Haemorrhoidectomy with harmonic scalpel

MainText

Momcilo Stosic, Igor Stojanovic

The Department of Surgery, General Hospital Vranje, Serbia

Introduction

Results

It is difficult to estimate the number of people suffering from

They were treated preoperatively from 0 to 6 days, an average of 2.6

hemorrhoids, it is probably greater than 1/3 of the population. ,2

days. The anesthesia was spinal /peridural or general. The spinal

Symptoms have about 20% of them3, and about 5% of that number is

catheter had been introduced to the four of the patients. The approximate

operated4. Many various ways of a treatment are reported, depending

time of the procedure was 30 minutes. The bleeding was at a minimum,

on the stadium of the Goligher. The 3rd and 4th degree are treated

in particular to the lateral sides of the nodules (Fig. 3). The arteries were

operationally. All me thods are based on open or closed techniques,

sutured. There was not the postoperative bleeding, the pain was reduced

the so-called "transfixed stitches. Technical resources that we use are

and patients were dismissed the same day, or after 3 days. The Diosmin

different: scissors, dyathermy, stapler, Ligasure Camera, harmonic

was

scalpel, radio-frequency knife, bipolar dythermy laser.5 The hospital in

continence. After one month some patients had complained of feeling the

Vranje has got the harmonic scalpel at the beginning of 2014.

stenosis (one patient did not have that feeling), one patient had the

prescribed.

There

were

not disorders

of

the

postoperative

occasional bleeding which eventually disappeared, and three of them had

Patient and methodology

the changed feeling during the defecation. All patients were satisfied with

For the first 5 months of 2014. we operated 10 patients by Milligan-

the treatment in comparison with the preoperative condition.

Morgan (open) method with the help of this device. The aim is to present
our first experience. More than half of the number of patients were
operated on by one surgeon. All patients were in the fourth degree of the

Inpregnancies

disease and they had pains, erosion, some bleeding; some of them had
non-reponobility nodulas. The approximate age of patients was 44.2
years (range 26-64). Only two women were operated (Fig. 1). Three
patients were alcoholic without a hepatic disturbance or coagulopathy
(Fig. 2); one patient was with the diabetes mellitus; four patients had the
hypertension.

Figure3

Figure2

Figure 2: Your caption to go here

Figure 3: Your caption to go here Quisque viverra

lectus ac lectus

Conclusion

The operation of hemorrhoids with the ultrascission device is with the less bleeding, less postoperative pain, and the
procedure is much faster.

References
Bulus a H, Tas A, Coskun A, Kucukazman M. Evaluation of two hemorrhoidectomy techniques: Harmonic scalpel and Fergusons with electrocautery. Asian Journal of
Surgery 2014; 37:20-23.
2
Ohning GV, Machicado GA, Jensen DM. Definitive therapy for internal hemorrhoids: new opportunities and options. Rev Gastroenterol Disord 2009;9:1626.
3
Riss S, Weiser FA, Schwameis K, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis 2012;27:215220
4
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiologic study. Gastroenterology 1990;98:380386.
5
Kaidar-Person O, Person B, Wexner S. Hemorrhoidal Disease: A Comprehensive Review. American College of Surgeons 2007;204(1):112-117.

Contact:
momcilostosic@gmail.com
www.momcilostosic.wix.com/hirurskiugao.com