Current development and clinical applications of artificial anal sphincter

ABSTRACT

Introduction

Fecal incontinence is a common chronic disease, which not only brings inconvenience to the lives of patients, but also causes great psychological harm to patients. Artificial anal sphincter is an innovative method that may treat fecal incontinence, and now has been clinically applied.

Areas covered

This article will review recent developments in mechanisms and clinical applications of artificial anal sphincter. The current results of clinical trials show that the implantation of artificial sphincter will cause morphological changes of surrounding tissues, and related biomechanical imbalance will lead to the loss of effectiveness of the device and various complications. In terms of safety, postoperative patients suffer from various complications such as infection, corrosion, tissue ischemia, mechanical failure, and difficulty in emptying. In terms of effectiveness, there is currently no long-term research data to prove that the implanted device can maintain a long-term functional state.

Expert opinion

The key issue for the safety and effectiveness of implantable devices is the biomechanical compatibility of implantable devices was proposed. Based on the superelasticity of shape memory alloy, this article proposes a new type of constant force artificial sphincter device, which provides a new direction for solving the clinical application of artificial anal sphincter.

KEYWORDS:

• Artificial anal sphincter
• Biomechanical compatibility
• Constant force
• Fecal incontinence
• Shape memory alloy
• Superelasticity

Article highlights

• In terms of long-term effectiveness, there is currently no long-term research data to prove that the implanted device can maintain a long-term functional state.

• The key issue for the safety and effectiveness of implantable devices is the biomechanical compatibility of implantable devices.

• The artificial anal sphincter embedded with constant force element may adapt to changes in the tissue morphology around the implant device, improve the biomechanical compatibility of the implant device, which provides a possibility to solve its clinical key technical problems.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Declaration of interest

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This research was based on the project of National Natural Science Foundation of China (Project No. 31900944).