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Online Published: 05 Jan 2023
 


Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study

Vaibhav Rathi, Jogesh Chandra Marhual, Sibajyoti Satapathy.


Abstract
Introduction: Harmonic scalpel Hemorrhoidectomy (HSH) is reported to have superior outcomes than Milligan-Morgan hemorrhoidectomy (MMH). However, there is considerable variability in time to return to daily activities, post-operative pain, operating time, and hospital stay. Aims and Objectives: To compare MMH and HSH in terms of various outcomes. Materials and Methods: This prospective randomized controlled study was performed over a period of 12-months (December 2019 to November 2020) in the Department of General Surgery of a tertiary care hospital and included 60 adult patients with grade III and IV hemorrhoids. The patients were randomly and equally divided into either of the two groups i.e., MMH (n=30) or HSH (n=30). Post-operatively patients were evaluated and follow-up to compare the outcomes, including operative time, intra-operative bleeding, post-operative pain, duration of hospitalization, time required to return to daily activities, and intra- and post-operative complications. Results: The time required to return to daily activity was significantly less in the HSH group (p-value=0.0004). The operative time, intra-operative bleeding, and duration of hospitalization were significantly less in the HSH group (all p-values<0.0001). The mean VAS score for post-operative static and post-defecation pain was significantly reduced in the HSH group at all the time intervals (all p-values<0.0001). Moreover, significantly higher proportion of patients in the MMH group had post-operative discharge (p-value=0.02). Conclusion: HSH is superior to MMH in terms of significantly reduced time to return to daily activities, operating time, intra-operative blood loss, post-operative static and post-defecation pain, hospitalization, and intra- and post-operative complications.

Key words: Harmonic Scalpel Hemorrhoidectomy, Hemorrhoids, Hemorrhoidectomy, Milligan Morgan Hemorrhoidectomy


 
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How to Cite this Article
Pubmed Style

Rathi V, Marhual JC, Satapathy S. Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. Int J Med Rev Case Rep. 2022; 6(24): 1-6. doi:10.5455/IJMRCR.172-1658837311

Web Style

Rathi V, Marhual JC, Satapathy S. Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. https://www.mdpub.net/?mno=89611 [Access: April 02, 2025]. doi:10.5455/IJMRCR.172-1658837311

AMA (American Medical Association) Style

Rathi V, Marhual JC, Satapathy S. Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. Int J Med Rev Case Rep. 2022; 6(24): 1-6. doi:10.5455/IJMRCR.172-1658837311


Vancouver/ICMJE Style

Rathi V, Marhual JC, Satapathy S. Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. Int J Med Rev Case Rep. (2022), [cited April 02, 2025]; 6(24): 1-6. doi:10.5455/IJMRCR.172-1658837311


Harvard Style

Rathi, V., Marhual, . J. C. & Satapathy, . S. (2022) Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. Int J Med Rev Case Rep, 6 (24), 1-6. doi:10.5455/IJMRCR.172-1658837311


Turabian Style

Rathi, Vaibhav, Jogesh Chandra Marhual, and Sibajyoti Satapathy. 2022. Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. International Journal of Medical Reviews and Case Reports, 6 (24), 1-6. doi:10.5455/IJMRCR.172-1658837311


Chicago Style

Rathi, Vaibhav, Jogesh Chandra Marhual, and Sibajyoti Satapathy. "Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study." International Journal of Medical Reviews and Case Reports 6 (2022), 1-6. doi:10.5455/IJMRCR.172-1658837311


MLA (The Modern Language Association) Style

Rathi, Vaibhav, Jogesh Chandra Marhual, and Sibajyoti Satapathy. "Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study." International Journal of Medical Reviews and Case Reports 6.24 (2022), 1-6. Print. doi:10.5455/IJMRCR.172-1658837311


APA (American Psychological Association) Style

Rathi, V., Marhual, . J. C. & Satapathy, . S. (2022) Harmonic scalpel assisted hemorrhoidectomy versus conventional Milligan Morgan hemorrhoidectomy in patients with Grade III and IV hemorrhoids: A prospective, randomized, controlled study. International Journal of Medical Reviews and Case Reports, 6 (24), 1-6. doi:10.5455/IJMRCR.172-1658837311


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