Impact of selective surgical pelvic autonomic nerve damage on the evoked neuromonitoring signal of the internal anal sphincter

2012 ◽  
Vol 57 (SI-1 Track-H) ◽  
Author(s):  
DW Kauff ◽  
KP Koch ◽  
O Kempski ◽  
KP Hoffmann ◽  
H Lang ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Nerve Damage ◽  
Autonomic Nerve ◽  
Pelvic Autonomic Nerve

Surface Electromyography Reliably Records Electrophysiologically Evoked Internal Anal Sphincter Activity: A More Minimally Invasive Approach for Monitoring Extrinsic Innervation

2016 ◽  
Vol 57 (1-2) ◽  
pp. 81-88 ◽  
Author(s):  
Daniel W. Kauff ◽  
Nicolas Wachter ◽  
Axel Heimann ◽  
Thilo B. Krüger ◽  
Klaus-Peter Hoffmann ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Autonomic Nerve ◽  
Pelvic Surgery ◽  
Transanal Total Mesorectal Excision ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Anterior Rectal Resection ◽  
Extrinsic Innervation

Background: Even in the case of minimally invasive pelvic surgery, sparing of the autonomic nerve supply is a prerequisite for maintaining anal sphincter function. Internal anal sphincter (IAS) innervation could be electrophysiologically identified based on processed electromyographic (EMG) recordings with conventional bipolar needle electrodes (NE). This experimental study aimed for the development of a minimally invasive approach via intra-anal surface EMG for recordings of evoked IAS activity. Methods: Six male pigs underwent nerve-sparing low anterior rectal resection. Electric autonomic nerve stimulations were performed under online-processed EMG of the IAS. EMG recordings were simultaneously carried out with conventional bipolar NE as the reference method and newly developed intra-anal surface electrodes (SE) in different designs. Results: In all experiments, the IAS activity could be continuously visualized via EMG recordings based on NE and SE. The median number of bipolar electric stimulations per animal was 27 (range 5-52). The neurostimulations resulted in significant EMG amplitude increases for both recording types [NE: median 3.0 µV (interquartile range, IQR 2.8-3.5) before stimulation vs. 7.1 µV (IQR 3.9-13.8) during stimulation, p < 0.001; SE: median 3.6 µV (IQR 3.1-4.3) before stimulation vs. 6.8 µV (IQR 4.8-10.3) during stimulation, p < 0.001]. Conclusions: Intra-anal SE enabled reliable EMG of electrophysiologically evoked IAS activity similar to the conventional recording via NE. The transfer of the method to access platforms for transanal total mesorectal excision or robotics may offer a practical more minimally invasive approach for monitoring extrinsic innervation.

scholarly journals Rhythmic calcium transients in smooth muscle cells of the mouse internal anal sphincter

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Caroline A. Cobine ◽  
Karen I. Hannigan ◽  
Megan McMahon ◽  
Emer P. Ni Bhraonain ◽  
Salah A. Baker ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Smooth Muscle Cells ◽  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Muscle Cells ◽  
Calcium Transients

scholarly journals Topohistology of the Paravaginal Nerves and Fasciae with Special Reference to Nerves to the Internal Anal Sphincter

2014 ◽  
Vol 67 (8) ◽  
pp. 495-503
Author(s):  
Fumitake Hata ◽  
Takashi Arakawa ◽  
Kuniaki Okada ◽  
Hidefumi Nishimori ◽  
Shinichiro Ikeda ◽  
...  
Keyword(s):  
Special Reference ◽  
Anal Sphincter ◽  
Internal Anal Sphincter

scholarly journals RhoA/ROCK pathway is the major molecular determinant of basal tone in intact human internal anal sphincter

2012 ◽  
Vol 302 (7) ◽  
pp. G664-G675 ◽  
Author(s):  
Satish Rattan ◽  
Jagmohan Singh
Keyword(s):  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Control Mechanisms ◽  
Rock Inhibitor ◽  
Critical Determinant ◽  
Molecular Control ◽  
Motility Disorders ◽  
Basal Tone ◽  
Before And After ◽  
Rational Therapy

The knowledge of molecular control mechanisms underlying the basal tone in the intact human internal anal sphincter (IAS) is critical for the pathophysiology and rational therapy for a number of debilitating rectoanal motility disorders. We determined the role of RhoA/ROCK and PKC pathways by comparing the effects of ROCK- and PKC-selective inhibitors Y 27632 and Gö 6850 (10−8to 10−4M), respectively, on the basal tone in the IAS vs. the rectal smooth muscle (RSM). Western blot studies were performed to determine the levels of RhoA/ROCK II, PKC-α, MYPT1, CPI-17, and MLC20in the unphosphorylated and phosphorylated forms, in the IAS vs. RSM. Confocal microscopic studies validated the membrane distribution of ROCK II. Finally, to confirm a direct relationship, we examined the enzymatic activities and changes in the basal IAS tone and p-MYPT1, p-CPI-17, and p-MLC20, before and after Y 27632 and Gö 6850. Data show higher levels of RhoA/ROCK II and related downstream signal transduction proteins in the IAS vs. RSM. In addition, data show a significant correlation between the active RhoA/ROCK levels, ROCK enzymatic activity, downstream proteins, and basal IAS tone, before and after ROCK inhibitor. From these data we conclude 1) RhoA/ROCK and downstream signaling are constitutively active in the IAS, and this pathway (in contrast with PKC) is the critical determinant of the basal tone in intact human IAS; and 2) RhoA and ROCK are potential therapeutic targets for a number of rectoanal motility disorders for which currently there is no satisfactory treatment.

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