Hemorrhoidectomy in Patients with Grade III and IV Disease: Harmonic Scalpel compared with Conventional technique.
Objectives: To compare conventional hemorrhoidectomy with harmonic scalped hemorhoidectomy for Ferguson hemorrhoidectomy is traditional closed procedure for 3rd and 4th degree hemorrhoids that is being practiced since centuries. With new innovations and technology, harmonic scalpel is an ultrasonic device which has shown to have promising results. With these two techniques a comparison study variables 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 3rd and 4th degree hemorrhoids.