title: Considerations on stimulated anal neosphincter formation: an anatomic investigation in search of alternatives to the gracilis muscle.
abstract: Electrically stimulated anal neosphincter formation with transposed gracilis is performed clinically in an increasing number of patients. The use of a stimulated gluteus maximus in this application has been reported also. The question arises whether or not an optimal design for such a procedure has already been ascertained. An anatomic study was performed on 30 human cadavers to evaluate the semitendinosus muscle and its suitability for construction of a stimulated anal neosphincter. Semitendinosus fulfilled requirements for transposition around the anal canal in all cases. The muscle length was found adequate for transposition; nerve and vascular supply provided a suitable arc of rotation. The pattern of innervation might allow selective stimulation of that particular part of the muscle, which is intended to restore sphincter function. For clinical application, a vascular delay procedure is strongly recommended.
authors.affiliation: Department of Plastic and Reconstructive Surgery, the Institute of Anatomy, Medical School at the University of Vienna, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Girsch
authors.forename: M
authors.initials: M
authors.lastname: Rab
authors.forename: N
authors.initials: N
authors.lastname: Mader
authors.forename: L P
authors.initials: LP
authors.lastname: Kamolz
authors.forename: T
authors.initials: T
authors.lastname: Hausner
authors.forename: W
authors.initials: W
authors.lastname: Schima
authors.forename: H
authors.initials: H
authors.lastname: Gruber
mesh_terms: D001003:Anal Canal / Q000294:innervation / Q000601:surgery*; D004558:Electric Stimulation; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation / Q000637:transplantation*; D013848:Thigh