Skip to main content
SpringerLink
Log in
Book cover

Reconstructive Surgery of the Rectum, Anus and Perineum pp 367–371Cite as

Autologous Neosphincters and Novel Technologies for Fecal continence

  • Chapter
  • First Online:

  • 2671 Accesses

Abstract

Few data of any statistical merit exist, but two newer options that may offer promise for autologous neosphincters and novel technologies for fecal continence include fat cell implantation and stem cell implantation. Although this chapter describes graciloplasty, gluteoplasty, and other autologous neosphincter reconstruction techniques, cell implantation can be undertaken readily from a technical point of view. However, preparation of the material for injection may require more expertise in the required techniques. As time passes we may gain an increasing familiarity with a variety of these options, and several of them will find niche uses in our therapeutic algorithm for treatment of fecal incontinence.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   279.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Chetwood CH. Plastic operation of the sphincter ani with report of a case. Med Rec. 1902;61:529.

    Google Scholar 

  2. Devesa JM, Madrid JM, Gallego BR, Vicente E, Nuño J, Enríquez JM. Bilateral gluteoplasty for fecal incontinence. Dis Colon Rectum. 1997;40:883–8.

    Article  CAS  PubMed  Google Scholar 

  3. Pak-Art R, Silapunt P, Bunaprasert T, Tansatit T, Vajrabukka T. Prospective, randomized, controlled trial of proximally based vs. distally based gluteus maximus flap for anal incontinence in cadavers. Dis Colon Rectum. 2002;45:1100–3.

    Article  PubMed  Google Scholar 

  4. Pickrell KL, Broadbent TR, Masters FW, Metzger JT. Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle; a report of four cases in children. Ann Surg. 1952;135:853–62.

    Article  CAS  PubMed  Google Scholar 

  5. Salmons S, Henriksson J. The adaptive response of skeletal muscle to increased use. Muscle Nerve. 1981;4:94–105.

    Article  CAS  PubMed  Google Scholar 

  6. Baeten CG, Konsten J, Spaans F, Visser R, Habets AM, Bourgeois IM, et al. Dynamic graciloplasty for treatment of faecal incontinence. Lancet. 1991;338(8776):1163–5.

    Article  CAS  PubMed  Google Scholar 

  7. Baeten CG, Bailey HR, Bakka A, Belliveau P, Berg E, Buie WD, et al. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum. 2000;43:743–51.

    Article  CAS  PubMed  Google Scholar 

  8. Rongen MJ, Uludag O, El Naggar K, Geerdes BP, Konsten J, Baeten CG. Long-term follow-up of dynamic graciloplasty for fecal incontinence. Dis Colon Rectum. 2003;46:716–21.

    Article  PubMed  Google Scholar 

  9. Matzel KE, Madoff RD, LaFontaine LJ, Baeten CG, Buie WD, Christiansen J, et al.; Dynamic Graciloplasty Therapy Study Group. Complications of dynamic graciloplasty: incidence, management, and impact on outcome. Dis Colon Rectum. 2001;44:1427–35.

    Google Scholar 

  10. Farag A, Gadallah NA, el-Sherif EM. Obturator internus muscle autotransplantation: a new concept for the treatment of obstructive constipation. An anatomical, physiological and pathological study. Eur Surg Res. 1993;25:341–7.

    Article  CAS  PubMed  Google Scholar 

  11. Laichman S, Skácel V. The internal obturator muscles functioning as the neosphincter of the anus (I). An experimental study of the muscles used for replacing the sphincter of the anus. Acta Univ Palacki Olomuc Fac Med. 1986;113:271–9.

    CAS  PubMed  Google Scholar 

  12. Laichman S, Skácel V. The internal obturator muscles functioning as the neosphincter of the anus (II). Accessibility of the internal obturator muscle from the point of view of topographical anatomy. Acta Univ Palacki Olomuc Fac Med. 1986;113:281–6.

    CAS  PubMed  Google Scholar 

  13. Skácel V, Laichman S. The internal obturator muscles functioning as the neosphincter of the anus (III). Surgical technique of the reconstruction of the neosphincter of the anus. Acta Univ Palacki Olomuc Fac Med. 1986;113:287–310.

