Dr. D. Y. Patil Medical College, Hospital & Research Centre, India
Posters & Accepted Abstracts: Surgery Curr Res
Patients with hemorrhoids constitute most of the patient population in general surgery clinics. Hemorrhoidectomy is the most definitive way of treating 3rd degree hemorrhoids. Two well-established methods are the Milligan-Morgan excision and the Ferguson technique. Although useful, both carry the risk of complications, the most significant being postoperative pain. Recent advances in instrumental technology have provided new alternatives in hemorrhoidectomy. The harmonic scalpel is an ultrasonically activated instrument with sound waves as its source of power, known for its ability to coagulate small and medium-sized vessels thus, potentially minimizing postoperative swelling and edema to the surrounding tissue. The harmonic scalpel possesses the unique advantage of causing very little lateral thermal injury to the tissues. A decreased lateral thermal injury (<1.5 mm) at the surgical site is translated into decreased postoperative pain. It also offers many benefits, including smaller incision, shorter hospital stay, less damage to tissues, quicker recovery and reduced scarring. In an attempt to compare the procedure and results of hemorrhoidectomy using ordinary scissors and harmonic scalpel, a prospective study was therefore performed. Here, a total of 60 patients, 30 patients undergoing harmonic scalpel assisted hemorrhoidectomy and 30 patients undergoing conventional Milligan-Morgan hemorrhoidectomy were studied. This study showed significant difference in operative time, blood loss during surgery and pain score on postoperative days 15, 1 month, 3 months and 6 months and postoperative analgesic requirement for harmonic scalpel assisted hemorrhoidectomy as compared to conventional Milligan- Morgan, which were statistically significant. Harmonic scalpel hemorrhoidectomy is a newer, safer, more effective, faster and bloodless operative technique with minimal tissue damage compared with the conventional Milligan-Morgan technique.