The Usefulness of a Harmonic Scalpel(R)  for Hemorrhoidectomy.

, Choe, Kyu Hyung; , Kim, Yu Yong; , Chang, Eu Myung

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Original Article

Journal of the Korean Society of Coloproctology 2002;18(1):10-14.

The Usefulness of a Harmonic Scalpel(R) for Hemorrhoidectomy.

Choe, Kyu Hyung , Kim, Yu Yong , Chang, Eu Myung

Hongmun Coloproctology Clinic, Uijongbu, Korea. choi@hongmun.co.kr

Abstract

PURPOSE
The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy.
METHODS
Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed.
RESULTS
The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture.
CONCLUSIONS
The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.

Key Words: Hemorrhoidectomy; Harmonic Scalpel Postoperative pain; Bleeding

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