    PubMed  Google Scholar 

  14. Skácel V, Laichman S. The internal obturator muscles functioning as the neosphincter of the anus (IV). Notes on the tactics and technique of muscle transposition. Acta Univ Palacki Olomuc Fac Med. 1986;113:311–6.

    PubMed  Google Scholar 

  15. Skácel V, Laichman S. The internal obturator muscles functioning as the neosphincter of the anus (V). Neosphincter in short-term and long-term clinical evaluation. Acta Univ Palacki Olomuc Fac Med. 1986;113:317–24.

    PubMed  Google Scholar 

  16. Farag A. Obturator internus muscle autotransfer: a new concept for the treatment of anismus. Clinical experience. Eur Surg Res. 1997;29:42–51.

    Article  CAS  PubMed  Google Scholar 

  17. Rab M, Mader N, Kamholz LP, Hausner T, Gruber H, Girsch W. Basic anatomical investigation of semitendinosus and the long head of biceps femoris muscle for their possible use in electrically stimulated neosphincter formation. Surg Radiol Anat. 1997;19:287–91.

    Article  CAS  PubMed  Google Scholar 

  18. Elbarrany WG, Al-Hayani A, Softa S. The blood and nerve supply of the longhead of the biceps femoris muscle; its possible use in dynamic neoanal sphincter. West Afr J Med. 2005;24:287–94.

    CAS  PubMed  Google Scholar 

  19. Shanahan DA, George B, Williams NS, Sinnatamby CS, Riches DJ. The long head of the biceps femoris: anatomic basis for its possible use in the construction of an electrically stimulated neoanal sphincter. Plast Reconstr Surg. 1993;92:55–8.

    Article  CAS  PubMed  Google Scholar 

  20. Konsten J, Baeten CG, Havenith MG, Soeters PB. Canine model for treatment of faecal incontinence using transposed and electrically stimulated Sartorius muscle. Br J Surg. 1994;81:466–9.

    Article  CAS  PubMed  Google Scholar 

  21. Furness JB, Shafton AD, Hirst GD, O’Connell HE. Stimulated smooth muscle neosphincter in male intrinsic sphincter deficiency: proof of principle studies in a rabbit model. Neurourol Urodyn. 2010;29 Suppl 1:S24–8.

    Article  PubMed  Google Scholar 

  22. Holschneider AM, Amano S, Urban A, Donhauser G. Animal experimental studies on the free transplantation of smooth colon muscles as an artificial sphincter in the rat. Z Kinderchir. 1984;39:182–90.

    CAS  PubMed  Google Scholar 

  23. Ruggiero R, Trere M, Ciliberti M, Iovino G. The smooth muscle autograft in continent colostomies. Experimental research on ­rabbits. Ann Ital Chir. 1991;62:75–80.

    CAS  PubMed  Google Scholar 

  24. Schrag HJ, Karwath D, Grub C, Fragoza Padilla F, Noack T, Hopt UT. Electrodynamic smooth muscle sphincter: development and biomechanical evaluation of a novel porcine artificial smooth muscle sphincter in a new in vitro stoma simulator. Int J Colorectal Dis. 2005;20:321–7.

    Article  CAS  PubMed  Google Scholar 

  25. Hofmann-von-Kap-Herr S, Koltai IL, Tennant LJ. Anal sphincter substitute using autologous smooth muscle in a fold-over, half-cylinder, double plasty (SMFD-plasty): a new method of treatment of anorectal incontinence. J Pediatr Surg. 1985;20:134–7.

    Article  CAS  PubMed  Google Scholar 

  26. Shafik IA, Shafik A. Double-loop puborectoplasty: novel technique for the treatment of fecal incontinence. Surg Technol Int. 2009;18:103–8.

    PubMed  Google Scholar 

  27. Kinugasa Y, Arakawa T, Abe SI, Ohtsuka A, Suzuki D, Murakami G, et al. Anatomical reevaluation of the anococcygeal ligament and its surgical relevance. Dis Colon Rectum. 2011;54:232–7.

    Article  PubMed  Google Scholar 

  28. Rehman H, Bezerra CC, Bruschini H, Cody JD. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2005;20(3):CD001754.

    Google Scholar 

  29. Shafik A. Perianal injection of autologous fat for treatment of sphincteric incontinence. Dis Colon Rectum. 1995;38:583–7.

