Prospective, randomized trial comparing diathermy and Harmonic Scalpel® hemorrhoidectomy

Tan, Jane J. Y.; Seow‐Choen, Francis

doi:10.1007/bf02234565

Cited by 81 publications

(45 citation statements)

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“…Most of these studies also reported less analgesic use and faster recovery with harmonic scalpel. However, other studies, including ours, found no significant difference in postoperative pain or other outcome-related variables between harmonic scalpel and conventional techniques [20][21][22].…”

Section: Discussioncontrasting

confidence: 56%

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

et al. 2015

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Section: Discussioncontrasting

confidence: 56%

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

et al. 2015

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“…Wound healing time is longer than that of the conventional scalpel, but shorter than that of electrocautery devices 122,123) . Postoperative complications are actually comparable 124,125) , but the cost is approximately ten times as great 126) .…”

Section: ) Ultrasonic Scalpelmentioning

confidence: 99%

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Yamana

2017

J Anus Rectum Colon

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The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.

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“…A major innovation has been the introduction of Harmonic Scalpel, monopolar shears (Ethicon Endosurgery, Cincinnati, OH) [8] and Stapled Transanal Rectal Resection (STARR) [9]. The results of Harmonic Scalpel hemorrhoidectomy have not demonstrated consistent improvement in postoperative pain when compared with standard technique [10,11]. The STARR procedure, when complicated or failed, has a poor outcome following surgical reintervention.…”

Section: Introductionmentioning

confidence: 99%

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

Guraya

Khairy²

2013

JCDR

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Objectives: This study was designed to evaluate the effectiveness of stapled hemorrhoidectomy (SH) in terms of cure of the symptoms and post-operative pain control. Material and Methods:In this prospective clinical study, SH (Ethicon Endo-surgery, Cincinnati, OH) was performed for all patients with grade III and grade IV hemorrhoids, presenting to the surgical clinics of Ohud and Meeqat Hospitals Almadinah Almunawwarah Saudi Arabia. The results of SH were evaluated by a questionnaire focusing on the relief of symptoms, severity of post operative pain, and complications of SH.Results: Thirty patients (21 males and 9 females); with a mean age of 39.6 years were recruited in this study. Twenty six (86%) patients had grade III and 4 (14%) presented with grade IV hemorrhoids. Perianal prolapse was the most frequent presentation reported in 23 (76%). Mean operating time was 21.7 minutes (range; 17-36 minutes) whereas mean hospital stay was 1.9 days. Post-operative pain was tolerable (nonpersistent) in 28 (93%) cases whereas 2 (7%) experienced mild pain requiring additional analgesia. Urinary retention was the most common complication found in 5 (16%) patients. All patients were cured of the hemorrhoids Conclusion: SH is a safe, rapid, and convenient surgical remedy for grade III and grade IV hemorrhoids with low rate of complications, minimal postoepative pain, and early discharge from the hospital.

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Prospective, randomized trial comparing diathermy and Harmonic Scalpel® hemorrhoidectomy

Abstract: Hemorrhoidectomy by Harmonic Scalpel is comparable to diathermy hemorrhoidectomy in terms of postoperative pain and complications.

Cited by 81 publications

References 6 publications

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

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