3 The procedure

Guidance

3.1 Insertion of a magnetic bead band for faecal incontinence aims to reinforce and improve the competence of the anal sphincter to prevent episodes of incontinence without creating obstruction, and with less morbidity than artificial bowel sphincter surgery. The magnetic bead band does not need to be adjusted once it has been inserted.

3.2 The procedure is done with the patient under general anaesthesia, using stringent asepsis. A tunnel is created around the anal canal via an anterior incision in the perineal body. A sizing tool is inserted to assess the circumference of the anal canal and the size of implant needed. The sizing tool is then removed and the implant is placed circumferentially around the upper anal canal. Fluoroscopy may be used to confirm the correct position. The ends of the implant are tied together. The wound is then closed.

3.3 The implant consists of a ring of interlinked titanium beads, each with a weak magnetic force that holds the beads together. During defecation, the beads separate, allowing the passage of stool. Magnetic attraction then brings the beads together to re-establish continence.