title: Modified technique for performing STARR with Contour Transtar™.
abstract: Stapled Transanal Rectal Resection (STARR) performed using CCS-30 Contour Transtar™ despite its recent introduction seems to be an effective surgical procedure to treat obstructed defecation syndrome. The major constraint of this procedure is the need to open the prolapse longitudinally using the CCS-30. This is often difficult and can lead to an inadequate or spiralling resection. Our modified technique, presented in this paper, creates the prolapse opening with an electric scalpel between two Kocher clamps, placed to grab the whole prolapsed tissue at 2 and 4 o'clock, respectively. The results of the first 83 procedures confirm that this technique allows the surgeon to simplify the prolapse's longitudinal opening and especially the first loading of the tissue between the CCS-30 jaws, which is necessary to start the circular resection, as confirmed by the absence of spiralling and major complications in this series.
authors.affiliation: Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea Hospital, School of Medicine and Psychology, University Sapienza of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Brescia
authors.forename: Marcello
authors.initials: M
authors.lastname: Gasparrini
authors.forename: Umile Michele
authors.initials: UM
authors.lastname: Cosenza
authors.forename: Giovanni
authors.initials: G
authors.lastname: Laracca
authors.forename: Andrea
authors.initials: A
authors.lastname: Milillo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pancaldi
authors.forename: Valeria
authors.initials: V
authors.lastname: Vitale
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Mari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome