Comparison Study of Hemorrhoid Surgery Using the Enseal Device to Standard Hemorrhoid Surgical Techniques

Study Overview
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Brief Summary
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The purpose of this study is to examine the advantages and disadvantages of using the EnSeal device in hemorrhoid surgery as compared to traditional hemorrhoid surgery techniques. It is hypothesized that the use of the Enseal device will demonstrate an improvement a patient's overall experience through less postoperative bleeding and pain, decreased time for wound healing, and a faster return to work.

Detailed Description
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The EnSeal Device is FDA approved for surgery in ligating and dividing vascular tissue during abdominal surgery. Electrical energy is converted into heat energy and resultant simultaneous division of tissues. This allows surgery to be bloodless and sutureless. It has been successfully used by many individual practitioners for hemorrhoidectomy, with apparent advantage and success; but to date, no comparative study has been done to assess the advantages and disadvantages of this method of hemorrhoidectomy, when compared to traditional excisional techniques. The investigators propose to use this device in the current study in the treatment of hemorrhoidal disease where vascular tissue is excised in bloodless and sutureless fashion. It is currently being used in institutions throughout the United States and Europe. After surgery, patients will receive the same standard postoperative instructions as for conventional hemorrhoidectomy, which include wound care, pain medicine, and other standard instructions. The patient will be followed in the office with visits at 3 to 4weeks, and 3 months postoperatively. At these visits, they will be assessed for postoperative complications including but not limited to: bleeding, urinary retention, fecal impaction, hospital re-admission and pain. Delayed complications -greater than four weeks- will be followed including impaired healing, constipation, abscess, fistula formation, fissure, and stenosis. The patient's pain score and type and amount of pain medications taken will be recorded by the patient daily for the first 2 weeks then weekly for a month postoperatively. This will be assessed using a pain diary which includes a visual analog pain scale (allowing the patient to describe their pain level on a scale between 1 and 10) and space to note the quantity of pain medications used. During each office visit, the operating surgeon will evaluate the patient.

Official Title
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Hemorrhoidectomy Using the Enseal Device: A Comparison to Open Hemorrhoidectomy Techniques

Conditions
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Hemorrhoids

Intervention / Treatment
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* Device: EnSeal Trio Tissue Sealing Device


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women between ages 18 through 80 American Society of Anesthesiologists (ASA) level I, II and III External hemorrhoids must be present and deemed sufficiently symptomatic to warrant removal Internal hemorrhoids at least Grade II Must be able to be seen post-operatively by the surgeon at 3 to 4 weeks and 3 months after surgery Exclusion Criteria: American Society of Anesthesiologists (ASA) level IV Grade I internal hemorrhoids Currently receiving coumadin, plavix, or other anticoagulants No prior sphincterotomy, drainage of abscess, fistulotomy, or similar procedures No pregnant women at the time of surgery No lactating women No inflammatory bowel disease No history of chronic, active hepatitis B, C, or HIV infection No prior chronic narcotic use (more than 30 days)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EnSeal Device<br>EnSeal Trio Tissue Sealing Device | Device: EnSeal Trio Tissue Sealing Device<br>* For surgery in ligating and dividing vascular tissue during abdominal surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-operative complications | Patients will be assess for postoperative complications including but not limited to: bleeding, urinary retention, fecal impaction, hospital re-admission and pain. | 3 to 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delayed Post-Operative Complications | Delayed complications (greater than 4 weeks) will be followed including impaired healing, constipation, abscess, fistula formation, fissure, and stenosis. | 3 months | 
| Post-Operative Pain | The patient's pain score and type and amount of pain medications taken will be recorded by the patient daily for the first 2 weeks then weekly for a month postoperatively. | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hemorrhoids, Rectal Diseases, Intestinal Diseases, Gastrointestinal Diseases, Digestive System Diseases