Hydraulic anal incontinence treatment

• US 6,482,145 B1
• Filed: 02/14/2000
• Issued: 11/19/2002
• Est. Priority Date: 02/14/2000
• Status: Expired due to Fees

• Current Assignee: Obtech Medical AG
• Original Assignee: Obtech Medical AG
• Inventors: Forsell, Peter
• Primary Examiner(s): Shaver, Kevin
• Assistant Examiner(s): Cadugan, Joseph A.
• Application Number:
  US09/503,483
• Time in Patent Office: 1,009 Days
• Field of Search: 128/897-899, 600/29-32, 600/37, 600/593, 604/27-28, 606/139-141, 606/151, 606/157, 606/201-203, 606/213, 606/228, 607/41
• US Class Current: 600/30
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61F 2/0018 magnetic
• CPC Class Codes: A61F 2/0036 implantable A61F2/0018 takes precedence
• CPC Class Codes: A61F 2/004 inflatable
• CPC Class Codes: A61F 2250/0001 Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

An anal incontinence treatment apparatus and method includes and uses an adjustable restriction device implanted in a patient, who suffers from anal incontinence. The restriction device engages the rectum of the patient to restrict the fecal passageway. An adjustment device is adapted to adjust the restriction device such that the rectum is temporarily released, in order to open the fecal passageway when the patient wishes to achieve defaecation.

Claims

1. An anal incontinence treatment apparatus, comprising:

an adjustable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

an adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and enlarge the fecal passageway to allow feces to readily pass therethrough,

an electrically powered hydraulic operation device adapted to be implanted in the patient for operating said adjustment device, and

energy transfer means for transferring, directly or indirectly, wireless energy into electric energy for powering said hydraulic operation device.

2. The apparatus according to claim 1, wherein said restriction device is adapted to control the restriction of the fecal passageway.

3. The apparatus according to claim 2, wherein said restriction device is adapted to control the restriction of the fecal passageway to change steplessly.

4. The apparatus according to claim 2, wherein said adjustment device is adapted to adjust said restriction device such that the fecal passageway is restricted in a predetermined extent that is satisfactory for the patient.

5. The apparatus according to claim 1, further comprising a control device for controlling said restriction device.

6. The apparatus according to claim 5, wherein said control device comprises an internal control unit adapted to be implanted in the patient for controlling said restriction device.

7. The apparatus according to claim 6, wherein said internal control unit is programmable.

8. The apparatus according to claim 7, wherein said control device comprises an external control unit outside the patient'"'"'s body and said internal control unit is programmable by said external control unit.

9. The apparatus according to claim 5, wherein said control device comprises an external control unit outside the patient'"'"'s body adapted to wirelessly control said restriction device.

10. The apparatus according to claim 9, wherein said external control unit is programmable.

11. The apparatus according to claim 1, further comprising at least one sensor adapted to be implanted in the patient for sensing at least one physical parameter of the patient.

12. The apparatus according to claim 11, wherein said sensor is adapted to sense the pressure against the restriction device, directly or indirectly, and said restriction device is adapted to release the restriction of the fecal passageway in response to said sensor sensing a predetermined pressure value.

13. The apparatus according to claim 11, further comprising a control device controlling said restriction device in response to signals from said sensor.

14. The apparatus according to claim 13, wherein said control device comprises an internal control unit adapted to be implanted in the patient and directly controlling said restriction device in response to signals from said sensor.

15. The apparatus according to claim 13, wherein said control device comprises an external control unit outside the patient'"'"'s body controlling said restriction device in response to signals from said sensor.

16. The apparatus according to claim 1, wherein said adjustment device adjusts said restriction device in a non-magnetic manner.

17. The apparatus according to claim 1, wherein said restriction device comprises an elongated restriction member and forming means for forming said restriction member into at least a substantially closed loop around the colon or rectum or the prolongation thereof, said loop defining a restriction opening, whereby said adjustment device adjusts said restriction member in said loop to change the size of said restriction opening.

18. The apparatus according to claim 17, wherein said forming means forms said restriction member into a loop having a predetermined size.

19. The apparatus according to claim 17, wherein said elongated restriction member is flexible, and said adjustment device is adapted to pull a first portion of said flexible restriction member from a second portion of said flexible restriction member opposite said first portion in said loop to squeeze the colon or rectum between two opposite lengths of said elongated flexible restriction member to restrict the fecal passageway.

