title: Comparison of vessel sealing systems with conventional.
abstract: BACKGROUND
  Haemorrhoids are cushions of submucosal vascular tissue located in the anal canal starting just distal to the dentate line. Haemorrhoidal disease is a common anorectal disorder which has symptoms of bleeding, prolapse, pain, thrombosis, mucus discharge, and pruritus. Haemorrhoidectomy is one of most frequently performed anorectal operation worldwide.
  
  
  OBJECTIVE
  The aim of this study was to compare the effectiveness of the LigaSure tissue sealing device, Harmonic Scalpel and conventional MM open haemorrhoidectomy.
  
  
  METHODS
  Sixty-nine patients with newly diagnosed symptomatic grade three or grade four haemorrhoidal disease, from July 2011 to December 2011 were recruited for the study. Patients were prospectively randomized to LigaSure, Harmonic Scalpel and conventional haemorrhoidectomy. Patients were evaluated on the basis of the mean operative time, postoperative pain, day of discharge, early and late complications.
  
  
  RESULTS
  Each group has twenty-three patients. Ten (14.5 %) were female and fifty-nine (85.5 %) were male. Mean age were 44.5 ± 10.8 for LigaSure group, 39.5±14.4 for Harmonic Scalpel group and 39.8 ± 13.6 for conventional haemorrhoidectomy group. Mean operative time was 12.6 ± 2.9 for LigaSure group, 12.6 ± 2.5 for Harmonic Scalpel group and 22.3 ± 4.5 for conventional haemorrhoidectomy group. Postoperative pain and required analgesic dose were significantly lower for conventional haemorrhoidectomy. Wound healing was also more rapid in conventional haemorrhoidectomy than both LigaSure and Harmonic Scalpel.
  
  
  CONCLUSIONS
  Lateral heat dissipation of energy based cautery such as Harmonel Scalpel and LigaSure is considerably high when compared with conventional methods. More thermal damage which is generated on tissue seems to be the reason for increased degree of postoperative pain and delay in wound healing.
authors.affiliation: Erzincan University Department of General Surgery, Erzincan, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Peker
authors.affiliation: Erzincan University Department of General Surgery, Erzincan, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Inal
authors.affiliation: Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey.
authors.forename: Huriye
authors.initials: H
authors.lastname: Güllü
authors.affiliation: Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey.
authors.forename: Düriye
authors.initials: D
authors.lastname: Gül
authors.affiliation: Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Palandoken State Hospital Department of Anesthesiology & Reanimation, Erzurum, Turkey.
authors.forename: Ayca Dumanli
authors.initials: AD
authors.lastname: Ozcan
authors.affiliation: Kafkas University Department of General Surgery, Kars, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Kılıç
keywords: Haemorrhoidectomy; Harmonic Scalpel; LigaSure