Dynamic graciloplasty resulting fecal continence without electrical stimulation: report of a case.

A 32 year-old man received dynamic graciloplasty for fecal incontinence due to a pelvic fracture. The perception of stool was obtained soon after the colostomy closure. Defecography and a manometric study showed that the patient could contract the transposed gracilis muscle independently.

Feasibility of dividing the main vessels for enhancement of dynamic graciloplasty.

Purpose: The technique of dynamic graciloplasty is not yet-completely satisfactory. Its function could be improved by ensuring total wrapping of the neoanus with the muscular part of the gracilis, but this can only be achieved by dividing the main blood vessels, which are considered essential for blood supply to the flap. We devised a vascular delay technique to preserve the flap without these vessels, which we performed first experimentally, then clinically, with promising results.