Comparison of Laser Hemorrhoidoplasty Versus Conventional Milligan Morgan Hemorrhoidectomy in Grade II and III Hemorrhoids

NCT07678814 — Not applicable, Completed, 96 participants, Allama Iqbal Medical College

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Comparison of Laser Hemorrhoidoplasty Versus Conventional Milligan Morgan Hemorrhoidectomy in Grade II and III Hemorrhoids: A Randomized Controlled Trial

Registry	NCT07678814, acronym LHP-MMH
Status	Completed
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: none, treatment
Enrollment	96 (Actual)
Sponsor	Allama Iqbal Medical College (Other)
Conditions	Hemorrhoids Second Degree, Hemorrhoids Third Degree, Internal Hemorrhoids
Interventions	Laser Hemorrhoidoplasty, Milligan Morgan Hemorrhoidectomy (Procedure)
Dates	start 2025-09-01, primary completion 2026-02-28, completion 2026-03-31, first posted 2026-07-01, last updated 2026-07-01
Locations	1 site in Pakistan

-Summary

Hemorrhoidal disease is one of the most common anorectal disorders. Conventional Milligan Morgan Hemorrhoidectomy remains the standard treatment but is associated with considerable postoperative pain. Laser Hemorrhoidoplasty has emerged as a minimally invasive alternative. This randomized controlled trial compares postoperative pain, patient satisfaction, and hospital stay between Laser Hemorrhoidoplasty and conventional hemorrhoidectomy in patients with Grade II and Grade III hemorrhoids.

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+Detailed description

This single-center randomized controlled trial was conducted in the Department of Surgery, Jinnah Hospital Lahore. Ninety-six patients diagnosed with Grade II or Grade III hemorrhoids were randomized into two equal groups.

Group A underwent Laser Hemorrhoidoplasty.

Group B underwent conventional Milligan Morgan Hemorrhoidectomy.

Patients were followed postoperatively for pain assessment using the Visual Analogue Scale (VAS), hospital stay, and patient satisfaction using a structured Likert-scale questionnaire.

+Arms and interventions

Arm	Type	Interventions	Description
Laser Hemorrhoidoplasty	Experimental	Procedure: Laser Hemorrhoidoplasty	Patients underwent Laser Hemorrhoidoplasty using diode laser energy applied to hemorrhoidal tissue.
Milligan Morgan Hemorrhoidectomy	Active comparator	Procedure: Milligan Morgan Hemorrhoidectomy	Patients underwent conventional open Milligan Morgan Hemorrhoidectomy.

Laser Hemorrhoidoplasty (Procedure): Patients randomized to the intervention group underwent Laser Hemorrhoidoplasty under spinal anesthesia. A diode laser probe was introduced into the hemorrhoidal tissue through a small mucosal entry point under direct visualization using an anoscope. Controlled laser energy was delivered submucosally to achieve coagulation, shrinkage, and fixation of the hemorrhoidal cushions while preserving the surrounding anoderm and mucosa. The procedure was performed according to standard surgical protocols with the aim of reducing postoperative pain, bleeding, and recovery time.
Milligan Morgan Hemorrhoidectomy (Procedure): Patients randomized to the control group underwent conventional open Milligan Morgan Hemorrhoidectomy under spinal anesthesia. The hemorrhoidal pedicles were identified, ligated, and excised using standard surgical techniques. The wounds were left open with preservation of mucocutaneous bridges between excision sites. Hemostasis was achieved as required. Patients received routine postoperative care and follow-up according to institutional protocols.

+Outcome measures

Primary outcomes

Postoperative Pain [Post Operative period: (6) Six Hourly in first 48 Hours, at 1 week post operative period & at 1 month post operatively.]: Pain measured using Visual Analogue Scale (VAS).
Patient Satisfaction [1 month postoperative]: Patient satisfaction assessed using Likert-scale questionnaire.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

Age ≥18 years Grade II hemorrhoids Grade III hemorrhoids Both genders

Exclusion Criteria:

Rectal prolapse Anal fissure Anorectal malignancy Pregnancy or lactating mothers

+Locations (1)

Facility	City	Country	Status
Jinnah Hospital, Lahore.	Lahore, Punjab Province	Pakistan