Harmonic Scalpel® compared with bipolar electro-cautery hemorrhoidectomy: A randomized controlled trial

Abo-hashem, A.A.; Sarhan, Abd-Elrahman; Aly, Ahmed

doi:10.1016/j.ijsu.2010.01.010

Cited by 44 publications

(36 citation statements)

References 21 publications

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“…However, in our study the return time to work could not be studied. Abo Hasem et al [20] noticed a P a g e / S a y f a | 13 significant difference in the time needed to return to work in favor to the HS method than the conventional one. Seventy-five percent of the patients in HS Group reported full-time return to work within the first two weeks postoperatively while for CH Group, this was true only for forty-five percent of the patients [20].…”

Section: Discussionmentioning

confidence: 99%

Geleneksel diyatermi ile kıyaslandığında harmonik bistürinin hemoroidektomide faydası var mıdır?

Dogan

Dönmez

Akturk

et al. 2018

Archives of Clinical and Experimental Medicine

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Aim: Symptomatic hemorrhoidal disease is among the most common surgical diseases and it may necessitate surgical intervention. The most common and effective approaches used for surgical treatment are harmonic scalpel hemorrhoidectomy and conventional diathermy excision. The aim of the study was to compare the outcomes of hemorrhoidectomy using harmonic scalpel and the conventional diathermy excision techniques. Methods: The files of 113 consecutively operated patients (26 females 23%, 87 males 77%), who were operated on for symptomatic Grade III-IV hemorrhoids, were retrospectively reviewed for length of operation and hospitalization, early and delayed bleeding, urinary retention, postoperative abscess and anal stenosis. Exclusion criteria were additional operations, recurrent cases and inflammatory bowel disease. Results: Conventional diathermy hemorrhoidectomy in 60 (53%) and harmonic scalpel hemorrhoidectomy were used in 53 patients (47%). There were significant differences between the operation and hospitalization times in favor of harmonic scalpel group (p<0.05 for both). The other parameters did not show any significant differences (p>0.05 for all). Conclusion: Harmonic scalpel hemorrhoidectomy is advantageous and superior to conventional diathermy hemorrhoidectomy in regard to shorter operation time and earlier discharge from the hospital with no additonal complications. Keywords: Harmonic, Hemorrhoidectomy, Scalpel, Surgery, Technique Öz Amaç: Semptomatik hemoroidal hastalık, en yaygın cerrahi hastalıklar arasındadır ve tedavide cerrahi müdahale gerekebilir. Cerrahi tedavide etkili yaklaşımlar harmonik bistüri ile hemoroidektomi ve konvansiyonel diyatermi ile eksizyondur. Çalışmanın amacı, harmonik bistüri ve konvansiyonel diyatermi eksizyon teknikleriyle yapılan hemoroidektomi sonuçlarını karşılaştırmaktı. Yöntemler: Semptomatik Evre III-IV hemoroid nedeniyle ardışık operasyon yapılan 113 hasta (26 kadın, % 23; 87 erkek, % 77) dosyaları retrospektif olarak incelendi ve operasyon ve hastanede kalış süresi, erken ve gecikmiş kanama, idrar yapmada zorluk, postoperatif apse ve anal stenoz araştırıldı. Dışlama kriterleri; ek cerrahi uygulanması, rekürren vakalar ve inflamatuvar bağırsak hastalığı idi. Bulgular: Altmış hastada (%53) konvansiyonel diyatermi ile hemoroidektomi ve 53 hastada (%47) harmonik bistüri ile hemoroidektomi uygulandı. Operasyon ve yatış süreleri arasında harmonik bistüri grubu lehine anlamlı farklılık tespit edildi (her ikisi için p<0,05). Diğer parametrelerde anlamlı bir farklılık yoktu (hepsi için p>0,05). Sonuç: Harmonik bistüri ile hemoroidektomi, ameliyat süresinin kısa olması ve hastaneden daha erken taburcu olmasına karşın ek bir komplikasyona rastlanmadığı için konvansiyonel diyatermi hemoroidektomisine göre avantajlıdır.

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Section: Discussionmentioning

confidence: 99%

Geleneksel diyatermi ile kıyaslandığında harmonik bistürinin hemoroidektomide faydası var mıdır?

