Obstructed defecation syndrome (ODS) is one of the most widespread clinical problems which frequently affects middle-aged females. There is a new surgical technique called stapled transanal rectal resection (STARR) that makes it possible to remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall with the use of a circular stapler. This surgical technique developed by Antonio Longo was proposed as an effective alternative for the treatment of ODS. In this study we present our preliminary results with the STARR operation for the treatment of ODS. For this purpose, 40 consecutive female patients with ODS due to rectal intussusception (RI) and/or rectocele (RE) were recruited in this prospective clinical study, from May 2008 to October 2010. No major operative or postoperative complications were recorded, and after 12-month follow-up, significant improvement in the ODS score system was observed, and the symptoms of constipation improved in 90% of patients; 20% of patients judged their final clinical outcome as excellent, 55% as good, and 15% as moderate, with only 10% having poor results. After analyzing our results we can conclude that STARR is an effective and safe procedure for the treatment of obstructed defecation syndrome due to rectal intussusception and/or rectocele and can be performed safely without major morbidity.

Hemorrhoidal disease is one of the most common anorectal disorders, affecting, in various forms, almost 50% of people over the age of fifty. Surgical treatment is considered the standard treatment for grade III and IV hemorrhoids. However, although it is considered a minor procedure, the post-operative course is protracted, and the post-operative complications are not negligible. The resulting pain-related complications after conventional hemorrhoidectomy (CH) are often the major factors that prolong hospital stay and delayed recovery. Recently various new treatment modalities have been developed with the aim of overcoming post-operative pain, such as stapled hemorrhoidopexy, Ligasure, and harmonic scalpel, sealing devices. The aim of this study is to evaluate and compare the conventional Milligan-Morgan hemorrhoidectomy (CH) with harmonic scalpel hemorrhoidectomy (HSH) on eighty four patients with symptomatic grade III or IV hemorrhoids operated on at the Department of General Surgery, AL-Jedaani hospital, Jeddah, Saudi Arabia, between May 2008 and January2011. The patients were randomly allocated to undergo either a CH (group]= 42 patients) or HSH (group 2=42 patients). After analyzing the data collected from this study we can conclude that; hemorrhoidectomy with harmonic scalpel can provide a safe, fast, low-morbidity alternative to conventional hemorrhoidectomy.

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Obstructed defecation syndrome (ODS) is one of the most widespread clinical problems which frequently affect middle -aged females. There is a new surgical technique called stapled trans-anal rectal resection, (STARR) which makes it possible to remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall with the use of a circular stapler. This surgical technique developed by Antonio Longo, was proposed as an effective alternative for the treatment of ODS. In this study we present our preliminary results with the STARR operation for the treatment of ODS. For this purpose, 40 consecutive female patients with ODS due to rectal intussusception (RI) and/or rectocele (RE),were recruited in this prospective clinical study, from May 2008 to October 2010. No major operative or postoperative complications were recorded, and after 12-months follow-up, significant improvement in the ODS score system was observed. The symptoms of constipation improved in 90% of patients, 20% of patients judged their final clinical outcome as excellent, 55% as good, 15% as moderate, with only 10% having poor results. After analyzing our results we can conclude that STARR is an effective and safe procedure for the treatment of obstructed defecation syndrome due to rectal intussusception and/or rectocele, and can be performed safely without major morbidity.