Comparison of Outcome of Bipolar Electrocautery versus Harmonic Scalpel in the Management of Third and Fourth Degree Hemorrhoids

Objective: To compare the outcome of bipolar electrocautery versus harmonic scalpel in the management of third degree hemorrhoids. Methodology: This is a comparative study performed at Different Private Clinics of Karachi from the duration of January 2020 to June 2020. Patients with symptomatic grade III hemorrhoids and grade IV hemorrhoids were randomly divided into two groups. . Either group had 64 patients. One group underwent hemorrhoidectomy using bipolar electrocautery (Group A), other group underwent hemorrhoidectomy using harmonic scalpel hemorrhoidectomy (Group B). Results: The total number of patients was 128 with 64 in either group. The mean operating time in group A was 22 ± 4.7 minutes, while that in group B was 35 ± 2.2 minutes. The mean duration of hospital stay among group A was 1.7 ± 0.5 days while among group B patients was 2.1 ± 1.2 days. Mean VAS score for pain at first post-operative day in group A patients was 7 ± 0.6 days while mean VAS score for pain among group B patients was 8.5 ± .2 days. Conclusion: Our study concludes that harmonic scalpel hemorrhoidectomy offers better post-operative patient satisfaction score as compared to bipolar diathermy. No significant difference in hospital stay was found. The number of patients with post-operative urinary retention were more in harmonic scalpel group while in diathermy group, more patients had post-operative hemorrhage.