Hemorrhoidectomy using harmonic ultrasound scalpel : results of a series of 110 consecutive patients

Abstract

As a very common and benign disease in surgical practice, hemorhoidal disease should have a very low level of postoperative morbidity and pain. The aim of this study was to evaluate postoperative pain and morbidity, time to complete healing and time off of work in a series of 110 consecutive hemorrhoidectomy patients using harmonic ultrasound scalpel device. One-hundred-and-ten consecutive three quadrant hemorrhoidectomy procedures for symptomatic prolapsed hemorrhoids (grade III and IV) were performed in our institution. Postoperative pain was assessed using a visual analogue pain scale (VAS). Outpatient`s follow-up was done at 3 weeks and 3 months. There were 72 males (65%) and 38 females (35%). Mean age was 48,5 years (22-76). Sixty-seven patients (61%) had grade III hemorrhoids and 43 patients (39%), grade IV. All operations were performed under spinal anaesthesia. Postoperative complications included 7 patients (6,3%): 2 patients were readmitted for haemorrhage without need for reintervention, and 5 had urinary retention. Postoperatively scheduled analgesia was enough for pain control in all patients. One-day surgery represents only 5% of our patients, 85% had a less than 24 hours hospital stay with surgery done the day of admission and 10% stayed for more than one day. Seventy-nine patients (92%) returned to work in between 3 weeks. Time to complete healing was 6 weeks. At the term of the follow-up, no recurrence was observed. In conclusion, hemorroidectomy using harmonic scalpel is a safe technique with very low morbidity rate, postoperative pain is acceptable and time off of work is low