Harmonic scalpel hemorrhoidectomy versus bipolar diathermy hemorrhoidectomy – A prospective evaluation

Background: Hemorrhoidal disease is a very common anorectal disorder occurring more frequently in individuals who are older than 40 years. Although early-stage diseases can be managed conservatively, late-stage diseases usually need surgical treatment. Aims and Objectives: The aim of the study was to compare harmonic scalpel hemorrhoidectomy with bipolar diathermy hemorrhoidectomy in terms of operative time, intraoperative bleeding, hospital stay, pain expectation score, time to start normal activity, and complications if any. Materials and Methods: The study entitled, "Harmonic scalpel hemorrhoidectomy versus bipolar diathermy hemorrhoidectomy-A prospective evaluation" was conducted in the Department of General and Minimal invasive Surgery SKIMS and SKIMS Medical College Srinagar from July 2017 to June 2019. The study was performed on all patients with Grade 3 and Grade 4 hemorrhoids. The total number of patients studied was 64, who were randomly subjected either to the harmonic scalpel hemorrhoidectomy or to bipolar diathermy hemorrhoidectomy. Results: Thirty-one patients were subjected to harmonic scalpel hemorrhoidectomy and 33 patients were subjected to bipolar diathermy hemorrhoidectomy. Mean operative time and intraoperative bleeding were significantly less in harmonic scalpel hemorrhoidectomy as compared to that of bipolar hemorrhoidectomy. The patients who underwent harmonic scalpel hemorrhoidectomy experienced significantly less pain and had significantly shorter hospital stay and early return to routine work in contrast to bipolar diathermy hemorrhoidectomy. Conclusion: Harmonic scalpel hemorrhoidectomy is recommended in patients with symptomatic Grade 3 internal hemorrhoids in association with large external components and those with Grade 4 hemorrhoids.