Sphincter Substitutes in Ostomies — Indications, Technique, Results

Abstract

Sphincteroplasties can generally be applied to all colostomies, ileostomies, gastric fistulas, incontinent bladders, the incontinent anus, and the incompetent gastric cardia. There are only some contraindications for sphincteroplasty. In cases of ileus, where the distended bowel cannot be decompressed proximally (by means of manipulation and gastric tube suction), a sphincteroplasty should not be performed primarily. If a sphincteroplasty is desired by the patient, a second transforming operation should be performed. Extensive diverticulosis of the colon is not a contraindication, provided that the affected segment is resected. The sphincteroplasty itself can be taken from bowel affected with diverticulosis, since its muscle is especially well developed and therefore particularly suited for sphincter function.