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


  • Ersin Gürkan Dumlu Ankara Ataturk and Training Hospital
  • Ahmet Gürer Ankara Ataturk and Training Hospital
  • Mehmet Tokaç Ankara Ataturk and Training Hospital
  • Mesut ÖzdedeoÄŸlu Ankara Ataturk and Training Hospital
  • Birkan Bozkurt Ankara Ataturk and Training Hospital
  • Gülten Kıyak Ankara Ataturk and Training Hospital
  • Mehmet Kılıç Yıldırım Beyazıt University Faculty of Medicine




hemorrhoidectomy, harmonic scalpel



Background: Harmonic scalpel (Ultracision) is a device that simultaneously cuts and coagulates soft tissues through ultrasonic vibration. In this study we aimed to determine the operative and postoperative characteristics of hemorrhoidectomy using the harmonic scalpel compared with the conventional closed technique.

Methods and Findings: Patients with grade III or IV hemorrhoids, operated between 2010 and 2013, using the harmonic scalpel (n=21) or the conventional closed technique (n=42) were included in the study. Exclusion criteria were thrombosed or strangulated hemorrhoids, concomitant perianal disease, history of recurrent perianal surgery and known tendency for bleeding. Patient characteristics, duration of operation, complications, postoperative pain measured on a visual analog scale (VAS), hospital stay, and return to regular activity were compared between the two groups retrospectively.

Patient characteristics (female:male ratio, mean age, hemorrhoid grade, and symptom duration) were similar between the two groups. Harmonic scalpel and conventional hemorrhoidectomy patients did not differ significantly in terms of VAS score of pain, complications, hospital stay or return to regular activity. However, duration of operation was significantly shorter with harmonic scalpel (24.2 vs. 36.2 min, p<0.05).

Conclusion: There is no clear evidence to support the routine use of harmonic scalpel system in hemorrhoid surgery.

Author Biographies

Ersin Gürkan Dumlu, Ankara Ataturk and Training Hospital

Department of General Surgery

Ahmet Gürer, Ankara Ataturk and Training Hospital

Department of General Surgery

Mehmet Tokaç, Ankara Ataturk and Training Hospital

Department of General Surgery

Mesut Özdedeoğlu, Ankara Ataturk and Training Hospital

Department of General Surgery

Birkan Bozkurt, Ankara Ataturk and Training Hospital

Department of General Surgery

Gülten Kıyak, Ankara Ataturk and Training Hospital

Department of General Surgery

Mehmet Kılıç, Yıldırım Beyazıt University Faculty of Medicine

Department of General Surgery


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General Surgery