    Article  CAS  PubMed  Google Scholar 

  30. Bernardi C, Favetta U, Pescatori M. Autologous fat injection for treatment of fecal incontinence: manometric and echographic assessment. Plast Reconstr Surg. 1998;102:1626–8.

    Article  CAS  PubMed  Google Scholar 

  31. Ho KS, Ho YH. Diagnosing and managing faecal incontinence. Ann Acad Med Singapore. 1999;28:417–23.

    CAS  PubMed  Google Scholar 

  32. Angioli R, Muzii L, Zullo MA, Battista C, Ruggiero A, Montera R, et al. Use of bulking agents in urinary incontinence. Minerva Ginecol. 2008;60:543–50.

    CAS  PubMed  Google Scholar 

  33. Nikolavasky D, Stangel-Wójcikiewicz K, Stec M, Chancellor MB. Stem cell therapy: a future treatment of stress urinary incontinence. Semin Reprod Med. 2011;29:61–70.

    Article  PubMed  Google Scholar 

  34. Wu G, Zheng X, Jiang Z, Wang J, Song Y. Induced differentiation of adipose-derived stromal cells into myoblasts. J Huazhong Univ Sci Technolog Med Sci. 2010;30:285–90.

    Article  PubMed  Google Scholar 

  35. Aghaee-Afshar M, Rezazadehkermani M, Asadi A, Malekpour-Afshar R, Shaeshmaeili A, Nematollahi-mahani SN. Potential of human umbilical cord matrix and rabbit bone marrow-derived mesenchymal stem cells in repair of surgically incised rabbit external anal sphincter. Dis Colon Rectum. 2009;52:1753–61.

    Article  PubMed  Google Scholar 

  36. Delo DM, Eberli D, Williams JK, Andersson KE, Atala A, Soker S. Angiogenic gene modification of skeletal muscle cells to compensate for ageing-induced decline in bioengineered functional muscle tissue. BJU Int. 2008;102:878–94.

    Article  PubMed  Google Scholar 

  37. Deasy BM, Huard J. Gene therapy and tissue engineering based on muscle-derived stem cells. Curr Opin Mol Ther. 2002;4:382–9.

    CAS  PubMed  Google Scholar 

  38. Aoi S, Shimotake T, Tsuda T, Deguchi E, Iwai N. Impaired expression of myogenic regulatory molecules in the pelvic floor muscels of murine embryos with anorectal malformations. J Pediatr Surg. 2005;40:805–9.

    Article  PubMed  Google Scholar 

  39. Pirro N, Konate I, Sielezneff I, Di Marino V, Sastre B. Anatomic bases of graciloplasty using end-to-side nerve pudendal anastomosis. Surg Radiol Anat. 2005;27:409–13.

    Article  CAS  PubMed  Google Scholar 

  40. Sato T, Konishi F, Endoh N, Uda H, Sugawara Y, Nagal H. Long-term outcomes of a ne-anus with a pudendal nerve anastomosis contemporaneously reconstructed with an abdominoperineal excision of the rectum. Surgery. 2005;137:8–15.

    Article  PubMed  Google Scholar 

  41. Schwabegger AH, Kronberger P, Obrist P, Brath E, Miko I. Functional sphincter ani externus reconstruction for treatment of fecal stress incontinence using free latissimus dorsi muscle transfer with coaptation to the pudendal nerve: preliminary experimental study in dogs. J Reconstr Microsurg. 2007;23:79–85.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ali A. Shafik M.D.

Authors
  1. Ali A. Shafik M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali A. Shafik M.D. .

Editor information

Editors and Affiliations

  1. Tamworth Rural Referral Hospital, Dean Street, Tamworth, 2340, New South Wales, Australia

    Andrew P. Zbar

  2. Delware Street 420, Minneapolis, 55455, Minnesota, USA

    Robert D. Madoff

  3. , Dept. Colorectal Surgery, Cleveland Clinic, Florida, Cleveland Clinic Blvd. 2950, Weston, 33331, Florida, USA

    Steven Wexner

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Shafik, A.A. (2013). Autologous Neosphincters and Novel Technologies for Fecal continence. In: Zbar, A., Madoff, R., Wexner, S. (eds) Reconstructive Surgery of the Rectum, Anus and Perineum. Springer, London. https://doi.org/10.1007/978-1-84882-413-3_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-413-3_34

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-412-6

  • Online ISBN: 978-1-84882-413-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation