HARMONICA SCALPEL VERSUS MILLIGAN MORGAN TECHNIQUE WITH ELECTRO CAUTERY FOR HAEMORRHOIDECTOMY.

Background: The hemorrhoids is a quite common disease that is usually treated by surgery (stage 3 and 4) depending on the grade of the disease at presentation with some role for conservative treatment when presented early (stage 1 and 2). The open conventional haemorrhoidectomy by Milligan Morgan supported by electro cautery was used, many new techniques established among these is Harmonica scalpel. Materials and method: 302 patients in stage 3 and 4 haemorrhoids involved in this study in the time period from January 2016 to December 2018. Harmonica scalpel used for the surgical treatment of 152 patients, and 150 patients treated by conventional haemorrhoidectomy. A comparison was made between these two methods regarding operation time, postoperative pain, post-operative bleeding, analgesics, hospitalization, time to return to normal activity and post-operative complications. Results: The average time for operation was 15?5 minutes with post-operative hospitalization 6 hours for Harmonica scalpel, for Milligan Morgan the average time for operation was 25?7 minutes with post-operative hospitalization 24 hours. Peri-operative bleeding was negligible for Harmonica scalpel and was significant for conventional haemorrhoidectomy. Post-operative bleeding was negligible in patients submitted to HS and was significant in patients underwent MM, analgesics were needed for 3 days after HS technique and 10 days for MM surgery. Conclusion: HS haemorrhoidectomy is preferred technique to be used in grade 3 and 4 haemorrhoids with shorter operation time, less intra-operative & post-operative bleeding, less post-operative pain & less post-operative complications as compared with the conventional Milligan Morgan's procedure.