{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:12:32Z","timestamp":1790093552188,"version":"4.0.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2004,9,20]],"date-time":"2004-09-20T00:00:00Z","timestamp":1095638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A novel prosthetic anal sphincter (PAS) has been developed that aims to occlude by flattening and angulating the bowel, reproducing the action of the puborectalis muscle. The safety of the PAS has been confirmed in biomechanical, in vitro and long-term animal survival studies. The Medical Devices Agency approved implantation in 12 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The PAS was placed in the pelvis around the anorectal junction via a transabdominal approach in 12 patients with severe faecal incontinence. The device was activated 6 weeks after surgery. Fibreoptic examination of the mucosa below the device was undertaken at various intervals during review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At a median follow-up of 59 (range 30\u201372) months nine of the 12 patients had a functioning PAS. There were no device-related infective complications after the initial operation but one patient developed pseudomembranous colitis and had the device removed. The PAS was effective in restoring continence in ten of 11 patients. Median (range) Cleveland Clinic continence scores improved from 16 (7\u201320) before to 3 (0\u20137) after surgery. In two patients the PAS was eventually removed owing to infection after revisional surgery. There was no clinical or histological evidence of gastrointestinal mucosal ischaemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The PAS was effective in restoring continence. There was no device-related infection after the initial operation, no device erosion and no clinical or histological evidence of gastrointestinal ischaemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4721","type":"journal-article","created":{"date-parts":[[2004,9,20]],"date-time":"2004-09-20T15:00:58Z","timestamp":1095692458000},"page":"1485-1492","source":"Crossref","is-referenced-by-count":52,"title":["Outcome after implantation of a novel prosthetic anal sphincter in humans"],"prefix":"10.1093","volume":"91","author":[{"given":"I G","family":"Finlay","sequence":"first","affiliation":[{"name":"Department of Coloproctology, Lister Surgical Unit, Glasgow Royal Infirmary, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, North Glasgow NHS Trust, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Hajivassiliou","sequence":"additional","affiliation":[{"name":"Department of Coloproctology, Lister Surgical Unit, Glasgow Royal Infirmary, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,9,20]]},"reference":[{"key":"2021070907015022200_bib1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1136\/bmj.307.6905.636","article-title":"Faecal incontinence: childbirth is responsible for most cases","volume":"307","author":"Swash","year":"1993","journal-title":"BMJ"},{"key":"2021070907015022200_bib2","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1046\/j.1365-2168.1999.00997.x","article-title":"Results of repeat anal sphincter repair","volume":"86","author":"Pinedo","year":"1999","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib3","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s10350-004-6381-z","article-title":"The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study","volume":"45","author":"Wong","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib4","first-page":"1","volume-title":"Prosthetic Anal Sphincter","author":"Carter"},{"key":"2021070907015022200_bib5","first-page":"29","volume-title":"Handbook of Fluids in Motion","author":"Cheremisinoff","year":"1983"},{"key":"2021070907015022200_bib6","first-page":"135","volume-title":"Handbook of Fluids in Motion","author":"Patel","year":"1993"},{"key":"2021070907015022200_bib7","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/bjs.1800830117","article-title":"Anorectal angle enhances faecal incontinence","volume":"83","author":"Hajivassiliou","year":"1996","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib8","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/BF02140902","article-title":"Assessment of a novel implantable anal sphincter","volume":"40","author":"Hajivassiliou","year":"1997","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib9","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1046\/j.1365-2168.1998.00948.x","article-title":"Effect of a novel prosthetic anal neosphincter on human colonic blood flow","volume":"85","author":"Hajivassiliou","year":"1998","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib10","volume-title":"The Classification Rules","author":"Medical Devices Agency UK","year":"1995"},{"key":"2021070907015022200_bib11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF02050307","article-title":"Etiology and management of fecal incontinence","volume":"36","author":"Jorge","year":"1993","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib12","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/0090-4295(73)90749-8","article-title":"Treatment of urinary incontinence by implantable prosthetic sphincter","volume":"1","author":"Scott","year":"1973","journal-title":"Urology"},{"key":"2021070907015022200_bib13","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1016\/S0022-5347(17)35793-2","article-title":"Success