Outcome of TAMIS Mucosal Resection in Patients With ODS

Various surgical approaches for the treatment of obstructed defecation syndrome (ODS) commonly associated with rectocele and rectal intussusception have been investigated in the literature. Methods such as stapled transanal resection of the rectum (STARR) and ventral prosthesis rectopexy (VPR) show promising results at least in the short term. In the long-term, however, the results do not seem convincing. Schiano di Visconte et al. report a recurrence of ODS symptoms in 40 percent of the patients, treated with stapled transanal rectal resection in a 10-year follow up. The clinical outcome of surgical treatment of ODS using transanal minimally invasive surgery (TAMIS) in the sense of a mucosal resection without stapling technique has not yet been investigated. This project is designed to show the short-term outcome of non-stapled mucosal resection through TAMIS.

Inclusion criteria

• Need of minimal invasive mucosal resection due to obstructed defecation syndrome after several unsuccessful conservative treatments over a period of more than 6 months with presence of an organic cause (Symptomatic intussusception with or without rectocele) in medical examinations (defecography, endoluminal ultrasound, endoanal manometry)
• Age: 18-90 years
• Ability and willingness to understand and comply with planned interventions during the study.
• Voluntarily signed informed consent after a full explanation of the study to the participant.

Exclusion criteria

• Any physical or mental disorder could interfere with the participant's safety during the clinical trial or with the study objectives.
• Inability to communicate well with the investigator due to language problems or reduced mental development.
• Inability or unwillingness to give written informed consent.