STARR is novel technique which involves a double stapling technique using two 33 mm circular staplers to carry out a full thickness resection of the lower rectum with simultaneous anastomosis to restore bowel continuity. It is done in Obstructed Defaection syndrome. ODS is defined as an acquired behavioural disorder characterized by excessive straining at stools with unsatisfactory evacuation in the absence of local, systemic or metabolic disorder associated with failure of relaxation of sphincters and pelvic floor muscles. It is characterized by a spectrum of symptoms including difficult evacuation, excessive straining during defecation, sensation of incomplete evacuation, prolonged time to defecate, anal pain, bleeding, and the use of digital manouvres to aid defecation. It is commoner in multiparous women. Associated anatomical conditions include rectal mucosal prolapse/rectal intussusceptions, rectocoele. urogenital prolapse, enterocoele.
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