TY - JOUR
T1 - Electrical contraction of the anal sphincter for intraoperative visualization of anal function
AU - Ohara, Nobuyoshi
AU - Takahashi, Hidekazu
AU - Katsuyama, Shinsuke
AU - Doki, Yuichiro
AU - Mori, Masaki
AU - Nakajima, Kiyokazu
N1 - Publisher Copyright:
© 2020, © 2020 Society of Medical Innovation and Technology.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Repairing sphincter defects to restore the anal aperture is a cornerstone of surgical treatment in cases of anal preserving surgery. Such procedures are selected and performed according to the surgeons’ experience. In the present study, we aimed to investigate a method for clear and intuitive intraoperative assessment of anal function under general anesthesia. Methods: This study was conducted in three-month-old female (35 kg) domestic swine (n = 8) under standard general anesthesia. Electrical stimulation of the anal sphincter was performed using prototype electric devices, and then the anal pressure was measured by manometry. We generated an anal dysfunctional model by excising the left puborectalis muscle. Anal function was semi-quantified and visualized using anorectal manometry. Results: Electrical stimulation with 12.5 mA output current and 15% duty ratio produced maximum anal pressure using the smallest amount of electricity. Histological examination confirmed the safety of the electrical muscular stimulation. Three-dimensional reconstruction of the results from the pressure curves of each sensor-enabled visualization of the functional anal canal. Monitoring using manometry under general anesthesia revealed the recovery of anal function upon suturing the excised puborectalis. Conclusions: Electrical muscular stimulation feasibly enabled visualization of anal function under general anesthesia in a porcine model.
AB - Background: Repairing sphincter defects to restore the anal aperture is a cornerstone of surgical treatment in cases of anal preserving surgery. Such procedures are selected and performed according to the surgeons’ experience. In the present study, we aimed to investigate a method for clear and intuitive intraoperative assessment of anal function under general anesthesia. Methods: This study was conducted in three-month-old female (35 kg) domestic swine (n = 8) under standard general anesthesia. Electrical stimulation of the anal sphincter was performed using prototype electric devices, and then the anal pressure was measured by manometry. We generated an anal dysfunctional model by excising the left puborectalis muscle. Anal function was semi-quantified and visualized using anorectal manometry. Results: Electrical stimulation with 12.5 mA output current and 15% duty ratio produced maximum anal pressure using the smallest amount of electricity. Histological examination confirmed the safety of the electrical muscular stimulation. Three-dimensional reconstruction of the results from the pressure curves of each sensor-enabled visualization of the functional anal canal. Monitoring using manometry under general anesthesia revealed the recovery of anal function upon suturing the excised puborectalis. Conclusions: Electrical muscular stimulation feasibly enabled visualization of anal function under general anesthesia in a porcine model.
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U2 - 10.1080/13645706.2020.1773855
DO - 10.1080/13645706.2020.1773855
M3 - Article
C2 - 32520648
AN - SCOPUS:85087120709
JO - Endoscopic surgery and allied technologies
JF - Endoscopic surgery and allied technologies
SN - 1364-5706
ER -