The electrically stimulated gracilis neo-anal sphincter

Abstract

Many patients with incontinence gain no relief from their symptoms following traditional surgical treatment and by necessity resort to a stoma. A number of attempts have been made to replace damaged or excised sphincters using the gracilis muscle to fashion a neo-anal sphincter. The results of the published series using the technique of unstimulated graciloplasty for the treatment of anal incontinence and in total anorectal reconstruction are reviewed. The results of these series are conflicting. In an effort to improve on these results the electrically stimulated neo-anal sphincter has been developed. The rationale behind its development and its evolution are discussed. The efficacy of the procedure in treating patients with incontinence or as part of total anorectal reconstruction is assessed.