Advertisement

Techniques in Coloproctology

, 13:317 | Cite as

Tips and tricks: haemorrhoidectomy with LigaSure™

  • Giovanni MilitoEmail author
  • Federica Cadeddu
How I Do It

Abstract

Haemorrhoidectomy is frequently associated with significant postoperative pain and prolonged hospital stay. New techniques to reduce these problems are constantly under evaluation. Amongst these, LigaSure haemorrhoidectomy is a safe and fast technique that fulfils the requirements of low-complication rate, fast wound healing and quick return to work, reduction in postoperative pain and hospitalisation. The authors detail all the steps of the surgical procedure: operative position; haemorrhoids exposure; dissection, vascular pedicle legation and haemorrhoidal removal, final control. Besides this, the attention is focused on the technical features of LigaSure technology, given that understanding of technical background is a prerequisite for adequate handling of the LigaSure device.

Keywords

LigaSure sealing system Open haemorrhoidectomy 

Supplementary material

Supplementary material 1 (WMV 12755 kb)

References

  1. 1.
    MacRae HM, McLeod RS (1995) Comparison of haemorrhoidal treatment modalities: a meta-analysis. Dis Colon Rectum 38:687–694CrossRefPubMedGoogle Scholar
  2. 2.
    Ho YH, Buettner PG (2007) Open compared to closed haemorrhoidectomy: meta-analysis of randomized controlled trials. Tech Coloproctol 2:135–143CrossRefGoogle Scholar
  3. 3.
    Muzi MG, Milito G, Nigro C et al (2007) Randomized clinical trial of LigaSure and conventional diathermy haemorrhoidectomy. Br J Surg 94:937–942CrossRefPubMedGoogle Scholar
  4. 4.
    Ho KS, Ho Y-H (2006) Prospective randomized trial comparing stapled hemorrhoidopexy versus closed Ferguson haemorrhoidectomy. Tech Coloproctol 10:193–197CrossRefPubMedGoogle Scholar
  5. 5.
    Tan JJ, Seow-Choen F (2001) Prospective, randomized trial comparing diathermy and Harmonic Scalpel® haemorrhoidectomy. Dis Colon Rectum 44:677–679CrossRefPubMedGoogle Scholar
  6. 6.
    Jayne DG, Botterill I, Ambrose NS, Brennan TG, Guillou PJ, O’Riordain DS (2002) Randomized clinical trial of LigaSure™ versus conventional diathermy for day-case haemorrhoidectomy. Br J Surg 89:428–432CrossRefPubMedGoogle Scholar
  7. 7.
    Palazzo FF, Francis DL, Clifton MA (2002) Randomized clinical trial of LigaSure™ versus open haemorrhoidectomy. Br J Surg 89:154–157PubMedGoogle Scholar
  8. 8.
    Milito G, Gargiani M, Cortese F (2002) Randomized trial comparing LigaSure™ haemorrhoidectomy with the diathermy dissection operation. Tech Coloproctol 6:171–175CrossRefPubMedGoogle Scholar
  9. 9.
    Franklin EJ, Seetharam S, Lowney J, Horgan PG (2003) Randomised, clinical trial of LigaSure™ vs conventional diathermy in haemorrhoidectomy. Dis Colon Rectum 46:1380–1383CrossRefPubMedGoogle Scholar
  10. 10.
    Wang JY, Lu CY, Tsai HL et al (2006) Randomized controlled trial of LigaSure™ with submucosal dissection versus Ferguson haemorrhoidectomy for prolapsed haemorrhoids. World J Surg 30:462–466CrossRefPubMedGoogle Scholar
  11. 11.
    Cheetham MJ, Cohen CR, Kamm MA, Phillips RK (2003) A randomized, controlled trial of diathermy haemorrhoidectomy vs. stapled haemorrhoidectomy in an intended day-care setting with longer-term follow-up. Dis Colon Rectum 46:491–497CrossRefPubMedGoogle Scholar
  12. 12.
    Milito G, Cadeddu F, Muzi MG, Nigro C, Farinon AM (2002) Haemorrhoidectomy with LigaSure™ versus conventional excisional techniques: meta-analysis of randomized controlled trials. Colorectal Dis. doi: 10.1111/j.1463-1318.2009.01807.x
  13. 13.
    Tan EK, Cornish J, Darzi AW, Papagrigoriadis S, Tekkis PP (2007) Meta-analysis of short-term outcomes of randomized controlled trials of LigaSure vs conventional haemorrhoidectomy. Arch Surg 142:1209–1218CrossRefPubMedGoogle Scholar
  14. 14.
    Mastakov MY, Buettner PG, Ho YH (2008) Updated meta-analysis of randomized controlled trials comparing conventional excisional haemorrhoidectomy with LigaSure for haemorrhoids. Tech Coloproctol 12:229–239CrossRefPubMedGoogle Scholar
  15. 15.
    Nienhuijs S, de Hingh I (2009) Conventional versus LigaSure haemorrhoidectomy for patients with symptomatic hemorrhoids. Cochrane Database Syst Rev 21:CD006761Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospital Tor VergataRomeItaly

Personalised recommendations