Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 8;16(8):e66430.
doi: 10.7759/cureus.66430. eCollection 2024 Aug.

A Retrospective Study of Milligan-Morgan Versus LigaSure Hemorrhoidectomy in the Treatment of Symptomatic Hemorrhoids at an Institute in North India

Anant Kaur Virk  1 , Rohin Kansal  1 , Carol Singh  1 , Madhav Mehta  1 , Baninder Arora  2 , Anmol Singh  1 , Kashish Malhotra  1 , Jasneet Grewal  1 , Himel Mondal  3 , Ashvind Bawa  1
Affiliations

A Retrospective Study of Milligan-Morgan Versus LigaSure Hemorrhoidectomy in the Treatment of Symptomatic Hemorrhoids at an Institute in North India

Anant Kaur Virk et al. Cureus. .

Abstract

Objective The present study aimed to assess and compare the surgical outcomes of hemorrhoidectomies performed using two different techniques: conventional Milligan-Morgan and another popular vessel sealing approach of LigaSure hemorrhoidectomy. Methods This retrospective study was conducted at our tertiary care hospital and involved patients who underwent either of the surgical procedures from June 2016 to March 2022. The patient demographics and data on the duration of operation, hospital stay, and postoperative recovery were collected and evaluated. Results Of the 91 cases reviewed, a total of 44 patients underwent Milligan-Morgan open hemorrhoidectomy and 47 had LigaSure hemorrhoidectomy. The mean operative time was significantly shorter for LigaSure hemorrhoidectomy (33.84 ±9.18 vs. 23.15 ±3.36 minutes for Milligan-Morgan and LigaSure, respectively, p<0.0001). Additionally, in comparison to Milligan-Morgan open hemorrhoidectomy, the LigaSure hemorrhoidectomy group exhibited a significant reduction in hospital stay (2.20 ±0.79 vs. 1.47 ±0.50 days), lower pain score [6.55 ±1.19 vs. 5.30 ±1.10 on the visual analog scale (VAS) on day one and 2.25 ±1.26 vs. 1.47 ±0.78 VAS on day seven], and faster return to normal activities (18.18 ±4.30 vs. 14.85 ±3.15 days). Conclusions When pitted against the traditional Milligan-Morgan method, the LigaSure approach to performing a hemorrhoidectomy is superior, owing to the shorter duration of operation, shorter hospital stays, lesser pain, and earlier return to normal activities. In light of these findings, surgeons may consider choosing this procedure to improve surgical outcomes and efficiency.

Keywords: general surgery; hemorrhoidectomy; hemorrhoids; ligasure; milligan–morgan; piles; return-to-work.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee at Dayanand Medical College and Hospital (DMCH), Ludhiana issued approval IEC No: 2022-737. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Image showing the use of LigaSure handheld device for hemorrhoidal mass excision
See this image and copyright information in PMC

References

    1. Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Gallo G, Martellucci J, Sturiale A, et al. Tech Coloproctol. 2020;24:145–164. - PMC - PubMed
    1. Still a case of "no pain, no gain"? An updated and critical review of the pathogenesis, diagnosis, and management options for hemorrhoids in 2020. Ng KS, Holzgang M, Young C. Ann Coloproctol. 2020;36:133–147. - PMC - PubMed
    1. Lifestyle and risk factors in hemorrhoidal disease. De Marco S, Tiso D. Front Surg. 2021;8:729166. - PMC - PubMed
    1. Comparison of surgical procedures implemented in recent years for patients with grade III and IV hemorrhoids: a network meta-analysis. Du T, Quan S, Dong T, Meng Q. Int J Colorectal Dis. 2019;34:1001–1012. - PubMed
    1. Hemorrhoids: diagnosis and treatment options. Mott T, Latimer K, Edwards C. https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html. Am Fam Physician. 2018;97:172–179. - PubMed

LinkOut - more resources