STARR Procedure & Pelvic Floor Repair – Smiles training research & academy

STARR Procedure &
Pelvic Floor Repair

Master the surgical management of ODS and Rectocele under the mentorship of Dr. Parameshwara CM.

WHY CHOOSE US

3-Day Mastery Curriculum

DAY 1: ANATOMY, DIAGNOSTICS & STAPLING ARCHITECTURE

Morning Session: The Functional Blueprint

Applied Pelvic Anatomy: A deep-dive into the “Three-Compartment” model, focusing on the rectovaginal septum and the structural support of the levator ani.
ODS Clinical Scoring: Mastering the Wexner and Agachan-Wexner scores to accurately select patients for the STARR intervention.
Dynamic Imaging Interpretation: Systematic analysis of MR-Defecatography and Cines to identify intussusception, rectocele, and enterocele.
The Physics of Stapling: Technical orientation on circular stapler mechanics, including staple height selection and “Tissue Compression Time” protocols.

Afternoon Session: Simulation & Technical Drills

Purse-String Architecture: Hands-on practice on high-fidelity simulators to master the 360° internal purse-string suture at the correct anatomical height.
Device Loading & Positioning: Step-by-step drills on introducing the trans-anal circum-anal dilator (CAD) and positioning the stapler head.
Vaginal Wall Protection Drills: Learning the “Digital Verification” maneuver to ensure the posterior vaginal wall is excluded from the staple line.
The “Firing” Protocol: Mastering the controlled firing sequence, including the 30-second compression rule and the “Donut Inspection” for completeness.

DAY 2: LIVE OT IMMERSION & THE STARR PROTOCOL

Morning Session: Live Surgical Execution

Step-by-Step STARR Procedure: Immersive observation of Dr. Parameshwara CM performing a Stapled Trans-Anal Rectal Resection for ODS.
Purse-String Height Selection: Clinical demonstration on identifying the precise level of rectal intussusception for staple placement.
Anatomical Verification: Learning the “Double-Check” maneuver to ensure zero vaginal wall entrapment during device closure.
Haemorrhoidal Pexy Integration: Observing the management of concomitant internal hemorrhoids during the functional repair.

Afternoon Session: Advanced Technical Drills

Staple Line Inspection: Detailed “Donut” analysis and the architecture of the 360-degree anastomosis.
Hemostasis Architecture: Hands-on drills for reinforcing the staple line with 3-0 absorbable sutures to prevent post-operative bleeds.
Instrumentation Management: Orientation with Contour Staplers and high-end circular devices for specialized pelvic anatomy.
The “Zero-Tension” Closure: Mastering the extraction of the stapler to avoid trauma to the newly constructed rectal wall.

DAY 3: PELVIC FLOOR REPAIR & FUNCTIONAL RECOVERY

Morning Session: Structural Reconstruction

- Perineorrhaphy Techniques: Mastering the architectural restoration of the perineal body to provide support for the posterior vaginal wall.
- Levator-Ani Plasty: Hands-on training in “Plication” techniques to tighten the pelvic floor and reduce rectocele protrusion.
- Sphincteroplasty Basics: Standardized protocols for identifying and repairing anal sphincter defects in post-traumatic or obstetric cases.
- Mesh vs. Suture Repair: A research-driven comparison of different materials for structural pelvic support.

Afternoon Session: Outcome Mastery & Research

Post-Operative STAR Protocols: Standardized care for pain management and early bowel movement post-pelvic reconstruction.
Functional Outcome Assessment: Learning to use post-operative scoring systems to measure success in defecatory function.
Complication Mitigation: Standardized workflows for managing chronic pelvic pain or “Urgency” post-STARR.
STAR Fellowship Convocation: Final clinical assessment followed by the Certification Ceremony and alumni network onboarding.

THE COMPETENCY GAP VS. THE BLUEPRINT

THE PROBLEM: The Competency Gap

Most surgical residencies focus on resection for pathology, leaving a massive gap in functional pelvic floor repair. Without specialized training, surgeons face high-tension errors in stapler positioning, leading to inadequate resection, chronic pain, and a fear of “missed” vaginal wall entrapment.

THE Solution: The Blueprint & S.T.A.R Proocols

Our proprietary vertical provides a standardized, research-backed roadmap for the pelvic floor. Move beyond diagnostic guesswork to precise, confident stapling execution. Our protocols ensure perfect anatomical orientation, verified vaginal safety, and optimized functional outcomes for every ODS patient.