Stapled Transanal Resection of the Rectum (STARR)

When is STARR performed?
The most common indication for this operation is for patients with an intussusception or a rectocoele. In our practice, this procedure is occasionally performed for patients who have had a laparoscopic ventral rectopexy but who still have ODS symptoms and are found still to have a loose bowel lining.

What other tests are necessary before the operation?
You will have been assessed by a surgeon before the operation and will have had tests including a defaecating proctogram.

What does the operation involve?
The operation is performed under general anaesthetic through the anal canal, without cuts or scars on the outside. The loose bowel is removed with a stapling gun which brings the two cut edges of the bowel together. At the end of the operation, the patient has a line of staples at the front and back of the lower rectum. On occasion, the surgeon may recommend that you need only the lining at the back or front excised in this way (a “posterior” or “anterior” STARR). These staples disappear in your motions over a few weeks.

What is the recovery like after surgery?
Patients will usually be able to go home the day following the procedure on laxatives to ensure that they do not strain. Many patients will get back to normal activity quickly, though this is variable and patients may get discomfort and urgency (a feeling of having to rush to the toilet when the urge to open your bowels arises). Sometimes patients find that they have to visit the toilet much more frequently than previously. Though these symptoms settle down, they may take several weeks to do so.