British Man Has 'Bionic Bottom'

Nov. 17, 2009— -- Ged Galvin keeps a cell phone-sized remote control in his pocket at all times.

But it doesn't power his TV or DVD player. It helps him control his bowels.

In a devastating motorcycle accident two years ago, the 55-year-old from South Yorkshire, England, suffered major internal injuries. Though doctors initially thought he might not live, they miraculously restored broken wrists, a shattered leg, a fractured pelvic bone, a detached retina and more.

To Galvin's dismay, however, they couldn't repair the muscles in his bottom responsible for controlling bowel movements. He underwent a colostomy -- a procedure that allows patients to pass fecal matter through an opening in the abdomen, instead of the rectum, but he said he dreaded living forever with a colostomy bag outside his body.

But an innovative medical technique that allows him to defecate normally, with a pacemaker-like device and remote control, he said, has given him a new lease on life.

"I've been through immense pain and suffering," Galvin said. "And here I am with this bionic bottom now. I feel great. I feel fantastic."

Galvin: Accident 'Ripped Me in Two'

The IT project manager, and father of two, said he was riding his motorcycle near his home two years ago, when a car shot out of a side road. The collision threw him 20 yards and, he said, "ripped me in two."

He spent 13 weeks in the hospital and three more in rehab. At first, doctors didn't think he would even survive the accident. Then, they didn't think he would ever walk again.

Time and again, Galvin's progress blew his doctors away.

"I was determined I was going to walk again. I knew I had to push myself," he said. "I'm really positive about things. I've always been like that. ... I just used the same mentality. I needed to get my body back and that's the consequence."

He also added, slyly, "I'm very stubborn by nature."

But though he healed beyond everyone's wildest expectations -- ultimately even walking -- he said doctors still couldn't address the problem he disliked most of all: the colostomy bag.

Colostomy Bag Like 'Dark Secret'

"I didn't want to tell people I have a stoma bag," he said. "It's a dark secret you're living with. Not necessarily because you're embarrassed but because you don't want to embarrass them either."

Twice, he said, doctors attempted operations to restore the sphincter muscles in his rear that control bowel movements. But Galvin was told the muscles were damaged beyond repair.

Still, he persevered, and his stubbornness apparently paid off.

His doctor referred him to Dr. Norman Williams, a Royal London Hospital surgeon and bowel disorder specialist, who thought Galvin would be an ideal candidate for his technique.

Called the Electrically Stimulated Gracilis Neosphincter (ESGN) operation, the procedure involves cutting a leg muscle from the groin to the knee and wrapping it around the patient's anus. The underlying theory is that the muscle, called the gracilis, will serve the function of the damaged sphincter muscle.

Leg Muscle Trained to Control Bowels

Though the gracilis and sphincter are different kinds of muscles -- one only works in short bursts, like when you want to run, and one must constrict continually -- the gracilis can be trained electrically to act like a sphincter and keep the anal canal closed.

To keep the muscle from falling back to its natural state, doctors also place an electrode on the nerve leading to the transplanted gracilis and attach it to a pacemaker-like stimulator in the patient's abdomen.

When activated, the stimulator sends electric impulses to keep the sphincter closed. When the stimulator is shut off via remote control, the muscle relaxes, allowing the bowels to open.

Galvin said he can actually relieve himself when the stimulator is still on but it's easier when it's off.

"There are lots of people in the same situation as me that potentially this operation can help," he said. "It changed my life again."

According to the U.K. charity, Bowel & Cancer Research, which Williams chairs and which funded Galvin's procedure, the technique has helped about 180 patients at the Royal London Hospital over the past 20 years.

Similar Technique Only Practiced by a Few U.S. Centers

American doctors say that though the operation has been studied in the United States, the technique is not widely practiced here.

Dr. Robert Cima, a colorectal surgeon with the Mayo Clinic in Rochester, Minn., estimated that about half a dozen centers in the United States have performed similar operations involving the gracilis and a stimulator since the late 1990s.

But though they found that it was a feasible treatment for fecal incontinence, it led to a number of post-operative downsides. It is estimated that about a third of patients will have some type of complication, he said.

Though 50 percent to 60 percent of the patients were able to remain continent while the stimulator was on, he said the main problem was keeping the muscle stimulated. Sometimes the wires connecting the stimulator the muscle would break, other times the muscle just wouldn't tolerate the constant stimulus, he said.

"Most of the patients who have incontinence are not like this gentleman," Cima said about Galvin, who said he was very fit at the time of his accident. "He was the ideal candidate."

Many patients with incontinence, he said, are older women who experienced fecal incontinence after childbirth. The lack of a strong gracilis muscle and other damaged nerves and muscles around the anus might compromise the technique's effectiveness, he added.

For most patients, he said, other treatments for incontinence suffice.

He also emphasized that many people in the United States have colostomy bags, like the one Galvin used to have, and enjoy a high quality of life.

"Their quality of life is similar to that of Americans in general," he said. "It all depends on your mindset."

Even though people don't talk about it, he said tens of thousands of Americans live with a colostomy bag or something similar.

"It's not like it was 20, 30 years ago. The technology and our understanding of how to construct a good ostomy have changed drastically," he said.

For his part, Galvin acknowledges that it's "a personal thing," but added," It just gave me my confidence back and basically gave me my life back."