An interventional study of Energy-based sutureless hemorrhoidectomy and Conventional Milligan-Morgan hemorrhoidectomy in Hemorrhoids, sponsored by Sohag University. Recruiting at 1 site in Egypt. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.
Sponsored by Sohag University · Not applicable, Interventional, and Treatment
Hemorrhoidal disease is a frequent benign anorectal ailment in surgical practice. Conventional excisional hemorrhoidectomy using the Milligan-Morgan technique remains effective but is significantly limited by severe postoperative pain and related complications. Sutureless hemorrhoidectomy utilizing energy-based vessel sealing devices (such as LigaSure or Harmonic Scalpel) aims to minimize tissue trauma, blood loss, and postoperative discomfort. This prospective comparative randomized clinical trial aims to evaluate and compare the perioperative and postoperative outcomes of sutureless hemorrhoidectomy versus conventional ligation hemorrhoidectomy in adult patients with advanced (grades III and IV) hemorrhoidal disease.
Symptomatic advanced hemorrhoids (grades III-IV) frequently require excisional surgical intervention. Traditional ligation techniques involve pedicle transfixion that often exacerbates postoperative pain, anal spasms, and urinary retention. Energy-based vessel sealing systems provide reliable pedicle occlusion without conventional transfixion or suture ligation, potentially expediting operative time and recovery. In this prospective randomized study conducted at the Department of General Surgery, Sohag University Hospital, 50 eligible adult patients with symptomatic grade III-IV hemorrhoidal disease will be randomly allocated (1:1) into two equal groups: Group A (n=25): Sutureless hemorrhoidectomy using an energy-based vessel sealing device. Group B (n=25): Conventional ligation hemorrhoidectomy using the standard Milligan-Morgan technique. Postoperatively, patients receive standardized analgesia and care, with systematic follow-up at 1 week, 2 weeks, 1 month, 3 months, and 6 months to evaluate pain scores, bleeding, wound healing, complication rates, return to normal activity, and symptom recurrence.
238 studies on the registry are indexed under Hemorrhoids; 73 are open to participants now.
This study's planned enrollment of 50 is below the median of 100 across 183 interventional studies indexed under Hemorrhoids.
Browse Hemorrhoids studies →Sohag University is the lead sponsor of 1,230 studies on the registry; 636 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients undergoing conventional excisional hemorrhoidectomy using the Milligan-Morgan technique with suture ligation of the vascular pedicle.
Procedure: Conventional Milligan-Morgan hemorrhoidectomy
Patients undergoing sutureless excisional hemorrhoidectomy using an energy-based vessel sealing device (LigaSure or Harmonic Scalpel) without conventional pedicle transfixion or suture ligation.
Procedure: Energy-based sutureless hemorrhoidectomy
Excision of hemorrhoidal columns with vessel pedicle sealing using an energy-based device (LigaSure or Harmonic Scalpel) without conventional pedicle transfixion or suture ligation.
Standard Milligan-Morgan hemorrhoidectomy with surgical dissection of hemorrhoidal columns and absorbable suture transfixion and ligation of vascular pedicles.
Postoperative Pain Score
Assessed using the Visual Analogue Scale (VAS) scored from 0 (no pain) to 10 (worst imaginable pain) at fixed postoperative intervals.
Time frame: Up to 6 months post-surgery
Incidence of Postoperative Bleeding
Evaluation of early or delayed postoperative perianal bleeding requiring intervention or readmission.
Time frame: Up to 6 months post-surgery
Operative Time
Duration in minutes from the initiation of tissue excision to complete surgical hemostasis.
Time frame: Intraoperative (at time of surgery)
Intraoperative Blood Loss
Estimated intraoperative blood loss measured in milliliters.
Time frame: Intraoperative (at time of surgery)
Total Postoperative Analgesic Requirement
Total analgesic dosage, type, and duration required for postoperative pain management.
Time frame: Up to 6 months post-surgery
Time to Complete Wound Healing
Clinical assessment of complete re-epithelialization of the anal wounds documented in weeks/months.
Time frame: Assessed at 1 week, 2 weeks, 1 month, 3 months, and 6 months
Length of Hospital Stay
Duration of postoperative stay in hours/days from operation until fulfilling discharge criteria.
Time frame: From surgical admission up to discharge (average 1-2 days)
Time to Return to Normal Activity
Recorded in days from surgery until the patient comfortably resumes routine daily non-strenuous activities.
Time frame: Up to 6 months post-surgery
Rate of Postoperative Complications and Recurrence
Incidence of urinary retention, wound infection, anal stenosis, continence disturbance, or symptom recurrence.
Time frame: Up to 6 months post-surgery
Plan to share: No
No publications or documents are linked to this record.
Start is estimated for Oct 2026; primary completion for Apr 2027, 6 months later.
Of 65 non-industry interventional studies with no phase under Hemorrhoids, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 35. This study's planned 6 months is below that.
Counting every sponsor, half of 70 studies reached it within 23 months; a quarter within 10 and three quarters within 35.
How these figures are worked out, and which studies are left out of them.
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