Double-gracilis anorectal neosphincter: technique of reconstruction after necrosis of the distal part of the muscles.

Purpose: The aim of the present study is to demonstrate further reconstruction of a double-gracilis anorectal neosphincter that had been destroyed because of a severe postoperative perineal infection, with necrosis of the distal part of the muscles.

Method: Each residual gracilis muscle was split longitudinally into two branches, which surrounded the neorectum, one posteriorly and the other one anteriorly, so as to perform a perineorectal double sling.

Result: Owing to a poor functional result, continence was achieved only by the support of an implantable pulse generator.

Conclusion: This technique seemed to permit the optimum use of the contractile potential of the residual gracilis muscles, which did not show evidence of defunction-related or ischemia-related fibrosis.