The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Stapled transanal rectal resection for obstructed defaecation syndrome.
It replaces the previous guidance on Stapled transanal rectal resection for obstructed defaecation syndrome (NICE interventional procedure guidance 169, April 2006).
Obstructed defaecation syndrome is characterised by the urge to pass faeces but an impaired ability to do so. It may be caused by a structural problem in the rectum. Common symptoms include constipation, excessive straining, pain and bleeding after passing faeces. In stapled transanal rectal resection (STARR), two circular staplers or a specific stapling device are used to remove the damaged part of the rectum and join the remaining parts back together.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.