoidectomy versus Voyant hemorrhoidectomy for grade III and IV hemorrhoids in terms of bleeding, urinary retention, and anal stenosis.

A prospective observational study was conducted from May 2017 to March 2023. Patients with concomitant anal disorders and patients who had undergone previous anal surgery were excluded from the study. Patient data collected during hospitalization and subsequent 30-day follow-up were entered into an electronic database. Data was analysed using Stata version 18 (StataCorp LLC, TX, USA).

In total, 123 patients were enrolled (61 in group A and 62 in group B). Patient demographics and clinical characteristics (age, gender, ASA score, hemorrhoid grade) and the number of resected piles were similar in the two groups. There were three cases of hemorrhage in group A (one requiring blood transfusion and reoperation) and four cases in group B (one requiring blood transfusion). In each group, two cases of anal (sub)stenosis occurred, all resolved with self mechanical anal dilatation. There were two cases of urinary retention in group A and one case in group B. No statistical differences were observed between the two groups in terms of postoperative bleeding, urinary retention, and anal stenosis.

The LigaSure and Voyant devices show comparable results in terms of postoperative complications in the treatment of grade III and IV hemorrhoids. However, the Voyant device is much less expensive.