Prospective Randomized Trial About THD Versus Ligasure Hemorrhoidectomy for Grade III and IV Hemorrhoids

Inclusion Criteria: * Patients with grade III and IV hemorrhoids according to Goligher classification * Patients ASA I, II or III and adequate hematological, renal and hepatic function * Patients who signed informed consent Exclusion Criteria: * Altered cognitive state that prevents collaboration in the study or patients who can neither read nor write * Fecal incontinence * Anal sphincter lesions * Recurrent hemorrhoids after previous surgical tratment * Previous anorectal surgery except banding, botulinum toxin injection and thrombectomy for hemorrhoid thrombosis * Injection sclerotherapy during the last five years * Concomitant anorectal disease (anal fistula, anal fissure, anal stenosis, rectocele, enterocele, anal condilomatosis). * Concomitant diagnosis of functional pelvic floor disease, inflammatory bowel disease and previous pelvic radiotherapy * Concomitant diagnosis of colorectal neoplasia or other neoplasia * Patients ASA IV, V * NSAIDs, Paracetamol, Tramadol, Metamizol and Petidine allergy * Coagulation disorders * Pregnancy and lactation * Rejection of the patient to sign the consent form.