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International Journal of Colorectal Disease

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01-07-2007 | Original Article

Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy.

Authors: Liam A. Haveran, Paul R. Sturrock, Mark Y. Sun, Janet McDade, Sudershan Singla, Craig A. Paterson, Timothy C. Counihan

Published in: International Journal of Colorectal Disease | Issue 7/2007

Abstract

Background

Harmonic Scalpel® hemorrhoidectomy (HSH) is an established surgical therapy for the treatment of symptomatic grade III and IV hemorrhoids. Hemorrhoid surgery is still being performed as an inpatient procedure with general or regional anesthesia in many centers today. There was a trend toward performing hemorrhoid surgery as an ambulatory procedure using local anesthesia supplemented with intravenous sedation. The aim of the current study was to evaluate the safety and efficacy of HSH performed with combination local anesthesia and intravenous sedation in an ambulatory surgical center.

Materials and methods

A retrospective review was performed on the clinical charts of all patients undergoing HSH in an ambulatory surgical center from 2001 to 2005. All hemorrhoidectomies were attempted under propofol/ketamine intravenous sedation and local anesthesia in the prone position. A simple, open technique without routine suture was used.

Results

During the study period, 180 patients (70 females) underwent HSM. Mean procedure and total operating room time were 12 and 28 min, respectively. One patient (0.6%) was converted to general endotracheal anesthesia. Ten patients (5.6%) required post anesthesia care unit (PACU) observation. All patients were discharged home after the procedure. Postoperative complications occurred in 19 patients (10.6%). There were no reoperations and the total readmission rate was 3.7%.

Conclusion

HSH performed with a combination of intravenous sedation and local anesthesia is safe and effective in the ambulatory surgery setting. The combined technique was associated with a rate of complications comparable to published series utilizing conventional hemorrhoidectomy techniques. Added benefits include shorter hospital stay and a potential for cost savings.

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Title: Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy.
Authors: Liam A. Haveran
Paul R. Sturrock
Mark Y. Sun
Janet McDade
Sudershan Singla
Craig A. Paterson
Timothy C. Counihan
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 7/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-006-0242-2

2024 ASCO Annual Meeting

Springer Medicine

Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy.

Abstract

Background

Materials and methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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