July 2025, Volume 3, Issue 7

Author

K Pulopu Wilson Zhimomi, Shahbaz Habib Faridi, Afzal Anees and Bushra Siddiqui

Abstract

Background: Hemorrhoidal disease, characterized by the enlargement and displacement of anal cushions, presents significant discomfort including pain, bleeding, and prolapse. The surgical treatment for advanced hemorrhoids (Grade III-IV) traditionally involved Open hemorrhoidectomy (Milligan-Morgan Hemorrhoidectomy), which is effective but associated with considerable postoperative pain and prolonged recovery. Minimally Invasive Procedure for Hemorrhoids (MIPH), introduced by Dr. Antonio Longo, offers a less painful alternative with faster recovery. This study compares the outcomes of MIPH and Open Hemorrhoidectomy by assessing duration of surgery, post operative pain, post operative bleeding, hospital stay, wound healing, return to work, and recurrence of hemorrhoids. Methods: This prospective study, conducted from August 2022 to July 2024, randomized 60 patients with Grade III and IV hemorrhoids into two groups: 30 undergoing MIPH and 30 undergoing Open Hemorrhoidectomy. Outcomes were evaluated using standardized tools and statistical analysis with a P-value <0.05 considered significant. Results: MIPH patients had significantly shorter operative times (23.83 ± 2.84 minutes vs 28.33 ± 2.73 minutes, P<0.001), less postoperative pain on Day 1 (VAS score 2.80 ± 1.34 vs 5.10 ± 1.15, P<0.001), and shorter hospital stays (1.40 ± 0.56 days vs 1.90 ± 0.76 days, P<0.01). Wound healing time was significantly faster in the MIPH group (6.40 ± 1.61 days vs 21.47 ± 4.48 days, P<0.001). Return to work was also quicker for MIPH patients (7.83 ± 2.48 days vs 17.70 ± 7.27 days, P<0.001). Both procedures had comparable rates of post-operative bleeding, recurrence, and residual prolapse, with no significant differences in anal stenosis or incontinence. Conclusions: MIPH is a superior alternative to Open Hemorrhoidectomy, offering reduced pain, shorter operative time, faster recovery, quicker return to work and similar safety outcomes. MIPH should be considered a preferred option for patients requiring surgical hemorrhoid treatment.