title: Vascular Z-shaped ligation technique in surgical treatment of haemorrhoid.
abstract: OBJECTIVE
  To present the effectiveness of minimal invasive vascular zet ligation in the surgical treatment of haemorrhoidal disease (HD).
  
  
  METHODS
  Among 138 patients with 2(nd)-4(th) grade internal HD having several complaints and operated at our hospital between 2003-2013; 116 patients who regularly attended 1-year control were included in the study. Operation times, postoperative early period pain, satisfaction score, complications and relapse details were obtained from computer records retrospectively. Visual Analogous Scale (VAS) scores were used for patient satisfaction on the 3(rd), 7(th) and 21(st) days. Technique; fixed suture which is constituted by the first leg of the Z-shaped suture (to pass by the mucosa and muscular layer) was put in the pile root in order to ensure vascular ligation and fixation. The second leg of the Z-shaped suture is constituted by mobile suture and it passes by the pile mucosa and submucosa which prolapses 5-10 mm below the first suture.
  
  
  RESULTS
  Seventy-five of the patients (65%) were male, 41 of them (35%) were female and their age average was 41. The mean operation time was 12 ± 4.8 min. VAS/satisfaction score was found as 2.2/4.3, 1.8/4.0, 1.2/4.4 respectively on the 3(rd), 7(th), and 21(st) days. Four of the patient (3.5%) had relapse.
  
  
  CONCLUSIONS
  This technique is an easily applicable, cost efficient way of operation which increases patient satisfaction.
authors.affiliation: Kazım Gemici, Ahmet Okuş, Department of General Surgery, Faculty of Medicine, Mevlana University, 42200 Konya, Turkey.
authors.forename: Kazım
authors.initials: K
authors.lastname: Gemici
authors.affiliation: Kazım Gemici, Ahmet Okuş, Department of General Surgery, Faculty of Medicine, Mevlana University, 42200 Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Okuş
authors.affiliation: Kazım Gemici, Ahmet Okuş, Department of General Surgery, Faculty of Medicine, Mevlana University, 42200 Konya, Turkey.
authors.forename: Serden
authors.initials: S
authors.lastname: Ay
keywords: Haemorrhoidectomy; Haemorrhoids; Z ligation