Ligasure versus Milligan-Morgan hemorrhoidectomy

Abstract

Background Conventional hemorrhoidectomy for grades III and IV hemorrhoids is a tedious procedure associated with significant morbidity and a prolonged convalescence. We compared LigaSure hemorrhoidectomy with conventional (Milligan-Morgan) hemorrhoidectomy for the treatment of grades III and IV hemorrhoids. Patients and methods A total of 80 consecutive patients of grades III and IV hemorrhoids were randomized to either the LigaSure hemorrhoidectomy (40 patients) or Milligan-Morgan hemorrhoidectomy (40 patients). The hemorrhoidal pedicle was coagulated with LigaSure in the LigaSure group and transfixed with 2/0 vicryl in Milligan-Morgan method. Results In comparison with Milligan-Morgan method, LigaSure hemorrhoidectomy had a shorter operating time (P<0.001 and was highly statistically significant), less blood loss (P<0.01 and was highly statistically significant), less postoperative pain (highly significant test P<0.01), postoperative complications including hemorrhage (15 vs. 0.0% at 5 days), urinary retention (P=0.169), and faster wound healing at 7 weeks. Conclusion Because of its ease of use and less postoperative pain and complication, LigaSure hemorrhoidectomy can be performed as a day-care procedure with less incidence of postoperative complications than Milligan-Morgan method.