Robotic Placement of the FENIX Continence Restoration System in a Patient with Previous Radiation to the Pelvis: A Case Report.

Autor:	Espinal M; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida. Electronic address: marianaespinalmk@gmail.com., DeStephano CC; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida., Guha P; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida., Gajarawala SP; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida., Chen AH; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida., Pettit PD; Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida.
Jazyk:	angličtina
Zdroj:	Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2018 Mar - Apr; Vol. 25 (3), pp. 528-532. Date of Electronic Publication: 2017 Jul 17.
DOI:	10.1016/j.jmig.2017.07.006
Abstrakt:	Fecal incontinence (FI) is a disabling problem affecting women. Conservative treatment includes dietary modification, antimotility agents, and pelvic floor physical therapy. If conservative medical management is unsuccessful, surgical intervention may be required. Surgical options include rectal sphincteroplasty, bulking agent injection, radiofrequency anal sphincter remodeling, and sacral nerve stimulation therapy. Recently, a new therapy for FI, the FENIX Continence Restoration System (Torax Medical, Inc., Shoreview, MN), has become available. The FENIX device is placed through a perineal incision; however, pelvic radiation and previous anal carcinoma are both contraindications. We report the case of a 62-year-old woman with FI after anal carcinoma. Treatment included surgery, chemotherapy, and pelvic radiation. Initially, she was treated with conservative therapy and sacral nerve stimulation, which were only partially effective. A physical examination showed perineal skin changes consistent with previous radiation, which increased the patient's risk of infection and a nonhealing wound. Therefore, a robotic approach was used to place the FENIX device and improve the patient's quality of life. Our case sets a precedent for expanding the treatment options of FI in patients with previous pelvic radiation and using a robotic approach for the placement of the FENIX device. (Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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