Stapler Surgery for Constipation and Rectal Prolapse in Nashik

By Dr. Jaideep Somvanshi  |  Panacea Clinic, Nashik  |  +91 9112220247

STARR Surgery — The Definitive Solution for ODS and Internal Rectal Prolapse

Stapled Transanal Rectal Resection (STARR) is a minimally invasive surgical procedure designed to treat two closely related conditions that cause severe constipation: Obstructed Defecation Syndrome (ODS) and internal rectal prolapse (intussusception). Both conditions involve abnormal descent and bulging of the rectal wall into the anal canal during straining, creating an obstruction to normal defecation.

STARR was pioneered by Dr. Antonio Longo of Italy — the same surgeon under whom Dr. Jaideep Somvanshi received advanced training. At Panacea Clinic Nashik, Dr. Somvanshi is among the very few surgeons in the Nashik region trained and experienced in performing STARR surgery with consistently excellent outcomes.

Who Needs STARR Surgery?

STARR surgery is indicated for patients with:

• Obstructed Defecation Syndrome (ODS) — chronic difficulty in emptying the bowel despite normal stool consistency
• Rectocele — anterior bulging of the rectal wall, especially in women after childbirth
• Internal rectal intussusception — the rectum partially telescopes into itself during straining
• Symptoms include excessive straining, incomplete evacuation, needing to use fingers to assist evacuation, and spending prolonged time on the toilet
• Failure to respond to biofeedback and conservative management

The STARR Procedure — What Happens?

STARR is performed entirely through the anus — no external cuts are made. Using specially designed circular staplers (PPH-03 and CONTOUR staplers), the surgeon removes excess rectal tissue from both the front and back walls of the rectum — simultaneously correcting the rectocele and the intussusception. The stapled tissue is permanently removed and the bowel wall is reapproximated with staples. The entire procedure takes 45–60 minutes under spinal or general anesthesia.

Benefits of STARR Surgery

• Corrects the anatomical cause of ODS — not just symptoms
• Performed entirely transanally — no abdominal incisions
• Short hospital stay — typically 24–48 hours
• Dramatic improvement in ODS symptoms in 80–90% of properly selected patients
• Can be combined with MIPH for patients with co-existing piles
• Safe for elderly patients and those with high surgical risk

Patient Selection and Pre-Operative Assessment

Proper patient selection is key to the success of STARR surgery. At Panacea Clinic, Dr. Somvanshi performs a thorough pre-operative workup including anorectal manometry, defecography, and clinical scoring (ODS and Longo's score) to confirm the diagnosis, exclude dyssynergia (which is better treated with biofeedback), and identify the extent of prolapse. This rigorous evaluation ensures that surgery is performed only in patients who will benefit most.

Post-STARR Recovery

After STARR surgery, patients typically experience mild urgency and increased frequency in the first 4–6 weeks as the rectum heals and adapts. These symptoms resolve spontaneously. Full functional recovery is usually achieved by 8–12 weeks. Long-term outcomes show sustained relief from ODS symptoms in the majority of patients.