Rectocele repair with stapled transvaginal rectal resection

Area of Science:

• Gastroenterology and Surgical Innovation
• Pelvic Floor Disorders
• Colorectal Surgery

Background:

• Constipation is a symptom of slow transit or obstructed defecation.
• Rectocele is a common cause of obstructed defecation syndrome (ODS).
• Accurate diagnosis and symptom quantification are crucial for effective rectocele treatment.

Purpose of the Study:

• To evaluate the clinical and functional outcomes of a novel transvaginal stapled rectal resection (TVSRR) technique for rectocele repair.
• To assess the efficacy of TVSRR in improving obstructed defecation syndrome (ODS) symptoms.
• To determine patient satisfaction and quality of life following TVSRR.

Main Methods:

• 84 female patients with grades II-III rectocele and ODS underwent TVSRR.
• Outcomes were assessed using the Altomare ODS scoring system, Pescatori continence score, manometry, visual analog score (VAS), and PAC-QOL questionnaire.
• Patients were followed for 12 months postoperatively.

Main Results:

• TVSRR showed no intraoperative complications and a low rate of early postoperative complications (e.g., urgency, dyspareunia, rectovaginal fistula).
• 94% of patients experienced significant improvement in ODS scores and VAS within the first postoperative year.
• Patient satisfaction and quality of life (QOL) significantly improved over the 12-month follow-up, with 54.7% reporting excellent outcomes.

Conclusions:

• TVSRR is a safe and effective technique for treating rectocele, with no risk of fecal incontinence.
• Large anterior rectocele is a primary indication for TVSRR.
• The use of a linear stapler in TVSRR is cost-effective, simple, and easy to perform.