COMPARISON OF EFFICACY BETWEEN CONVENTIONAL EXCISION TECHNIQUE AND LIGASURE® FOR HAEMORRHOIDS A PROSPECTIVE OBSERVATIONAL COHORT STUDY IN A TERTIARY CARE HOSPITAL IN MANDYA

Abstract

Background: Haemorrhoids are a common anorectal condition characterized by the abnormal dilation of veins in the anal and rectal regions. While conventional Milligan-Morgan haemorrhoidectomy remains a definitive treatment, it is often associated with significant postoperative pain and longer recovery. The LigaSure® vessel sealing system offers a novel approach, promising reduced blood loss, postoperative pain, and faster recovery.
Objective: To compare the efficacy, postoperative complications, and recovery outcomes of haemorrhoidectomy performed using LigaSure® versus the conventional Milligan-Morgan technique in patients with Grade III and IV prolapsing haemorrhoids.
Methods: A hospital-based prospective observational cohort study was conducted from December 2023 to December 2024 on 60 patients aged 20–65 years with Grade III and IV haemorrhoids. Patients were randomly allocated to LigaSure® haemorrhoidectomy (Group A, n=30) or conventional Milligan-Morgan haemorrhoidectomy (Group B, n=30). Key parameters assessed included operating time, intraoperative blood loss, postoperative pain (12 hours, first bowel movement, and one week), duration of analgesic use, postoperative complications, and time to return to work.
Results: The mean age of patients was 51 years, with most common group of age involved was between 40 – 60 years. LigaSure® haemorrhoidectomy resulted in significantly less blood loss (51.92 ± 15.68 mL vs. 70.34 ± 25.59 mL), lower pain scores at 12 hours (6.30 vs. 6.98), first bowel movement (5.40 vs. 6.03), and one-week post-surgery (3.57 vs. 4.57), as well as faster pain resolution (7.9 vs. 11.1 days) and fewer analgesic use days (6.40 vs. 10.14). Postoperative bleeding was lower in the LigaSure® group (10 vs. 23 patients), and return to work was quicker (9.86 vs. 12.74 days). Operating time was similar between groups (38.5 ± 11.9 minutes vs. 36.6 ± 9.8 minutes).
Conclusion: LigaSure® haemorrhoidectomy demonstrates superior outcomes compared to the conventional technique, with reduced intraoperative blood loss, postoperative pain, analgesic use, and complications, as well as faster recovery and return to work. Despite its higher cost, LigaSure® is a promising alternative for managing Grade III and IV haemorrhoids.