LigaSure™ for Hemorrhoidectomy

Excerpt

To the Editor—We read with interest the article by Franklin et al.,1 entitled “Randomized, Clinical Trial of LigaSure™ vs. Conventional Diathermy in Hemorrhoidectomy,” showing the advantages of LigaSure™ for hemorrhoidetomy in terms of reduction of operative time and pain. The study is in line with two recent papers on the topic2, 3 and adds profound information on the applicability and impact of LigaSure™.4 However, two aspects should be considered. Several handsets for LigaSure™ technology are available for open and laparoscopic surgery4. We would be interested to know which type of handset was applied in the study by Franklin et al.1 Use of scalpel for incision of the perianal skin at the beginning of the procedure would spare use of monopolar diathermy in LigaSure™-treated patients and would most probably add to a reduction in costs. Did the grade of hemorrhoids (III vs. IV) have an effect on feasibility in patients treated with LigaSure™? How would the authors comment on the learning curve issue? …