Abstract

Introduction: Haemorrhoids are dilated vascular structures that act as a cushion around the
anal canal. Haemorrhoidectomy is the gold standard surgical protocol for symptomatic
haemorrhoids in grades III and IV. The incidence rate of symptomatic haemorrhoids ranges
from 4.4 to 36.4% of the general population. There are many aetiological factors that can
cause haemorrhoidal disease, which include: constipation, pregnancy, increased intraabdominal
pressure with obstruction of venous return, diarrhoea, prolonged straining, aging,
and abnormalities of internal and sphincter. With the arrival of newer devices,
hemorrhoidectomy resulted in less postoperative pain and less perioperative blood loss
compared with haemorrhoidectomies done with conventional surgical techniques. Maximum
(KLS Martin Group, Germany) is the new launch in vessel sealing systems that has been
introduced recently. It is a bipolar electrosurgical device that is a combination of pressure and
radiofrequency. It seals the blood vessels with a diameter of up to 6 mm by denaturing elastin
and collagen from the vessel wall and connective tissue around them with minimal damage to
the collateral structures limited to 2 mm over the surgical site. This coagulation zone can
withstand up to 3 times the systolic blood pressure