外科ジャーナル

Efficacy of Harmonic US and LigaSure in Surgical Treatment of 3rd and 4th Degree Internal Hemorrhoids versus Conventional Hemorrhoidectomy

Abstract

Mohamed Aly Elhorbity, Mohamed Ibrahim Mansour and Nady Ahmed Mahmoud

The hemorrhoids are normal vascular components in the anal canal. About 5% of the general population is affected by symptoms related to hemorrhoidal disease. They will become a disease when inflamed or enlarged, termed "hemorrhoid" that is frequently applied for indicating to a disease. Hemorrhoids are commonly diagnosed by physical examination.

The internal hemorrhoids were originated above the dentate (pectinate) line meanwhile; external hemorrhoids were originated below it. During 1985, the internal hemorrhoids were categorized into 4 grades based on the degree of prolapse.

The aim of the present investigation is to determine and estimate the efficacy of hemorrhoidectomy performed by the harmonic US and LigaSure scalpels in terms of minimizing postoperative pain, and lowering the complexities versus conventional hemorrhoidectomy.

Between October 2015 and October 2019, this investigation included 60 patients complaining from III or IV-degree internal hemorrhoids, classified into 3 groups; 20 patients for each, group A, in which hemorrhoidectomy done with harmonic US scalpel, group B, hemorrhidectomy done with LigaSure and group C, hemorrhidectomy done with conventional scalpel and monopolar electrocautery.

Harmonic scalpel and LigaSure, are more safe and effective procedures for surgical treatment of Grade III and Grade IV hemorrhoidal disease. Less postoperative pain, time consuming, bloodless and lower postoperative complications compared with conventional hemorrhidectomy and earlier wound healing. However, the unique disadvantage of Harmonic scalpel and LigaSure is a moderately expensive than the conventional protocol.