CONSIDERATIONS ON STIMULATED ANAL NEOSPHINCTER FORMATION - AN ANATOMIC INVESTIGATION IN SEARCH OF ALTERNATIVES TO THE GRACILIS MUSCLE

Electrically stimulated anal neosphincter formation with transposed gr acilis is performed clinically in an increasing number of patients. Th e use of a stimulated gluteus maximus in this application has been rep orted also. The question arises whether or not an optimal design for s uch a procedure has already been ascertained. An anatomic study was pe rformed on 30 human cadavers to evaluate the semitendinosus muscle and its suitability for construction of a stimulated anal neosphincter. S emitendinosus fulfilled requirements for transposition around the anal canal in all cases. The muscle length was found adequate for transpos ition; nerve and vascular supply provided a suitable are of rotation. The pattern of innervation might allow selective stimulation of that p articular part of the muscle, which is intended to restore sphincter f unction. For clinical application, a vascular delay procedure is stron gly recommended.