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Comparison Study: Ligasure Versus Conventional Hemorrhoidectomy in III and IV Degree Hemorrhoids.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03848468
Recruitment Status : Completed
First Posted : February 20, 2019
Last Update Posted : February 20, 2019
Information provided by (Responsible Party):
Safia Zahir Ahmed, Services Hospital, Lahore

Brief Summary:
A comparison study was performed between Ligasure and Milligan morgan hemorrhoidectomy to find out the outcome between these two techniques in 3rd and 4th degree hemorrhoids.This advance vessel sealing device is used to seal the pedicle of the vessel and does not burn the surrounding tissues , so the outcome was monitored in terms of operative time, post operative pain pain, duration of wound healing in 3 weeks and return to normal activities

Condition or disease Intervention/treatment Phase
Hemorrhoidectomy Hemorrhoids Third Degree Hemorrhoids Fourth Degree Operative Time Pain, Postoperative Wound Healing Return to Work Procedure: Hemorrhoidectomy Not Applicable

Detailed Description:


Milligan Morgan hemorrhoidectomy is conventional procedure in 3rd and 4th degree hemorrhoids but recent advances in ligasure hemorrhoidectomy have shown to produce favorable results. Comparison of these two is studied in terms of pain outcome as patient perceives, operative time, wound healing and return to normal activities.


To compare the outcome of ligasure hemorrhoidectomy with conventional hemorrhoidectomy in III and IV degree hemorrhoids.


Randomized controlled trial


The study was conducted in surgical unit 1, Services hospital, Lahore.


Study was completed in six months after the approval of synopsis i.e. from 1st April 2014 to 30th September 2014.


After approval from hospital ethical committee, 100 patients fulfilling the inclusion criteria has been recruited from outdoor and emergency department. A detailed history had been taken including demographic data (age, address) and all patients had been clinically examined .Patients was divided in two groups randomly using random number tables. Group A: Conventional hemorrhoidectomy. Group B: Ligasure hemorrhoidectomy. Patients had been requested to sign an informed consent. They had been assured regarding confidentiality and expertise used for the procedure. All procedures have been performed by a single surgical operating team to control bias. Preoperatively operative time was noted. Post operatively pain had been assessed after 6 hours, 24 hours, and 48 hours, wound has been assessed in 2nd and 3rd postoperative week to assess epithelization and return to normal activities in days. All data had been collected and recorded on the Proforma

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Covidien 5mm ligasure
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Comparison Study: Ligasure Versus Conventional Hemorrhoidectomy in III and IV Degree Hemorrhoids.
Actual Study Start Date : April 1, 2014
Actual Primary Completion Date : September 30, 2014
Actual Study Completion Date : September 30, 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Hemorrhoids

Arm Intervention/treatment
Active Comparator: CH(conventional Hemorrhoidectomy)
conventional hemorrhoidectomy
Procedure: Hemorrhoidectomy
excision of 3rd and 4th degree hemorrhoids

Experimental: LH (Ligasure Hemorrhoidectomy)
Ligasure hemorrhoidectomy
Procedure: Hemorrhoidectomy
excision of 3rd and 4th degree hemorrhoids

Primary Outcome Measures :
  1. operative time [ Time Frame: each participant was measured from the start of operation till the dressing i.e duration of 20 minutes to 60 minutes ]
    was measured from start of incision to the dressing in minutes

  2. mean postoperative pain [ Time Frame: each participant was individually assessed after operation in 6 hours,24 hours and 48 hours post-operative and changes noted in 48 hours ]
    on Visual analogue scale,a scale to assess the post operative pain ,8-10 as maximum pain, 5-7 as moderate pain, 2-4 minimum pain, 1-0 as no pain and change in final outcome has been assessed after 48 hours

  3. wound healing [ Time Frame: to assess change in the parameter in 3 weeks ]
    assessed in scheduled appointment every week and has been defined as complete epithelization on physical examination .Wound was graded as 1-sloughy, 2-no granulation, 3-granulation, 4-epithelizing , 5-completely epithelized

  4. Return to work [ Time Frame: assessed individually from the day of surgery to resume of daily activities i.e 1 to 7 days ]
    has been defined as day of discharge till resume of work that is patient is able to perform daily routine activities normally as before operation.

Information from the National Library of Medicine

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Ages Eligible for Study:   19 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • patients with III and IV degree hemorrhoids assessed on proctoscopy had been included in this study.

Exclusion Criteria:

  • Patients with permanently prolapsed hemorrhoids limited to one quadrant only and had been assessed on per rectal examination and proctoscopy
  • Any other anorectal pathology on history and per rectal examination
  • Previous anal surgery assessed by history and per rectal examination
  • Inability to give informed consent
  • ASA(American Society of Anesthesiologists) grade III/IV on detailed history, clinical examination and laboratory findings e.g. deranged hepatic and renal profile and evidence of ischemic heart disease

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03848468

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services Hospital
Lahore, Punjab, Pakistan, 54000
Sponsors and Collaborators
Services Hospital, Lahore

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Responsible Party: Safia Zahir Ahmed, principal investigator, Services Hospital, Lahore Identifier: NCT03848468    
Other Study ID Numbers: ServicesH
First Posted: February 20, 2019    Key Record Dates
Last Update Posted: February 20, 2019
Last Verified: February 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Safia Zahir Ahmed, Services Hospital, Lahore:
Visual Analogue pain score
conventional Hemorrhoidectomy
Ligasure Hemorrhoidectomy
Additional relevant MeSH terms:
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Pain, Postoperative
Postoperative Complications
Pathologic Processes
Neurologic Manifestations
Signs and Symptoms
Rectal Diseases
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Vascular Diseases
Cardiovascular Diseases