Anorectal angle measurement

Details Anorectal angle measurement Anorectal angle measurement

1998-05-13

2000-09-12

Hindenburg, Max

Surgery

Diagnostic testing

Measuring anatomical characteristic or force applied to or...

600593, A61B 5103

Patent

active

061170917

DESCRIPTION:

BRIEF SUMMARY
This invention relates to apparatus and methods for measuring the anorectal angle and more generally to apparatus and methods for measuring, monitoring or observing the local anatomy or selected parameters in the anal canal and/or rectum.
Measurement of the anorectal angle (the angle of the anus relative to the rectum) is part of the investigations undertaken to determine the functionality of the anal canal and rectum in patients suffering defecatory disorders. The passage of stools is controlled by a muscular sling which controls the anorectal angle, between an acute angle (closed) and an obtuse angle (open). Lack of proper control can lead to constipation or faecal incontinence. In addition to anorectal angle, the manometric pressure at various points in the rectum and anal canal may be detected, and electro-myological readings may be taken to determine muscle activity.
Generally, the measurement of the anorectal angle has been performed by inserting into the rectum of the patient a radiological contrast medium which has the consistency of a soft stool, to simulate a soft faecal motion. The patient then sits on a radiolucent toilet and is screened radiologically whilst defecating. The difference between the angle of the rectum before and during defecation provides some indication as to whether there may be a functional disorder of the anorectum in patients who have problems in defecating. This procedure is referred to as a defecating proctogram and is unpleasant for the patient, invasive (requiring exposure to radiation) and many Radiological Units will not or cannot perform the procedure. The procedure also of course requires special equipment and a skilled radiologist to observe and interpret the results.
A need therefore exists for an apparatus and method for use in monitoring the anal canal and/or rectum, for example for measuring anorectal angle which, alleviates at least some of the above problems, allowing the measurement to be carried out more widely.
Accordingly, in one aspect, this invention provides a method for use in monitoring the anal canal and/or rectum of a patient, which comprises inserting through the anus into the rectum an elongate flexible element and measuring or observing the angular deflection of said flexible element, and/or the contour adopted thereby.
Preferably, said angular deflection is measured in a single plane, for example the horizontal plane if the patient is lying on his or her side.
Preferably the change of said angular deflection is measured during a simulated defecatory process.
Preferably, said angular deflection is measured using a sensor associated with said elongate flexible element.
Thus in preferred embodiments of this invention, the anorectal angle may be measured without requiring exposure to radiation and without requiring the patient to defecate.
In another aspect, this invention provides apparatus for use in monitoring the anal canal and/or rectum of a patient, which apparatus comprises an elongate flexible element designed to be introduced via the anus into the rectum and having associated therewith angular deflection detecting means for detecting the angular deflection thereof and/or the contour adopted by said flexible element.
Preferably, said angular deflection detecting means comprises an elongate flexible core element and sensor means responsive to longitudinal strain disposed along opposed sides of the core element to determine angular deflection between spaced regions thereof. In one embodiment, the sensor means comprise respective elongate strain gauges extending along substantially the whole length of the elongate flexible core element at circumferentially spaced locations.
Preferably said elongate flexible element comprises a rubber or rubber-like outer sheath within which is disposed said angular deflection detecting means.
Preferably, said outer sheath includes an inflatable region in the distal position thereof, and whereby said region may be inflated in use to stimulate the rectum.
Preferably, said apparatus includes pressure detecting me

REFERENCES:
patent: 4366810 (1983-01-01), Slanetz, Jr.
patent: 4687002 (1987-08-01), Lahr
patent: 4873990 (1989-10-01), Holmes et al.

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