Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique (original) (raw)
Related papers
The professional medical journal, 2020
To compare conventional hemorrhoidectomy with harmonic scalped hemorhoidectomy in terms of pain outcome as a patient perceives, time taken for operation and length of stay in hospital. Study Design: Randomized controlled trial. Setting: Services hospital Lahore. Period: From August 2015 to February, 2016. Material & Methods: Patients were divided into two equal groups: Group A: conventional hemorrhoidectomy and Group B: Harmonic Scalpel. The study was performed by a single surgical operating team. Patient's selection criteria were male and female between 20 to 80 ages with III and IV degree hemorrhoids. The outcomes were operative time, post-operative pain and duration of stay in the hospital. Results: One hundred patients with mean age 40.86+10.26 were included and randomly assigned. This came out significant difference in operative time 28.4+11.004, postoperative pain 3.73+1.96, and length of hospital stay 2.43+1.795. There were equal distribution in age and gender in both groups. Conclusions: It is concluded that harmonic scalpel technique in hemorrhoidectomy is better than conventional closed hemorrhoidectomy in 3 rd and 4 th degree hemorrhoids.
Harmonic Scalpel® treatment of haemorrhoidectomy versus Milligan–Morgan's method
International Journal of Health Sciences (IJHS), 2022
Haemorrhoidal disease develops slowly. In comparison to electrocautery, surgical intervention with the Harmonic Scalpel® shear is a revolutionary approach for ablation of symptomatic fourth and third egree haemorrhoids. In contrast to electrocautery, Harmonic Scalpel® causes less discomfort because of its restricted lateral thermal injury during tissue dissection. The purpose of this study was to observe how effective Harmonic Scalpel® is at reducing postoperative problems after a haemorrhoidectomy. A harmonic US scalpel device was utilized to do the hemorrhoidectomy in group A, while a monopolar electrocautery device was employed in group B, which included 82 individuals. In this study, postoperative pain was more statistically significant in the Harmonic haemorridectomy group A than in group B haemorridectomy, in keeping with a pain numerical analogue scale of 1 to 10. The postoperative pain in group A was statistically significant on the 1st, 2nd, 4th, 7th, 14th, and 28th days of follow up, p<0.001. Time off work and patient satisfaction were statistically significant in the harmonic group, 2.50±0.066 compared to the surgery group, 3.56±0.070 (p<0.05). Healing of postoperative ulcers was statistically significant in the harmonic group (2.640.062 vs. 4.120.062 in surgery) (p<0.037). Haemorridectomy using a harmonic scalpel is more safe and effective surgical technique for the treatment of haemorrhoids in grades III and IV. The postoperative 9413 pain, time of the procedure, the postoperative complications, and wound healing are lower compared with conventional haemorridectomy.
International Surgery Journal
Background: Haemorrhoidal disease is one of the most frequently encountered anorectal condition in the clinical practice of a surgeon. Haemorrhoidectomy is the treatment of choice for grade III and IV haemorrhoids but is associated with significant postoperative pain and complications. Harmonic dissection causes less lateral tissue injury and thus less intra-operative bleeding and post-operative complications. The present study compares Harmonic Haemorrhoidectomy with conventional Haemorrhoidectomy.Methods: In a randomized controlled trial, patients with grade III and IV haemorrhoids satisfying inclusion and exclusion criteria were allocated to Harmonic scalpel haemorrhoidectomy or conventional Milligan Morgan open haemorrhoidectomy by block randomisation of 4. The outcome factors were intra operative blood loss, postoperative pain on VAS scale, urinary retention and anal stenosis after one month of follow up.Results: Total of 40 cases were enrolled. Of them, 22 were allocated to Ha...
Haemorrhoidectomy; Outcome Using Harmonic Scalpel Versus Conventional Closed Haemorrhoidectomy
THE PROFESSIONAL MEDICAL JOURNAL, 2017
Internal haemorrhoids are symptomatic anal cushions and characteristically lie in the 3, 7 and 11 o'clock position whereas external haemorrhoids relate to venous channels of the inferior haemorrhoidal plexus. Objectives: To compare the outcome of haemorrhoidectomy using harmonic scalpel versus conventional closed haemorrhoidectomy. Study Design: Randomized control trial.
Asian Journal of Surgery, 2015
In this prospective randomized study, our aim is to compare the shortand long-term results of harmonic scalpel hemorrhoidectomy (HSH) and stapler hemorrhoidopexy (SH) methods in the surgical treatment of Grade III and Grade IV hemorrhoidal disease. Methods: Ninety-nine consecutive patients diagnosed with Grade III or Grade IV internal hemorrhoidal disease were included in the study. Patients were randomized to HSH (n Z 48) or SH (n Z 51) treatments. Data on patient demographic and clinical characteristics, operative details, postoperative pain score on a visual analog scale, additional analgesic requirement, postoperative short-and long-term complications, and recurrence of hemorrhoidal disease were also recorded. Patients were regularly followed for a total period of 24 (6e36) months. Results: The patient demographic and clinical characteristics were similar in the two groups. The operative time was significantly shorter in the HSH group compared with the SH group. Overall pain scores were not significantly different between the groups, although severe pain was significantly more common in the HSH group. Recurrence was significantly lower in the HSH group compared with the SH group. Conclusion: HSH and SH are both safe and effective methods for surgical treatment of Grade III and Grade IV hemorrhoidal disease. In our study, the HSH method was determined to be safer, easier, and faster to perform, and associated with fewer long-term recurrences than the SH method.
Harmonic Scalpel Hemorrhoidectomy—Open versus Closed: A Comparative Study
International Journal of Recent Surgical and Medical Sciences
Background Hemorrhoids are one of the frequent presenting complaints in the surgical outpatient department of any hospital. Multiple options are available for the treatment of these based on the grade. Recently, there are many varieties of energy devices being tried for hemorrhoidectomy to decrease the postoperative pain and achieve better hemostasis intraoperatively. This study represented an effort to compare open versus closed method of harmonic scalpel hemorrhoidectomy to determine the differences in terms of operative time, hospital stay, postoperative bleeding, pain, and other complications. Method A total of 40 patients, 20 each in open and closed method harmonic scalpel hemorrhoidectomy, were followed up for 6 weeks postoperatively. Early and late outcomes were compared. Incontinence if any was measured with Vaizey incontinence score. Result There was significant prolonging of operative time in closed method (30.25 ± 5.49 vs. 22.0 ± 4.70). Postoperative pain was significantl...