Aug 01, 2025
Hemorrhoids are a common anal disease, with 10% to 20% of patients requiring surgical treatment [1]. Common issues with traditional hemorrhoidectomy are postoperative bleeding and pain. The Agiseal electrosurgical vessel sealer divider, a novel tissue-cutting and coagulating device, brings significant improvements to hemorrhoid surgery.
Agiseal,independently developed by ShouLiang-med, uses advanced real-time feedback and intelligent generator technology. By delivering high-frequency electrical energy combined with constant pressure between the jaws, it causes denaturation of collagen and fibrin within the target vessels. It fuses the vessel walls, forming a transparent band that achieves permanent lumen closure. Its advantages include: no need for excessive separation during closure, and faster closure speed; no smoke, maintaining a clear surgical field; and low local temperatures, minimizing damage to surrounding tissues. According to reports [2], the United Kingdom has successfully applied electrosurgical vessel sealer divider in haemorrhoidectomy procedures, achieving excellent haemostasis outcomes and significantly reducing postoperative pain in patients.
Traditional mixed hemorrhoidectomy is often associated with significant bleeding, which not only prolongs surgery time but also obscures the surgical field and reduces procedural accuracy. Conventional haemostasis methodssuch as ligation or electrocoagulation are also prone to causing collateral damage to surrounding tissues, thereby delaying wound healing. The application of the electrosurgical vessel sealer divider allows for pre-closure of haemorrhoidal tissue vessels prior to excision., resulting in minimal bleeding during excision along the closure zone. Furthermore, this technique eliminates the need for conventional suture ligation of the stump, simplifying the procedure and shortening operative time. Its core principle (inducing fibrin deformation and coagulation) also ensures safe and reliable hemostasis [3].
In traditional surgery, suture ligation of the hemorrhoidal pedicle tissue easily triggers sphincter spasm, leading to severe postoperative pain. The Agiseal hemorrhoidectomy does not require ligation of the haemorrhoidal tissue, thereby reducing the incidence and intensity of postoperative pain from the source. Additionally, the sealing process causes minimal thermal damage to surrounding tissues, effectively avoiding burns and tissue edema caused by the thermal effects of electrocautery. Postoperative pain is typically controlled with oral medications alone, significantly reducing discomfort and minimizing the risk of drug side effects [4].
Benefiting from advantages such as minimal intraoperative bleeding, minimal tissue damage, and milder postoperative pain, patient recovery is accelerated, and hospital stays are significantly shortened. Although the single-use cost of the electrosurgical vessel sealer divider may be higher than traditional instruments, preliminary statistics show that the overall hospitalization costs for patients do not increase significantly,which may be mainly attributed to the effective reduction in the number of hospital days [3].
In summary, for patients with grade III to IV mixed hemorrhoids, the use of electrosurgical vessel sealer divider for hemorrhoidectomy is more advantageous than traditional hemorrhoid surgery in terms of reducing intraoperative blood loss and shortening hospital stay [3]. Its precise, efficient, and minimally invasive characteristics provide patients with a more comfortable and faster recovery experience.
Reference:
[1] BLEDAY R，PENA JP，ROTHENBERGER DA，et al.Symptomatic hemorrhoids: current incidence and compli -cations of operative surgery［J］.Dis Colon Rectum，1992，35（5）:471-481.
[2] PALAZZO FF，FRANCIS DL，CLIFTON MA. et al. Randomized clinical trial of Ligasure versus open haemorrhoid -ectomy［J］. Br J Surg，2002，89（2）:154-157．
[3] Wang Zhanjun, Jia Shan, Wang Zhengliang,et al.A Comparative Study of Hemorrhoidectomy with Ligasure Technique and Milligan-Morgan Surgery［J］.Journal of Colorectal & Anal Surgery,2017,23(04):477-480.
[4] NIENHUIJS SW， DE HINGH IH. Pain after conventional versus Ligasure haemorrhoidectomy.A meta -analysis［J］.International Journal of Surgery，2010，8（4）:269-273.
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