Comparing Outcomes of Conventional Hemorrhoidectomy With Hemorrhoidectomy Using the Harmonic Scalpel

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Anorectal Disorders

Background:

• Hemorrhoidal disease is a prevalent condition requiring surgical intervention.
• Milligan-Morgan hemorrhoidectomy is the standard for advanced hemorrhoids (grade III/IV).
• Postoperative pain is a significant drawback of conventional hemorrhoidectomy.

Purpose of the Study:

• To compare the efficacy of harmonic scalpel hemorrhoidectomy versus the conventional technique.
• To evaluate perioperative outcomes including bleeding, operating time, and pain.
• To assess the impact on hospital stay and urinary retention.

Main Methods:

• Prospective observational study of 112 patients with grade III/IV hemorrhoids.
• Comparison between conventional hemorrhoidectomy (n=59) and harmonic scalpel (n=53).
• Data collected on intraoperative bleeding, operating time, postoperative pain, hospital stay, and urinary retention.

Main Results:

• Harmonic scalpel group showed significant reductions in operating time (p<0.001) and intraoperative blood loss (p<0.001).
• Markedly decreased postoperative pain (p<0.001), urinary catheterization (p=0.018), and hospital stay (p<0.001) with harmonic scalpel.
• The harmonic scalpel technique demonstrated superior perioperative outcomes.

Conclusions:

• Harmonic scalpel hemorrhoidectomy offers significant advantages over the conventional method.
• Reduced intraoperative and postoperative complications are key benefits.
• This technique presents a more effective management option for grade III and IV hemorrhoids.