Page 14 - WJOLS - World Journal of Laparoscopic Surgery

Hemorrhoidectomy with Harmonic Scalpel vs Conventional Hemorrhoidectomy

results No anal stenosis or incontinence was noted in either group.
The postoperative pain scores were 5.4 ± 0.5 vs 6.8 ± 1.2 on
The mean age of patients who underwent harmonic scalpel post operative day 1 (POD1) and 1.5 ± 1.2 vs 4.1 ± 0.6 on POD3 in
hemorrhoidectomy and conventional hemorrhoidectomy was the harmonic scalpel group and conventional hemorrhoidectomy
30 ± 9.2 years and 35.8 ± 5 years, respectively. The mean hospital group, respectively; these differences were statistically significant
stays were 1 ± 0.1 days for group I and 2.5 ± 0.6 days for conventional (p < 0.05) Table 1 and Figure 1.
hemorrhoidectomy.
The mean operating time of the harmonic scalpel group
was 10 ± 0.7 minutes and 20.5 ± 2.2 minutes for conventional dIscussIon
hemorrhoidectomy (p < 0.05). This difference was statistically Hemorrhoidectomy is one of the most common surgical procedures
significant and is shorter in the harmonic group. performed in Al-Sabah Hospital, Kuwait.
There was no significant difference between group I and Hemorrhoidectomy is the most effective and definitive
group II in terms of the number of excised hemorrhoids. treatment for symptomatic hemorrhoids.
In the conventional group, one patient had minor bleeding on Traditional hemorrhoidectomy techniques, including a
postoperative day 1; conversely in the harmonic group, no bleeding Milligan–Morgan open hemorrhoidectomy and a Ferguson closed
occurred for any patients. hemorrhoidectomy, are known to be very effective and appropriate
One patient had urinary retention in group II and none from treatment for grade III and IV hemorrhoids. However, the traditional
group I, the harmonic scalpel group. surgical methods are accompanied by complications such as

Table 1: Outcome of harmonic scalpel hemorrhoidectomy vs conventional hemorrhoidectomy
Harmonic scalpel group Conventional hemorrhoidectomy

Characteristic (25 patients) I group group (25 patients) II group p value
Age 30.1 ± 9.2 35.8 ± 5
Mean hospital stay (days) 1 ± 0.1 2.5 ± 0.6 0.025
Operating time (minutes) 10 ± 0.7 20.5 ± 2.2 0.043
Postoperative bleeding 0 1
Urinary retention 0 1
Anal stenosis 0 0
Anal incontinence 0 0
Postoperative pain 24 hours 5.4 ± 0.5 6.8 ± 1.2 0.032
Postoperative pain 48 hours 4.8 ± 1.4 6.5 ± 1.2 0.044
Postoperative pain 72 hours 1.5 ± 1.2 4.1 ± 0.6 0.022

Fig. 1: Outcome of harmonic scalpel vs conventional hemorrhoidectomy

122 World Journal of Laparoscopic Surgery, Volume 11 Issue 3 (September–December 2018)