Dogan

Dönmez

Akturk

et al. 2018

Archives of Clinical and Experimental Medicine

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“…Harmonic scalpel achieved favorable postoperative pain scores compared with open or closed hemorrhoidectomy with scissors and/or monopolar or bipolar electrocautery in a number of prospective randomized studies [14][15][16][17][18][19]. The difference in pain was attributed to avoidance of lateral thermal energy in harmonic scalpel as opposed to electrocautery.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

et al. 2015

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“…6 and Abo hashem et al, (2010). 7 The later authors reported that pain at first defecation and at rest first and second week after surgery was significantly lower in HS group then MM group. Armstrong et al, (2001) reported that postoperative pain was significantly less in the HS group.…”

Section: Graph 4: Postoperative Complications In Patients Treated Bymentioning

confidence: 92%

Harmonic Scalpel Haemorrhoidectomy vs Conventional Milligan and Morgan Haemorrhoidectomy: A Prospective Study

Kasthuri¹,

Reddy²

2015

jemds

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BACKGROUND:Haemorrhoids are one of the most frequent anorectal disorders encountered in the primary care setting. Heamorrhoidectomy is the procedure of choice. Harmonic scalpel had been advocated for performing bloodless Haemorrhoidectomy, in place of electric cautery and ligatures. AIM: The aim of this study is to compare Harmonic scalpel Haemorrhoidectomy with conventional M. M. Haemorrhoidectomy using electric cautery in the management of grade III and grade IV haemorrhoids with reference to certain characteristics like postoperative pain, complications, hospital stay, cost of surgery. METHODS AND MATERIALS: This is a randomized single blind control study with 50 patients divided into two groups. 25 patients underwent M. M. Haemorrhoidectomy (M. M. Group), and rest underwent Harmonic scalpel Haemorrhoidectomy (H. S. Group). Results were compared in relation to certain characteristics like perioperative bleeding, postoperative pain and complications, hospital stay, cost of surgery. RESULTS: Age and gender wise distribution in both groups is comparable. Intraoperative bleeding was more frequent in the MM group than in HS group (32% versus 16% respectively). Intraoperative bleeding was more frequent in the MM group than in HS group (32% versus 16% respectively). Hospital stay was prolonged in the MM group than HS group, as 44% in MM group were discharged at three days, when compared to 76% in HS group. CONCLUSION: Harmonic scalpel haemorrhoidectomy had better outcome in characteristics like postoperative pain, post-operative complications, hospital stay, but its more expensive than conventional M. M. Haemorrhoidectomy. KEYWORDS: Harmonic scalpel, Haemorrhoidectomy, Milligan Morgan. INTRODUCTION:Haemorrhoids are one of the commonest anorectal disorders encountered in general surgical practice. They are the most common cause of bleeding per rectum and responsible for considerable patient suffering and disability. (1) Haemorrhoidectomy is the treatment of choice for grade III and grade IV Haemorrhoids. Post-operative course after haemorrhoidectomy will be protracted and painful. Different surgical techniques and use of recent advancements in instrumentations like Harmonic scalpel, Ligature and circular stapler (PPH) had been advocated for better outcome and to minimize perioperative bleeding and post-operative pain.Harmonic scalpel is an ultrasonically activated instrument, which vibrates at a rate of 55,000 HZ per second. It generates less temperature during tissue dissection and controls bleeding by coacptive coagulation at low temperatures ranging from 50 o C to 100 o C. Coagulation occurs by means of protein denaturation when the blade vibrating at 55000 HZ, couples with protein, denaturating it to form a coagulum that seals small coapted vessels. When the effect is prolonged, secondary heat is produced that seals larger vessels.By contrast, electro surgery and lasers coagulate by burning (Obliterative coagulation) at higher temperatures (150 o C to 400 o C). Blood and tissue are desiccated and oxidiz...

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Harmonic Scalpel® compared with bipolar electro-cautery hemorrhoidectomy: A randomized controlled trial

Abstract: This study demonstrates significantly reduced postoperative pain after Harmonic Scalpel Hemorrhoidectomy compared with bipolar electro-cautery Hemorrhoidectomy. Most likely, this result came from the avoidance of excessive lateral thermal injury caused by bipolar electrocautery.

Cited by 44 publications

References 21 publications

Geleneksel diyatermi ile kıyaslandığında harmonik bistürinin hemoroidektomide faydası var mıdır?

Geleneksel diyatermi ile kıyaslandığında harmonik bistürinin hemoroidektomide faydası var mıdır?

Hemorrhoidectomy in Patients with Grade III or IV Disease: Harmonic Scalpel Compared With Conventional Closed Technique

Harmonic Scalpel Haemorrhoidectomy vs Conventional Milligan and Morgan Haemorrhoidectomy: A Prospective Study

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