Sphincteroplasty

Fecal incontinence, as a result of trauma to the muscular sphincter complex, has long been surgically treated by approximation of healthy muscular edges on either side of the defect. In his 1923 textbook, Lockhart-Mummery described the operative procedure of mobilizing muscle lateral to the defect and sewing the ends firmly in contact [1]. Operative success was usually most satisfactory, yet contingent on proper antiseptic precautions and carefully performed technique. In 1940, however, Blaisdell reported general dissatisfaction among American proctologists with this classic plastic repair due to infectious complications, technical challenges, and poor outcomes [2]. Blaisdell went on to describe two techniques that involved overlapping muscle edges while leaving the scarred portion of the sphincter intact. The reefing operation brought together muscle opposite the site of damage to narrow the circumference of the anal outlet and thus avoid manipulation of the damaged portion of the sphincter [2].