Anatomical basis of antropyloric transposition for fecal incontinence in humans: the infrapyloric approach

Abstract

Careful preservation of the pyloric valve vascularity by preserving the IP a. by dividing the Rt GEA at its origin increases vascularity, survival and contractility of the pyloric graft in perineum.

Free Antropyloric Valve Flap for End-Stage Fecal Incontinence as a Substitute to Permanent Colostomy

“…11 Subsequent studies by our team focusing on the infrapyloric vasculature showed the infrapyloric vessels originating from RGEA and gastroduodenal artery (GDA) with various anatomic variations. 17 GDA as the sole source of infrapyloric vessels was not noticed in any of the specimens studied. The technical modification, then followed, by ligating the RGEA distal to the origin of infrapyloric artery resulted in better graft vascularity.…”

“…The technical modification, then followed, by ligating the RGEA distal to the origin of infrapyloric artery resulted in better graft vascularity. 17 Previous studies have also noticed infrapyloric artery to be originating from RGEA in 55% of cases. 16 Some authors have classified infrapyloric artery as types A and B, according to its origin from gastroduodenal artery and RGEA, respectively.…”

Feasibility of Neurovascular Antropylorus Perineal Transposition With Pudendal Nerve Anastomosis Following Anorectal Excision: A Cadaveric Study for Neoanal Reconstruction

“…Therefore, smooth muscles can serve as better sphincter replacements physiologically. Preliminary studies on the use of APV transposition in the perineum following a resected or damaged anal sphincter (as a substitute for an abdominal stoma in humans) have recently accomplished this [5,11]. The transposed pyloric valve (smooth muscle) was shown to behave as a tonic sphincter when removed from the gastroduodenal continuity, with a median pressure of 30 mmHg on manometry [17].…”

“…In the abdominal part, branches of the gastroepiploic arcade to the stomach along the greater curvature were divided, retaining the supply to the APV segment based on the left gastroepiploic artery as described previously by us [5,11]. The AV was carefully harvested after it gave the hepatic branch, retaining its integrity to the part of the removed antropyloric segment (Fig.…”