Surgical Treatment of Hemorrhoids: Harmonic Scalpel Compared with Ferguson’s Hemorrhoidectomy

Surgical treatment is considered to be the best therapeutic modality for third and fourth-degree hemorrhoidal disease. Many different methods of hemorrhoidectomy aim to decrease pain, and complications. The aim of this study was to compare the results of Harmonic Scalpel (HS) hemorrhoidectomy with conventional Ferguson’s hemorrhoidectomy for the treatment of grade III and IV hemorrhoids. During a period of 26 months, 192 patients of grade III and IV hemorrhoids who underwent HS hemorrhoidectomy and Ferguson’s hemorrhoidectomy were evaluated retrospectively. All patients had ano-rectal examination prior to operation to exclude other colorectal pathologies. All patients had the same kind of analgesia during the postoperative course. Pain was assessed using a visual analog scale from 0 to 10. 54 female and 30 male patients were treated with HS hemorrhoidectomy, and 63 female, 45 male patients treated with Ferguson’s hemorrhoidectomy. The mean age of patients were 42.68 (range, 22-67). The intra and postoperative complication rates were similar in each groups. The average operating time in the HS and Ferguson’s hemorrhoidectomy groups was 14.5±3 min and 32±3.2 min respectively (p<0.001). The mean intraoperative blood loss was 10.2±2.5 ml with HS and 22±4.5 ml with Ferguson’s hemorrhoidectomy (p<0.001). The VAS pain scores on day 0, 1 and 7 in HS group were 3.1±1.1, 2.8±0.8 and 1.1±0.3 and in the Ferguson’s group were 6.3±1.4, 4.8±1.6 and 1.5±0.8 respectively (p<0.001). Harmonic scalpel hemorrhoidectomy is a safe, effective and bloodless operative technique with minimal tissue damage. It is associated with significant less postoperative pain and similar complications compared to conventional hemorrhoidectomy.