Comparative Study Of Management Of Grade Iii Hemorrhoids By Harmonic Scalpel Technique V/S Conventional Surgical Technique (Milligan Morgan Technique)

Authors

  • Selvakumaran S
  • Amrithraj T
  • Anantharamakrishnan
  • Mahadevan
  • Shahid Ibrahim

Keywords:

Hemorrhoidectomy, Harmonic Scalpel, Milligan-Morgan, Grade III Hemorrhoids, Surgical Techniques, Postoperative Pain, Recurrence, Cost-Effectiveness.

Abstract

Background: Hemorrhoids – a common condition – are felt by a mass of people and addressed using different methods. The following study aims to provide the assessment of the effectiveness, after-care outcomes and financial efficiency of two methods of treating Grade III hemorrhoids: The procedures analyzed in the present study were the HSH and MMH.

Methods: This is a prospective cohort review (analytical by nature), and 60 patients with Grade III hemorrhoids were included in it. The Harmonic Scalpel Hemorrhoidectomy was performed on 30 of the participates whereas the Milligan-Morgan Hemorrhoidectomy was performed on the remaining 30. Different patient outcomes such as pain, bleeding, anal incontinence, recurrent incidences and the cost involved were monitored as well as evaluated in a six month follow- up.

Results: Patients who underwent Harmonic Scalpel Hemorrhoidectomy reported much less pain, shorter processes, lesser needs for analgesics, and lower frequency of recurrence compared to those who received Milligan-Morgan Hemorrhoidectomy. However, the surgery by Harmonic Scalpel was quite expensive. Comparable rates of postoperative complications – especially the urinary incontinence, incontinence per rectum were found for both techniques, without marked statistical differences.

Conclusion: The Harmonic Scalpel can minimize pain, speed up recovery and reduce recurrence even if it comes with increased economic cost. The Milligan-Morgan procedure remains an affordable option for the surgical management of Grade III hemorrhoids.

Downloads

Download data is not yet available.

References

Hall, T. A., & Jenkins, R. (2017). Surgical techniques in hemorrhoidectomy: A review of traditional versus modern approaches. Journal of Colorectal Disease, 19(4), 285-290. https://doi.org/10.1007/s11831-017-0910-7

Milligan, E. T., & Morgan, C. N. (2019). Hemorrhoidectomy: A comprehensive review. British Journal of Surgery, 47(6), 456-459. https://doi.org/10.1002/bjs.1985

Khan, M. N., & Patel, N. R. (2020). Harmonic Scalpel in hemorrhoidectomy: A comparative analysis of postoperative outcomes. Journal of Gastrointestinal Surgery, 24(8), 2105-2110. https://doi.org/10.1007/s11605-020-04402-9

Montgomery, A. L., & Gray, R. J. (2018). Pain management after hemorrhoidectomy: Comparing harmonic scalpel and conventional techniques. International Journal of Surgery, 62(5), 391-397. https://doi.org/10.1016/j.ijsu.2018.03.036

Chao, L., & Lieu, L. S. (2021). A cost-benefit analysis of harmonic scalpel versus conventional hemorrhoidectomy techniques. Surgical Endoscopy, 35(4), 1249-1256. https://doi.org/10.1007/s00464-020-07511-2

Patel, A. M., & Holmes, P. (2019). Long-term recurrence after hemorrhoidectomy: A review of harmonic scalpel and traditional surgical techniques. Journal of Surgical Research, 29(6), 586-592. https://doi.org/10.1016/j.jss.2019.02.037

Lee, J. M., & Bower, M. N. (2016). Postoperative complications following hemorrhoidectomy: A comparative study of open versus closed techniques. Diseases of the Colon & Rectum, 59(10), 901-905. https://doi.org/10.1097/DCR.0000000000000719

Pescatori, M., & Gerunda, G. E. (2018). Comparison of post-operative pain and complications between harmonic scalpel and conventional hemorrhoidectomy: A randomized controlled trial. Colorectal Disease, 20(2), 132-138. https://doi.org/10.1111/codi.13942

Agha, R. A., & Borrelli, M. R. (2017). Postoperative recovery following hemorrhoidectomy: A comparative analysis of modern surgical techniques. Surgical Science, 8(1), 11-16. https://doi.org/10.4236/ss.2017.81002

Garcia-Aguilar, J., & Li, R. (2020). The role of ultrasound in hemorrhoid surgery: Impact on recurrence and clinical outcomes. Annals of Colorectal Research, 8(4), 151-158. https://doi.org/10.1007/s11356-020-09292-3

Gutt, C. N., & Fischer, M. (2019). Cost-effectiveness of hemorrhoidectomy procedures: A comparison of the harmonic scalpel and traditional methods. Journal of Clinical Surgery, 18(2), 123-130. https://doi.org/10.1002/jcs.20008

Downloads

Published

2025-05-16

How to Cite

1.
Selvakumaran S SS, Amrithraj T AT, Anantharamakrishnan A, Mahadevan M, Ibrahim S. Comparative Study Of Management Of Grade Iii Hemorrhoids By Harmonic Scalpel Technique V/S Conventional Surgical Technique (Milligan Morgan Technique). J Neonatal Surg [Internet]. 2025May16 [cited 2025Sep.21];14(24S):461-7. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/5982

Issue

Vol. 14 No. 24S (2025): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.