Authors : Stefan Farke , Boris Jansen-Winkeln , Christian Franke , Roland Scherer , Harald Gogler , Thorsten Unglaube and Frank Fischer
Abstract: Transanal resection of the distal rectal wall was developed by LONGO for the treatment of severe chronic proctogenic constipation This prospective trial was designed to assess the introduction of this technique in our unit. Previously, our standard procedure for the transperineal therapy of a symptomatic rectocele was the anterior plication of the rectocele. We used the double-stapler resection technique to treat patients with proctogenic constipation that failed to improve with conservative management. The underlying diagnoses were symptomatic rectocele, descending perineum syndrome and intussusception. Slow transit constipation and spastic pelvic floor were ruled out pre-operatively. Each patient underwent a conservative therapeutic attempt involving laxatives and bio-feedback training. Between January 2003 and August 2004 the double-stapler resection of the distal rectal ampulla was used in 20 patients. All were female with a mean age of 57 years. The mean stay in hospital was 6,6 days. All patients could be operated on as planned. No conversion to a conventional technique was necessary. The mean operating time was 37 min. One complication had to be reoperated but was treated successfully with this. The symptoms of 13 women had disappeared or were significantly better, 4 subjects reported only slight improvement and 3 remained unchanged. Based on the data currently available, transanal resection of the distal rectal ampulla using the double-stapler method seems to have a low complication rate and leads to symptomatic improvement in the majority of patients.
Stefan Farke , Boris Jansen-Winkeln , Christian Franke , Roland Scherer , Harald Gogler , Thorsten Unglaube and Frank Fischer , 2008. First Experiences in Using a Double Stapler Technique for the Transanal Resection of Rectoceles . Surgery Journal, 3: 17-20.