Resección transanal con grapas del recto (STARR)
Rectal prolapse is very common in elderly women, although it may present at any age and in both male and female. It is generally not a life-threatening situation, but the symptoms can be very frustating. Surgical treatment of rectal prolapse is possible and most of the external prolapse can be treated by surgery successfully, often with a minimally invasive surgical procedure. Internal prolapses are traditionally harder to treat and traditional surgery may not be suitable for many patients.
Rectal prolapse is a very common problem and it may exist without any other symptoms, but depending upon the nature of the rectal prolapse there may be feeling of something coming out of anus, mucous discharge, rectal bleeding, ulceration and degrees of fecal incontinence and obstructed defecation symptoms.
Stapled trans-anal rectal resection (STARR) is a minimally invasice procedure which aims to remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall of the patient with the use of a disposable comercially available circular stapler. If patient selection is not correct than In contrast to other methods, STARR does not correct the descent of the complete rectum. STARR only removes the redundant tissue especially mucosa. The STARR operation has been shown to improve rectal sensitivity and decrease rectal volume, the reason thought to create urgency. The Stapled trans-anal rectal resection (STARR) technique was initially developed from a similar stapling procedure for prolapsing hemorrhoids. Since, specialized circular staplers have been developed for use in external rectal prolapse and internal rectal intussusception. STARR surgery was compared with radiofrequency and other technique and found to be more effective in reducing symptoms and improving quality of life.
Complications, sometimes serious, have been reported following STARR, but the procedure is now considered safe and effective. STARR by PPH circular stapler surgical technique is contraindicated in patients with weak anal sphincters as it may cause incontinence and urgency. It is very common possible complication and with anismus which is paradoxical contraction of the pelvic floor during attempted defecation. About 80% of patients do not report urgency after properly performed procedure. The anal sphincter of many patient also get stretched during improperly performed surgery.
