Jin Wentian, Yan Guozheng, Wu Hao, Lu Shan, Zhou Zerun
Institute of Medical Precision Engineering and Intelligent Systems, Department of Instrument Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Artif Organs. 2017 Sep;41(9):845-851. doi: 10.1111/aor.12874. Epub 2017 Jul 18.
Artificial anal sphincter (AAS) is an in situ implanted device that acts as a treatment for fecal incontinence regardless of etiology by augmenting the incompetent sphincteric structures. However, AAS is impeded from becoming a valid therapy by its high rate of ischemic complication and malfunction. This article presents an original puborectalis-like artificial anal sphincter (PAAS) that features a low risk of ischemia necrosis and rectal perception remodeling. The device retains continence by reproducing the action, including the pulling and angulating the rectum, of the puborectalis muscle, which forms the anorectal angle and reduces the required clamping pressure. Three rectal pressure sensors were embedded to maintain the pressure exerted on the rectal wall in a safe range and to monitor the distention of the rectum. A series of in vitro studies were conducted with a porcine rectum, and this PAAS prototype manifested the ability of maintaining continence with a clamping pressure considerably lower than that required by other AAS devices. The pressure sensors exhibit good linearity, and the function of rectal perception remodeling has also revealed high reliability with a success rate of 93.3%.
人工肛门括约肌（AAS）是一种原位植入装置，通过增强功能不全的括约肌结构来治疗各种病因引起的大便失禁。然而，AAS因其缺血性并发症和故障发生率高而难以成为一种有效的治疗方法。本文介绍了一种原创的耻骨直肠肌样人工肛门括约肌（PAAS），其具有缺血坏死风险低和直肠感知重塑的特点。该装置通过重现耻骨直肠肌的动作（包括牵拉直肠和使其成角）来保持控便能力，耻骨直肠肌形成肛管直肠角并降低所需的夹紧压力。嵌入了三个直肠压力传感器，以将施加在直肠壁上的压力维持在安全范围内，并监测直肠扩张情况。使用猪直肠进行了一系列体外研究，该PAAS原型表现出以远低于其他AAS装置所需的夹紧压力保持控便的能力。压力传感器具有良好的线性，直肠感知重塑功能也显示出高可靠性，成功率为93.3%。
