Artificial Muscle Devices: Innovations and Prospects for Fecal Incontinence Treatment.

Fattorini, Elisa; Brusa, Tobia; Gingert, Christian; Hieber, Simone E; Leung, Vanessa; Osmani, Bekim; Dominietto, Marco D; Büchler, Philippe; Hetzer, Franc; Müller, Bert (2016). Artificial Muscle Devices: Innovations and Prospects for Fecal Incontinence Treatment. Annals of biomedical engineering, 44(5), pp. 1355-1369. Springer 10.1007/s10439-016-1572-z

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Fecal incontinence describes the involuntary loss of bowel content, which is responsible for stigmatization and social exclusion. It affects about 45% of retirement home residents and overall more than 12% of the adult population. Severe fecal incontinence can be treated by the implantation of an artificial sphincter. Currently available implants, however, are not part of everyday surgery due to long-term re-operation rates of 95% and definitive explantation rates of 40%. Such figures suggest that the implants fail to reproduce the capabilities of the natural sphincter. This article reviews the artificial sphincters on the market and under development, presents their physical principles of operation and critically analyzes their performance. We highlight the geometrical and mechanical parameters crucial for the design of an artificial fecal sphincter and propose more advanced mechanisms of action for a biomimetic device with sensory feedback. Dielectric electro-active polymer actuators are especially attractive because of their versatility, response time, reaction forces, and energy consumption. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence during daily activities.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Brusa, Tobia and Büchler, Philippe

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

0090-6964

Publisher:

Springer

Language:

English

Submitter:

Philippe Büchler

Date Deposited:

17 May 2017 11:09

Last Modified:

17 May 2017 11:09

Publisher DOI:

10.1007/s10439-016-1572-z

PubMed ID:

26926695

Uncontrolled Keywords:

Biomimetic design; Electro-active polymer actuator; Fecal sphincter

BORIS DOI:

10.7892/boris.95279

URI:

https://boris.unibe.ch/id/eprint/95279

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