Harmonic Scalpel Hemorrhoidectomy—Open versus Closed: A Comparative Study

Abstract

Background Hemorrhoids are one of the frequent presenting complaints in the surgical outpatient department of any hospital. Multiple options are available for the treatment of these based on the grade. Recently, there are many varieties of energy devices being tried for hemorrhoidectomy to decrease the postoperative pain and achieve better hemostasis intraoperatively. This study represented an effort to compare open versus closed method of harmonic scalpel hemorrhoidectomy to determine the differences in terms of operative time, hospital stay, postoperative bleeding, pain, and other complications. Method A total of 40 patients, 20 each in open and closed method harmonic scalpel hemorrhoidectomy, were followed up for 6 weeks postoperatively. Early and late outcomes were compared. Incontinence if any was measured with Vaizey incontinence score. Result There was significant prolonging of operative time in closed method (30.25 ± 5.49 vs. 22.0 ± 4.70). Postoperative pain was significantly more in open method group compared with closed on days 1, 3, 7, and 21. There was no significant difference between groups in terms of hospital stay, postoperative bleeding, and complications. Conclusion Leaving mucosa open after hemorrhoidal tissue excision is comparable to closed in terms of safety complication and is cost effective in terms of operative times and utility of suture materials at the expense of need for analgesics.