Stapler hemorrhoidopexy versus open hemorrhoidectomy

Background: Hemorrhoids are a common anorectal condition requiring surgical intervention in advanced stages. Open hemorrhoidectomy (Milligan–Morgan technique) is effective but associated with significant post-operative pain and delayed recovery. Stapler hemorrhoidopexy offers a minimally invasive alternative with potentially better short-term outcomes. Aims and Objectives: This study aims to compare the clinical outcomes of stapler hemorrhoidopexy and open hemorrhoidectomy in terms of post-operative pain, complications, analgesic needs, and hospital stay among patients with Grade III and IV hemorrhoids. Materials and Methods: A prospective comparative study was conducted on 100 patients undergoing either open hemorrhoidectomy (n=50) or stapler hemorrhoidopexy (n=50) at Maharani Laxmi Bai Medical College, Jhansi. Post-operative pain was assessed using the Visual Analog Scale at 6, 12, and 24 h. Data on complications, analgesic requirements, and hospital stay were collected and analyzed statistically. Results: Stapler hemorrhoidopexy showed significantly lower pain scores at all time intervals (P<0.0001). It also resulted in fewer complications such as bleeding (20% vs. 38%) and incontinence (10% vs. 26%). Analgesic requirements were markedly reduced (8% vs. 92%), and mean hospital stay was shorter (1.86±0.670 days vs. 4.34±1.189 days). However, the stapler group had a higher incidence of residual prolapse (38% vs. 10%). Conclusion: Stapler hemorrhoidopexy provides superior short-term outcomes compared to open hemorrhoidectomy, with less pain, faster recovery, and fewer complications, though residual prolapse remains a concern. It is a preferable option in suitable patients.