LIGASURE HEMORRHOIDECTOMY (LH) WITH “NEAR BASE“ TECHNIQUE
Keywords:
haemorrhoidectomy, vessel sealing, hemorrhoidal nodulesAbstract
Aim: In this study we evaluated the use of Milligan-Morgan hemorrhoidectomy with LigaSure vessel sealing using “near base” techniques.
Materials and methods: Grades 3 and 4 hemorrhoidal nodules were operated with LigaSure (LH) by coagulation and cutting of the hemorrhoidal nodules at positions 5, 7 and 11 o’clock. Under anesthesia, the patient was placed in a modified lithotomy position. By using an anoscope and light retraction, a 5 mm "V" incision was made with a surgical scalpel at the border of the anal canal to the skin. The nodule was raised with a surgical instrument and the LigaSure was placed on the base of the nodule, coagulated and incised without additional suture sutures. Revision of hemostasis was made and vaseline gauze was placed without a stopper. A control of the wound was done within 24 hours. Subsequent check-ups were made on 7, 14 and 28 days.
Results: A total of 52 patients undergoing surgery were operated with LH. The average surgical intervention lasted 17.0+4.1 minutes. The average postoperative pain (Visual Analog score- 1-6) was 3. There was postoperative minor bleeding in 5.76% of patients that was resolved with conservative treatment, pruritus in 5.76%, flatus incontinence at one month in 7.69% of patients. No stenosis or incontinence were observed.
Conclusion: According to our results and the results from the comparative literature, LH is an effective and safe method in the surgical treatment of grades 3-4 hemorrhoidal nodules, and it should be used as a routine.
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