Our Summary

This study aimed to compare two surgical methods for removing severe hemorrhoids: ENSEAL® and Milligan-Morgan hemorrhoidectomy, which is the current gold standard. The research was carried out at Lahore General Hospital in Pakistan from 2020 to 2022 on 140 patients split into two equal groups. Group A had the ENSEAL® procedure, while Group B had the Milligan-Morgan procedure.

The study found that the ENSEAL® method was quicker, resulted in less blood loss, and caused less post-operative pain than the Milligan-Morgan procedure. Therefore, the researchers concluded that ENSEAL® could be a safe and efficient alternative treatment for severe hemorrhoids.

FAQs

  1. What were the two surgical methods compared in the study for removing severe hemorrhoids?
  2. What were the results of the comparison between the ENSEAL® and Milligan-Morgan procedures?
  3. Could ENSEAL® be considered a safe and efficient alternative treatment for severe hemorrhoids according to the study?

Doctor’s Tip

After undergoing a hemorrhoidectomy, it is important to follow your doctor’s post-operative instructions carefully. This may include taking pain medication as prescribed, keeping the surgical area clean and dry, and avoiding strenuous activities that could put pressure on the healing area. It is also important to eat a high-fiber diet, stay hydrated, and avoid straining during bowel movements to prevent recurrence of hemorrhoids. If you experience any severe pain, bleeding, or other complications, be sure to contact your doctor immediately.

Suitable For

Patients who are recommended for hemorrhoidectomy typically have severe hemorrhoids that have not responded to conservative treatments such as dietary changes, topical medications, and rubber band ligation. They may experience symptoms such as persistent bleeding, prolapse, pain, itching, and difficulty with hygiene. These patients may have grade III or IV hemorrhoids as classified by the Goligher’s classification system, which are large, prolapsed hemorrhoids that may require surgical intervention for symptom relief.

Timeline

Timeline of patient experience before and after hemorrhoidectomy:

Before surgery:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and discomfort.
  2. Patient consults with a healthcare provider who recommends surgical intervention for severe hemorrhoids.
  3. Patient undergoes pre-operative assessments and tests to ensure they are fit for surgery.
  4. Patient receives instructions on pre-operative preparations such as fasting and medication adjustments.

During surgery:

  1. Patient is placed under anesthesia.
  2. Surgeon performs the chosen surgical method (ENSEAL® or Milligan-Morgan hemorrhoidectomy) to remove the hemorrhoids.
  3. Procedure typically lasts for about 30-60 minutes.

After surgery:

  1. Patient wakes up in the recovery room and is monitored for any immediate post-operative complications.
  2. Patient may experience some pain, discomfort, and bleeding in the immediate post-operative period.
  3. Patient is discharged from the hospital with post-operative care instructions.
  4. Patient may need to take pain medication and stool softeners to manage pain and bowel movements.
  5. Patient is advised to follow a specific diet and avoid strenuous activities to aid in the healing process.
  6. Follow-up appointments are scheduled to monitor the healing progress and address any concerns or complications.
  7. Patient gradually resumes normal activities as advised by the healthcare provider.
  8. Patient experiences relief from hemorrhoid symptoms and improved quality of life after successful healing from the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications of a hemorrhoidectomy procedure?
  2. How long is the recovery time after a hemorrhoidectomy?
  3. Will I need to take time off work or make any lifestyle changes during the recovery period?
  4. Are there any dietary restrictions or recommended foods to eat after a hemorrhoidectomy?
  5. Will I need to take any medications or use any special care techniques to help with healing and pain management?
  6. How long will it take for me to see improvement in my symptoms after the procedure?
  7. Are there any long-term effects or potential complications that I should be aware of?
  8. How often will I need follow-up appointments after the procedure?
  9. Are there any alternative treatment options for severe hemorrhoids that I should consider?
  10. What is the success rate of the ENSEAL® procedure compared to the Milligan-Morgan procedure for severe hemorrhoids?

Reference

Authors: Javed S, Kaiser A, Khan AZ, Javed A, Chaudhary S, Javed A, Shahid MH. Journal: Cureus. 2022 Oct 29;14(10):e30834. doi: 10.7759/cureus.30834. eCollection 2022 Oct. PMID: 36407175