Observational Study Evaluating Minimally Invasive Ferguson Hemorrhoidectomy for Advanced Grade III-IV Hemorrhoids

What this Trial Is About

Hemorrhoids are vascular structures in the anal canal that help maintain continence, but when enlarged and descending, they cause symptoms like rectal bleeding and anal swelling, known as hemorrhoidal syndrome. In advanced cases Goligher grade III-IV, surgery is the standard treatment, with excisional hemorrhoidectomy being the most common procedure. Two main surgical techniques are used Milligan-Morgan without wound closure and Ferguson with wound closure. While both are effective long-term, Ferguson hemorrhoidectomy tends to cause less postoperative pain and better early healing. Minimally invasive surgery MIS uses enhanced visualization tools to improve precision and reduce tissue damage, though it has rarely been applied in anal surgery. This observational IDEAL phase 2a study evaluates the reproducibility of applying MIS techniques to closed Ferguson hemorrhoidectomy for advanced hemorrhoids. Researchers investigate whether this adaptation can decrease postoperative pain and speed recovery while maintaining the established effectiveness of the Ferguson method. Participants with symptomatic grade III-IV hemorrhoids who consent to surgery will undergo the minimally invasive closed hemorrhoidectomy. Researchers will assess the technical reproducibility of the surgery over 30 days post-operation and monitor adverse events, postoperative pain and analgesic use during the first 14 days, and longer-term outcomes including symptom scores and clinical failure rates over one year. The study aims to gather detailed information on recovery and safety under real clinical conditions.

Reproducibility of a Minimally Invasive Ferguson-type Hemorrhoidectomy for Grade III Hemorrhoids