CHENNAI: If you thought the worst thing to lose in an accident is an arm or a leg, imagine losing an anus. Well, the loss of function of the muscles in this region to be more precise. After over two years of passing motion through a plastic bag, R Lakshmi is not only happier with her ‘artificial anus’ but also not shy in the least to talk about it. The surgery that took place at Lifeline Institute of Minimal Access Surgery last month has given this Civil Services aspirant a sense of relief that few youngsters her age can relate to.
The 25-year-old, who hails from Guntur in Andhra Pradesh, recalls “I would have to walk into restaurants or go to the temple nearby with this colostomy bag stuck on to my belly. I could barely eat for fear of having to fill up the bag too soon. Sometimes I would empty it into the commode as many as six times a day.”
This was in addition to the trauma an amputated leg and painful physiotherapy sessions that followed her road accident. A colostomy bag is a plastic bag attached to the stoma (opening of colon on to the skin) to collect waste that would normally pass through a person’s rectum and be excreted through the anus. It is fiited with an airtight plastic rim for the smooth storage of faeces and is attached to the skin with adhesive.
After being turned away by numerous doctors and told to get used to her condition, Lakshmi chanced upon Dr JS Rajkumar who suggested a procedure called graciloplasty.
“We used the muscles of her inner thigh as substitute for her anal muscles,” he says. But here was the challenge. “The muscles of thigh are meant to contract quickly, whereas the muscles needed to keep the anus closed, act slowly and strongly, for a long period of time. To bring about this change, a series of electrical treatments were begun on the thigh muscles to change them from fast to slow muscles,” explains Rajkumar, chairman of the hospital. The process was slow as well, and sessions had to be conducted for almost six months, before Lakshmi could undergo the surgery.
“In other words, winding the thigh muscles around the anus and stitching them to the bones of the rump,” he adds.
Numerous tests were conducted for several weeks post surgery to assess the functioning of muscles and the capacity of the rectum.
“Instead of closing the colostomy bag, we continued to use it to add fluids so that they could flow directly to the rectum to see how long Lakshmi could hold herself back before she had to go to the restroom,” says Rajkumar. Once this was increased from 15 minutes to over an hour, the medical team finally declared Lakshmi ready to remove the apparatus on her belly, and answer nature’s call at long last bag-free.