Vascular anatomy of gracilis muscle: arterial findings to enhance graciloplasty

Dynamic graciloplasty has recently been developed for reconstruction of ana l function in patients who are fecally incontinent in preference to per mom ent abdominal colostomy. Since the muscular portion of gracilis is wrapped around the neoanus, the length of the gracilis are influences the functiona l outcome of graciloplasty. Although dissection of the main pedicle (i.e. t he main artery and vein) can facilitate gracilis to have enough muscle are, it has been unclear whether there are any vessels proximal to the main ped icle or through the origin of the muscle which could support blood flow int o the whole of gracilis. In this study, the vascular anatomy of gracilis in both legs of 26 Japanese cadavers was examined. All muscles had a main ped icle, mean maximum diameter 1.08 mm, entering at the proximal one-third of the muscle. However, only 18 muscles (34.6%) had an accessory artery in the proximal portion in addition to the main pedicle. Some arteries always exi st at the origin of the muscle, having a mean maximum diameter of 0.34 mm, suggesting that they might be able to support the whole gracilis without su pply from the main pedicle.