Techniques in Coloproctology

, Volume 22, Issue 5, pp 389–391 | Cite as

Intraoperative check for enterocele in perineal stapled prolapse resection

  • C. E. Förster
  • I. Füglistaler
  • D. C. Steinemann
Trick of the Trade

Various surgical techniques have been described for the treatment of external rectal prolapse. However, there is no accepted standard surgical therapy. Generally, transabdominal rectopexy with or without sigmoid resection is distinguished from the perineal approach. For the perineal approach, the Rehn–Delorme technique involves mucosectomy with reinforcement of the rectal muscular tube, while the Altemeier technique consists of a full-thickness rectal resection. Perineal stapled prolapse resection (PSP) was proposed as an alternative by Scherer et al. [1].

PSP is a further development of stapled transanal rectal resection (STARR) for internal rectal prolapse in patients suffering from outlet obstruction. While originally two circular hemorrhoid staplers (PPH-01) were employed for STARR, the Transtar technique uses a specially designed curved cutter stapler (Contour Transtar™ 30 mm, Ethicon Inc., Somerville, NJ, USA) [2]. Full-thickness resection of the prolapsing rectum is performed...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent to publication of the images in this article was obtained from the patient concerned.


  1. 1.
    Scherer R, Marti L, Hetzer FH (2008) Perineal stapled prolapse resection: a new procedure for external rectal prolapse. Dis Colon Rectum 51:1727–1730CrossRefPubMedGoogle Scholar
  2. 2.
    Brescia A, Gasparrini M, Cosenza UM,et al (2013) Modified technique for performing STARR with Contour Transtar™. Surgeon 11(Suppl 1):S19-22PubMedGoogle Scholar
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    Hetzer FH, Roushan AH, Wolf K et al (2010) Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg 10:9CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Reibetanz J, Boenicke L, Kim M, Germer CT, Isbert C (2011) Enterocele is not a contraindication to stapled transanal surgery for outlet obstruction: an analysis of 170 patients. Colorectal Dis 13:e131-136CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pelvic Floor UnitSt.Clara Hospital BaselBaselSwitzerland

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