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Sutureless Closed Hemorrhoidectomy: A New Technique

Sayfan, Joel MD; Becker, Alexander MD; Koltun, Lev MD

Advances In Surgical Technique

Objective To compare a new technique of radical hemorrhoidectomy using an electrothermal device originally devised to seal vessels in abdominal operations, with the conventional open Milligan-Morgan procedure performed with diathermy.

Summary Background Data Hemorrhoidectomy is one of the most commonly performed anorectal operations. Two well-established methods, the “open” Milligan-Morgan excision and the “closed” Ferguson technique, both carry risks of postoperative bleeding, urinary retention, and late anal stenosis. The convalescence is similarly long and difficult after both operations. The quest for an improved technique of radical excision of hemorrhoids is justified.

Methods In this case-control study, two groups of patients were alternatively allocated into study and control groups. In the study group (n = 40), an electrothermal system was used. The tissue fusion produced by this device consists of melting of collagen and elastin. This technique essentially achieves a sutureless closed hemorrhoidectomy. The operative time, postoperative complications, and time off work were compared with the group undergoing conventional Milligan-Morgan hemorrhoidectomy (control group, n = 40).

Results The operative time and time off work were significantly shorter in the study group. There were also fewer postoperative complications in this group.

Conclusions The “tissue-welding” properties of this device and the shape of the electrode handpiece may be successfully applied to the performance of an operation most appropriately described as a “modified sutureless closed hemorrhoidectomy.” This pilot study shows that this new technique is simple and safe, significantly shortens the operation, and is followed by a significantly easier and shorter recovery.

From the Department of Surgery “A,” Haemek Medical Center, Afula, and B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

Correspondence: Joel Sayfan, MD, FACS, Department of Surgery, Haemek Medical Center, Afula, Israel.


Accepted for publication February 12, 2001.

© 2001 Lippincott Williams & Wilkins, Inc.