Is LigaSure “not real surgery”?

It is still excisional surgery with real wounds and recovery — energy sealing changes hemostasis, not the need for soft-stool aftercare.

Which method has the lowest recurrence?

Excisional hemorrhoidectomy typically has lower recurrence than stapled lift techniques; early pain trade-offs are discussed case by case.

Conditions/Hemorrhoids/Chapter

Detailed chapter

Hemorrhoid Surgery Methods

Name: Hemorrhoid Surgery Methods
Creator: Assoc. Prof. Cengiz Dibekoğlu, MD

Standard hemorrhoidectomy, LigaSure, and Longo — matched to grade and goals

Standard hemorrhoidectomy removes enlarged piles surgically — open (Milligan–Morgan style) or closed (Ferguson style). LigaSure energy-device excision is a modern form of the same principle. Longo stapling is a “lift” method for selected internal prolapse. Advanced disease often gets the most durable control from excision — the least painful method is not always the most lasting.

Hemorrhoid surgery methods — educational figure — Hemorrhoid surgery · educational illustration

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LigaSure option
Longo (stapler)

Step-by-step overview

1
Assessment
Grade, symptoms, and endoscopy when indicated decide the method.
2
Anesthesia
Spinal, general, or selected local anesthesia with sedation.
3
Operation
Standard excision, LigaSure, or stapler (Longo) as planned.
4
Early aftercare
Pain control, soft stools, sitz baths, and hygiene are planned before discharge.

Key points

Open hemorrhoidectomy
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Classic excision leaves wounds open to heal. Still a gold standard for advanced and mixed internal–external disease. Recurrence is low; early pain can be more noticeable.
Closed hemorrhoidectomy
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After excision the mucosa is sutured closed. Selected cases may gain comfort or wound-care advantages. The goal remains symptom relief with sphincter protection — not oncology.
LigaSure excision
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Energy sealing divides vessels with controlled hemostasis and may shorten operative time. Recurrence profile is close to classic hemorrhoidectomy. See the dedicated LigaSure chapter for detail.
Longo (stapler)
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A circular stapler removes a mucosa–submucosa ring and lifts piles upward. Selected internal prolapse cases may have better early comfort; recurrence risk can be higher than standard excision in many series.
How the choice is made
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Grade, mixed external disease, prior office treatments, and your priorities (durability versus early comfort) are weighed together. Soft stools and analgesia after any excision matter as much as the instrument used.
- Advanced / mixed disease → often excision
- Selected internal prolapse → Longo may be discussed
- Failed banding / office care → escalate thoughtfully

Frequently asked questions

Is LigaSure “not real surgery”?
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It is still excisional surgery with real wounds and recovery — energy sealing changes hemostasis, not the need for soft-stool aftercare.
Which method has the lowest recurrence?
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Excisional hemorrhoidectomy typically has lower recurrence than stapled lift techniques; early pain trade-offs are discussed case by case.

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This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.