Abstract : Study is conducted to compare Harmonic scalpel assisted (ultrasonic) versus Milligan-Morgan (conventional) technique in the management of hemorrhoids, with respect to operative time/complications, post-operative pain, hospital stay and time to resume activity in patients operated in our institute. Prospective comparative study conducted in our institute from September 2019- October 2021 following approval from Ethical committee of hospital. Before surgery, all patients were kept nil by mouth overnight and given a prophylactic antibiotic dose, 30 minutes before induction. All of the procedures were conducted by the same surgical team, under spinal anesthesia, and intra-operative and post-operative data were documented. Mean age of 50 study sample was 49.50 years, with highest 63 years and lowest 38 years. There were 32 (64%) males & 18 (36%) females. 18 (36%) had grade III hemorrhoids, 28% with grade IV hemorrhoids, 9 (18%) with grade II hemorrhoids, 8 (16%) with interno-external hemorrhoids & 1 (2%) fibrosed hemorrhoids. Intraoperative bleeding was more in conventional group. Post operative local edema, infection, fecal incontinence, anal stenosis and recurrence are common complications with conventional hemorrhoidectomy. Mean surgery duration, intra-operative bleeding, post-operative pain score, mean hospital stay, duration to resume normal activity for harmonic scalpel assisted hemorrhoidectomy was significantly lower than Milligan-Morgan hemorrhoidectomy (p=0.000). Our study inferred that harmonic scalpel assisted hemorrhoidectomy is associated with less intra-operative time, blood loss, local edema, post-operative pain, hospital stay, and early return to normal activity/ work as compared with Milligan-Morgan hemorrhoidectomy..
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