Haemorrhoidectomy using harmonic scalpel: An initial report

Objective: The objective of this study was to evaluate the surgical outcomes of haemorrhoidectomy using harmonic scalpel. Method: From June to August 1999, 12 patients suffering from third degree piles were admitted for harmonic scalpel haemorrhoidectomy. The whole operation was performed entirely with the harmonic scalpel with the power set at level 3. The pedicles were coagulated with the harmonic scalpel rather than transfixed. Postoperatively, pethidine injection was given intramuscularly on demand for pain control. The postoperative pain score (0–10) from the first to the fifth postoperative day was assessed. Patients were followed up at 4, 8 and 12 weeks, and complications were recorded. Results: Twelve patients with a median age of 48 years were studied. The median operation time was 15 min (range: 12–20), with a median blood loss of 15 mL (range: 2–25). The median postoperative stay was 2 days (range: 2–4). The median pain score was maximal at postoperative day one (score: 3). The pain score rapidly dropped over the next 2 days, and became zero by postoperative day 4. Only two patients required pethidine injections on the first postoperative day. Conclusion: Preliminary evidence suggests harmonic scalpel haemorrhoidectomy is safe and expedious; it is associated with less pain compared with conventional scissors dissection, and is a good alternative to diathermy excision.

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