title: Tailored prolapse surgery for the treatment of haemorrhoids and obstructed defecation syndrome with a new dedicated device: TST STARR Plus.
abstract: OBJECTIVE
  The aim of the study was to assess the safety, efficacy and feasibility of stapled transanal procedures performed by a new dedicated device, TST STARR Plus, for tailored transanal stapled surgery.
  
  
  METHODS
  All the consecutive patients admitted to eight referral centres affected by prolapses with III-IV degrees haemorrhoids or obstructed defecation syndrome (ODS) with rectocele and/or rectal intussusception that underwent stapled transanal resection with TST STARR plus were included in the present study. Haemostatic stitches for bleeding of the suture line, specimen volume, operative time, hospital stay and perioperative complications were recorded.
  
  
  RESULTS
  From 1 November 2012 to 31 March 2013, 160 consecutive patients (96 females) were enrolled in the study. In 94 patients, the prolapse was over the half of the circular anal dilator (CAD). The mean duration of the procedure was 25 min. The mean resected volume of the specimen was 13.3 cm(3), the mean hospital stay was 2.2 days. In 88 patients (55%), additional stitches on the suture line were needed (mean 2.1). Suture line dehiscence was reported in four cases, with intraoperative reinforcement. Bleeding was reported in seven patients (5%). Urgency after 30 days was reported in one patient. No major complication occurred.
  
  
  CONCLUSIONS
  The new device seems to be safe and effective for a tailored approach to anorectal prolapse due to haemorrhoids or obstructed defecation.
authors.affiliation: Proctological and Perineal Surgery, University Hospital of Pisa, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Naldini
authors.forename: Jacopo
authors.initials: J
authors.lastname: Martellucci
authors.forename: Roberto
authors.initials: R
authors.lastname: Rea
authors.forename: Stefano
authors.initials: S
authors.lastname: Lucchini
authors.forename: Michele
authors.initials: M
authors.lastname: Schiano di Visconte
authors.forename: Angelo
authors.initials: A
authors.lastname: Caviglia
authors.forename: Claudia
authors.initials: C
authors.lastname: Menconi
authors.forename: Donglin
authors.initials: D
authors.lastname: Ren
authors.forename: Ping
authors.initials: P
authors.lastname: He
authors.forename: Domenico
authors.initials: D
authors.lastname: Mascagni
mesh_terms: D001003:Anal Canal / Q000601:surgery; D003248:Constipation / Q000601:surgery*; D003672:Defecation; D005240:Feasibility Studies; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011391:Prolapse; D012002:Rectal Diseases / Q000601:surgery*; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation*; D013577:Syndrome