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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 1  |  Page : 27-33

Randomized comparative study of Ligasure versus conventional (Milligan-Morgan) hemorrhoidectomy


Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Mohamed Ezzat El Sayed
24 Masqid Belal st. Gamaa, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.155930

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Objectives The objective of this study was to evaluate the two approaches for hemorrhoid surgery - Ligasure hemorrhoidectomy and conventional (Milligan-Morgan) hemorrhoidectomy - in terms of operative time and blood loss, as well as postoperative pain, bleeding, analgesic requirement, urinary retention, discharge, stenosis, fecal incontinence, wound healing, and patient satisfaction. Background To compare the surgical outcome of hemorrhoidectomy performed using Ligasure bipolar diathermy with conventional hemorrhoidectomy. Patients and methods Twenty patients with grade III or IV hemorrhoids were randomized equally to conventional hemorrhoidectomy (group 1) and Ligasure (group 2) hemorrhoidectomy. Operative details were recorded, and patients recorded daily pain scores on a linear analogue scale. Follow-up was weekly for 2 months and then monthly for 6 months to evaluate complications, return to normal activity, ongoing symptoms, and patient satisfaction. Results The mean reduced intraoperative blood loss (±SD) was 1.2 ± 1.6 ml (ranging from 0 to 5 ml) in the Ligasure group (group 2) versus 22.2 ± 6.58 ml (ranging from 15 to 35 ml) in the conventional group (group 1) (P = 0.0001). The mean operative time in minutes in the Ligasure group was 6.6 ± 4.3 (ranging from 5 to 10 min) versus 21.7 ± 4.3 in the conventional group (ranging from 15 to 26 min) (P < 0.001). There was significant difference in postoperative pain scores and analgesic requirement especially in the first week. Wound healing was excellent in the Ligasure group. There was no difference between the two groups in terms of degree of patient satisfaction and number of postoperative complications. Conclusion Ligasure is an effective instrument for hemorrhoidectomy, which results in lower volume of blood loss, less postoperative pain, quicker wound healing, and earlier return to work.


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