title: Challenges faced in the clinical application of artificial anal sphincters.
abstract: Fecal incontinence is an unresolved problem, which has a serious effect on patients, both physically and psychologically. For patients with severe symptoms, treatment with an artificial anal sphincter could be a potential option to restore continence. Currently, the Acticon Neosphincter is the only device certified by the US Food and Drug Administration. In this paper, the clinical safety and efficacy of the Acticon Neosphincter are evaluated and discussed. Furthermore, some other key studies on artificial anal sphincters are presented and summarized. In particular, this paper highlights that the crucial problem in this technology is to maintain long-term biomechanical compatibility between implants and surrounding tissues. Compatibility is affected by changes in both the morphology and mechanical properties of the tissues surrounding the implants. A new approach for enhancing the long-term biomechanical compatibility of implantable artificial sphincters is proposed based on the use of smart materials.
authors.affiliation: State Key Laboratory of Mechanical System and Vibration, Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
authors.forename: Ming-hui
authors.initials: MH
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Mechanical System and Vibration, Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Mechanical System and Vibration, Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.|School of Mechanical Engineering, Shanghai Dianji University, Shanghai 200240, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Zhao
authors.affiliation: State Key Laboratory of Mechanical System and Vibration, Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Luo
mesh_terms: D001187:Artificial Organs; D019544:Equipment Failure Analysis; D019317:Evidence-Based Medicine; D005242:Fecal Incontinence / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D011474:Prosthesis Design; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome; D014481:United States
keywords: Artificial anal sphincter (AAS); Biomechanical compatibility; Fecal incontinence (FI); Smart materials