of the narrow backed cuff design of the AMS 800 artificial bowel sphincter: analysis of 144 patients","volume":"150","author":"Leo","year":"1993","journal-title":"J Urol"},{"key":"2021070907015022200_bib14","first-page":"390","article-title":"Experiences with an artificial sphincter to establish continence in dogs","volume":"54","author":"Sofia","year":"1988","journal-title":"Am Surg"},{"key":"2021070907015022200_bib15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/0022-4804(89)90057-7","article-title":"An artificial anal sphincter. Phase 2: implantable sphincter with a perineal colostomy","volume":"46","author":"Satava","year":"1989","journal-title":"J Surg Res"},{"key":"2021070907015022200_bib16","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/S0140-6736(87)90829-4","article-title":"Implantation of artificial sphincter for anal incontinence","volume":"ii","author":"Christiansen","year":"1987","journal-title":"Lancet"},{"key":"2021070907015022200_bib17","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1046\/j.1464-410x.1999.00952.x","article-title":"Uneven pressure application by the artificial urinary sphincter: an explanation for tissue ischaemia?","volume":"83","author":"Hajivassiliou","year":"1999","journal-title":"BJU Int"},{"key":"2021070907015022200_bib18","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3109\/03091909709031153","article-title":"Biomechanical evaluation of an artificial anal sphincter prosthesis","volume":"21","author":"Hajivassiliou","year":"1997","journal-title":"J Med Eng Technol"},{"key":"2021070907015022200_bib19","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1046\/j.1365-2168.1998.00555.x","article-title":"Non-invasive measurement of colonic blood flow distribution using laser Doppler imaging","volume":"85","author":"Hajivassiliou","year":"1998","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib20","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1007\/BF02054523","article-title":"Results of artificial sphincter in severe anal incontinence. Report of 14 consecutive implantations","volume":"39","author":"Lehur","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib21","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/BF02237423","article-title":"Restoring control: the Acticon Neosphincter artificial bowel sphincter in the treatment of anal incontinence","volume":"43","author":"O'Brien","year":"2000","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib22","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1046\/j.0007-1323.2001.01895.x","article-title":"Multicentre retrospective analysis of the outcome of artificial anal sphincter implantation for severe faecal incontinence","volume":"88","author":"Altomare","year":"2001","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib23","first-page":"105","article-title":"Clinical, physiological, and radiological study of a new purpose-designed artificial bowel sphincter","volume":"352","author":"Vaizey","year":"1998","journal-title":"Lancet"},{"key":"2021070907015022200_bib24","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/BF02054522","article-title":"Artificial anal sphincter","volume":"39","author":"Wong","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib25","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1046\/j.1365-2168.2000.01398.x","article-title":"Manometric assessment of an artificial bowel sphincter","volume":"87","author":"Savoye","year":"2000","journal-title":"Br J Surg"},{"key":"2021070907015022200_bib26","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1007\/s10350-004-6230-0","article-title":"Comparison of quality of life and anorectal function after artificial sphincter implantation","volume":"45","author":"Lehur","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070907015022200_bib27","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1016\/S0140-6736(00)02409-0","article-title":"Reassessing artificial bowel sphincters","volume":"355","author":"Malouf","year":"2000","journal-title":"Lancet"},{"key":"2021070907015022200_bib28","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/0140-6736(91)92031-V","article-title":"Development of an electrically stimulated neoanal sphincter","volume":"338","author":"Williams","year":"1991","journal-title":"Lancet"},{"key":"2021070907015022200_bib29","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1046\/j.1365-2168.2002.02018.x","article-title":"Systematic review of dynamic graciloplasty in the treatment of faecal incontinence","volume":"89","author":"Chapman","year":"2002","journal-title":"Br J Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.4721","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/11\/1485\/36728500\/bjs4721.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/11\/1485\/36728500\/bjs4721.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T16:17:13Z","timestamp":1625847433000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/91\/11\/1485\/6150690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,9,20]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2004,9,20]]},"published-print":{"date-parts":[[2004,10,20]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.4721","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,11]]},"published":{"date-parts":[[2004,9,20]]}}}