Dynamic graciloplasty for restoration of continence after traumatic destruction of the rectum and sphincters: report of a case

Abstract

A thirteen-year-old girl was run down by a speedboat, which resulted in traumatic destruction of the rectum and anal sphincters. She was treated by using a modified Duhamel procedure for rectal reconstruction and a double gracilis muscle transposition as the sphincter replacement procedure. Eight weeks after the first operation, intramuscular electrodes were implanted in both gracilis muscles and connected with an implanted electrical stimulator. This electrically stimulated gracilis muscle neosphincter restored sphincter function while anorectal sensation was preserved as a result of an intact rectovaginal septum. After closure of the temporary colostomy, the patient has good continence.