COMPARISON OF ADVANCED BIPOLAR TISSUE FUSION TECHNOLOGY (LIGASURE™) HEMORRHOIDECTOMY VERSUS CONVENTIONAL MILLIGAN MORGAN HEMORRHOIDECTOMY

Abstract

Background: Conventional hemorrhoidectomy is a common surgical procedure which associated with postoperative morbidities such as pain, urine retention, postoperative bleeding and anal stenosis.\xa0 The use of the Ligasure™ could result in decreased incidence of postoperative pain and complications as it has minimal thermal spread and limited tissue burn. \nObjective: To evaluate hemorrhoidectomy using advanced bipolar electrocautery tissue fusion technology (LigaSure™) versus conventional Milligan-Morgan technique by monopolar diathermy. \nPatients and methods: This prospective study included sixty patients scheduled for elective hemorrhoidectomy at Al-Azhar University Hospitals (El-Hussen and Bab Al-sha reia University Hospitals), Department of Surgery. All sixty patients were divided in two equal comparative groups:\xa0 Group A underwent conventional Milligan-Morgan hemorrhoidectomy and group B underwent Ligasure™ hemorrhoidectomy.\xa0 Data of the sixty patients of the study was collected by the mean investigator himself from January 2020 to September 2020, then the analysis of the data was followed by different statistical methods.\xa0 Such as the chronological presentation, the percentages, the arithmetic averages, and the t test. The data of the study were analyzed by statistical program SPSS, then Microsoft Excel sheets used to graph the results and integrated into Microsoft Word. \nResults: Ligasure™ hemorrhoidectomy has a major improvement over the conventional technique. Technically, the Ligasure™ method was much simpler and can be safely carried out by relatively inexperienced junior surgeons. In comparison with conventional hemorrhoidectomy, Ligasure™ hemorrhoidectomy had less operating time (17.28 vs 9.85 minutes, p value <0.001) and had less intraoperative blood loss (65 vs. 17 ml, p value: <0.001). The post-operative pain was lesser in Ligasure™ than conventional hemorrhoidectomy. Post procedure\xa0\xa0 complications such as bleeding (3.5% vs 10%), urinary retention (10% vs 20%) and wound infection (14% vs 20%) were all lower in the Ligasure™ group, and shorter postoperative hospital-stay (1.4 vs 3.2 days). \nConclusion: Ligasure™ hemorrhoidectomy was a suture less hemorrhoidectomy technique to achieve tissue and vessel sealing. It was safe, simple and effective, with less intraoperative bleeding, postoperative discomfort and other complications in comparison to conventional hemorrhoidectomy.