Laparoscopic approach in a case of retroperitoneal and mesorectal haematoma following STARR procedure

Stapled transanal rectal resection (STARR) is a widely accepted procedure for treatment of obstructed defecation syndrome.

We analyzed major bleeding following STARR and exposed our experience regarding its conservative management with particular attention about diagnostic and therapeutic aspects.

A case by case discussion should be carried out and treatments should be driven by the features and the progression of the haematoma with regards to size, inflammatory signs or severe rectal obstruction.

If a second surgical time and exploration is considered, laparoscopy should be an effective choice while laparotomy, stoma or rectal resection should be considered in those cases with strong suspicious of peritonitis and pelvic abscess.