Journal of Shanghai Jiao Tong University

Journal of Shanghai Jiaotong University >

2019 , Vol. 53 >Issue 10: 1151 - 1158

DOI: https://doi.org/10.16183/j.cnki.jsjtu.2019.10.002

Design and Experimental Verification of a Novel Puborectalis-Like Artificial Anal Sphincter

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  • School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China

Online published: 2019-11-01

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Abstract

In order to treat severe fecal incontinence, a novel puborectalis-like artificial anal sphincter (PAAS) based on three rings is designed to pull and angulate the rectum. The gear box can be fully encapsulated inside the PAAS, and the motor power is transmitted from inside to outside. In addition, a flexible pressure sensor is designed and customized to detect the force exerted on the intestinal wall when the pulling arm pulls the rectum with the O-rings to achieve good waterproof effect. Finally, the mechanical and waterproof properties are assessed, and the animal implantation is conducted. The results indicate that: the final transmission efficiency of PAAS is 49%～59%, the output torque is 2.04～2.51N·m; there is good linearity between the output of flexible pressure sensor and the force exerted on the intestinal wall; PAAS can maintain the intraluminal pressure up to 98cm water column with clamping pressure of 6.6kPa; no leakage occurrs after 4050 movements; the anastomosis can be effectively avoided in implantation and PAAS works effectively in a Sipsongpanna miniature pig model. PAAS proposed in this paper has a good all-round performance of waterproof as well as maintaining continence.

Key words： puborectalis-like artificial anal sphincter; three-ring actuator; flexible pressure sensor; waterproof; animal experiment

Cite this article

LU Shan,WANG Zhiwu,YAN Guozheng,ZHOU Zerun . Design and Experimental Verification of a Novel Puborectalis-Like Artificial Anal Sphincter[J]. Journal of Shanghai Jiaotong University, 2019 , 53(10) : 1151 -1158 . DOI: 10.16183/j.cnki.jsjtu.2019.10.002

References

［1］FATTORINI E, BRUSA T, GINGERT C, et al. Artificial muscle devices: Innovations and prospects for fecal incontinence treatment ［J］. Annals of Biomedical Engineering, 2016, 44(5): 1355-1369.

［2］FORTE M L, ANDRADE K E, LOWRY A C, et al. Systematic review of surgical treatments for fecal incontinence ［J］. Diseases of the Colon & Rectum, 2016, 59(5): 443-469.

［3］WONG W D, JENSEN L L, BARTOLO D C C, et al. Artificial anal sphincter ［J］. Diseases of the Colon & Rectum, 1996, 39(12): 1345-1351.

［4］CHOWDRI N A, PARRAY F Q. Benign anorectal disorders: A guide to diagnosis and management ［M］. India: Springer, 2016.

［5］CHRISTIANSEN J, LORENTZEN M. Implantation of artificial sphincter for anal incontinence: Report of five cases ［J］. Lancet, 1989, 32(5): 432-436.

［6］PARKER S C, SPENCER M P, MADOFF R D, et al. Artificial bowel sphincter: Long-term experience at a single institution ［J］. Diseases of the Colon & Rectum, 2003, 46(6): 722-729.

［7］GOOS M, BAUMGARTNER U, LHNERT M, et al. Experience with a new prosthetic anal sphincter in three coloproctological centres ［J］. BMC Surgery, 2013, 13(1): 45.

［8］WANG X F, DASILVA G, MARON D J, et al. Outcomes of reimplantation of the artificial bowel sphincter ［J］. Diseases of the Colon & Rectum, 2016, 59(2): 122-126.

［9］DOLL A, HEINRICHS M, GOLDSCHMIDTBOEING F, et al. A high performance bidirectional micropump for a novel artificial sphincter system ［J］. Sensors & Actuators, 2006, 130/131: 445-453.

［10］RUTHMANN O, RICHTER S, SEIFERT G, et al. The first teleautomatic low-voltage prosthesis with multiple therapeutic applications: A new version of the german artificial sphincter system ［J］. Artificial Organs, 2010, 34(8): 635-641.

［11］KE L, YAN G, YAN S, et al. Feedback control of TET system with variable coupling coefficients for a novel artificial anal sphincter ［J］. Journal of Medical Engineering & Technology, 2014, 38(2): 90-99.

［12］KE L, YAN G, WANG Y, et al. Design and evaluation of an intelligent artificial anal sphincter system powered by an adaptive transcutaneous energy transfer system ［J］. International Journal of Artificial Organs, 2015, 38(3): 154-160.

［13］RASMUSSEN O , SRENSEN M, TETZSCHNER T, et al. Anorectal pressure gradient in patients with anal incontinence ［J］. Diseases of the Colon & Rectum, 1992, 35(1): 8-11.

［14］PRICHARD D, HARVEY D M, Fletcher J G, et al. Relationship among anal sphincter injury, patulous anal canal, and anal pressures in patients with anorectal disorders ［J］. Clinical Gastroenterology and Hepatology, 2015, 13(10): 1793-1800.

［15］FINLAY I G, RICHARDSON W, HAJIVASSILIOU C A. Outcome after implantation of a novel prosthetic anal sphincter in humans ［J］. British Journal of Surgery, 2004, 91(11): 1485-1492.

［16］DEVESA J M, REY A, HERVAS P L, et al. Artificial anal sphincter: Complications and functional results of a large personal series ［J］. Diseases of the Colon & Rectum, 2002, 45(9): 1154-1163.

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