20. The apparatus according to claim 19, wherein said elongated restriction member is non-inflatable, and said adjustment device mechanically adjusts said restriction member in said loop.

21. The apparatus according to claim 17, wherein said adjustment device changes the size of said restriction opening such that the outer circumferential confinement surface of said restriction member is changed.

22. The apparatus according to claim 17, wherein said adjustment device changes the size of said restriction opening such that the outer circumferential confinement surface of said restriction member is unchanged.

23. The apparatus according to claim 1, wherein said restriction device comprises at least two elements adapted to be positioned on different sides of the colon or rectum or the prolongation thereof, and said adjustment device is adapted to squeeze the colon or rectum or the prolongation thereof between said elements to restrict the fecal passageway.

24. The apparatus according to claim 1, wherein said restriction device comprises at least two articulated clamping elements adapted to be positioned on opposite sides of the colon or rectum or the prolongation thereof, and said adjustment device is adapted to move said clamping elements toward each other to clamp the colon or rectum or the prolongation thereof between said clamping elements to restrict the fecal passageway.

25. The apparatus according to claim 1, wherein said restriction device is adapted to bend the colon or rectum or the prolongation thereof.

26. The apparatus according to claim 25, wherein said restriction device comprises at least two bending members adapted to be positioned on opposite sides of the colon or rectum or the prolongation thereof, and said adjustment device is adapted to move said bending members against the colon or rectum or the prolongation thereof in two opposite spaced apart directions to bend the colon or rectum or the prolongation thereof to restrict the fecal passageway.

27. The apparatus according to claim 26, wherein said bending members comprise rollers.

28. The apparatus according to claim 1, further comprising a reservoir adapted to be implanted in the patient and containing a predetermined amount of hydraulic fluid, wherein said hydraulic operation device operates said adjustment device by using said hydraulic fluid of said reservoir.

29. The apparatus according to claim 28, wherein said adjustment device comprises an expandable cavity in said restriction device, the colon or rectum or the prolongation thereof being constricted upon expansion of said cavity and released upon contraction of said cavity, and said hydraulic operation device distributes hydraulic fluid from said reservoir to expand said cavity and distributes hydraulic fluid from said cavity to said reservoir to contract said cavity.

30. The apparatus according to claim 29, wherein said reservoir defines a chamber for said predetermined amount of fluid and said hydraulic operation device changes the size of said chamber.

31. The apparatus according to claim 30, wherein said hydraulic operation device comprises first and second wall portions of said reservoir, which are displaceable relative to each other to change the size of said chamber of said reservoir.

32. The apparatus according to claim 31, wherein said first and second wall portions of said reservoir are displaceable relative to each other by non-manual manipulation thereof.

33. The apparatus according to claim 31, wherein said first and second wall portions of said reservoir are displaceable relative to each other by magnetic means, hydraulic means, or electric control means.

34. The apparatus according to claim 31, wherein said hydraulic operation device distributes fluid from said reservoir to said cavity in response to a predetermined first displacement of said first wall portion of said reservoir relative to said second wall portion of said reservoir and distributes fluid from said cavity to said reservoir in response to a predetermined second displacement of said first wall portion relative to said second wall portion.

35. The apparatus according to claim 29, wherein said hydraulic operation device comprises a pump for pumping fluid between said reservoir and said cavity.

36. The apparatus according to claim 35, wherein said pump comprises. a first activation member for activating said pump to pump fluid from said reservoir to said cavity and a second activation member for activating said pump to pump fluid from said cavity to said reservoir.

37. The apparatus according to claim 36, wherein said first and second activation members are operable by manual manipulation thereof.

38. The apparatus according to claim 36, wherein at least one of said activation members operates when subjected to an external predetermined pressure.

39. The apparatus according to claim 36, wherein at least one of said first and second activation members are operable by magnetic means, hydraulic means, or electric control means.

40. The apparatus according to claim 35, wherein said operation device comprises a fluid conduit between said pump and said cavity, said reservoir forming part of said conduit.

41. The apparatus according to claim 40, wherein said conduit and pump are devoid of any non-return valve.

42. The apparatus according to claim 41, wherein said reservoir forms a fluid chamber with a variable volume, and said pump distributes fluid from said chamber to said cavity by reduction of the volume of said chamber and withdraws fluid from said cavity by expansion of the volume of said chamber.

43. The apparatus according to claim 42, wherein said operation device comprises a motor for driving said pump.

44. The apparatus according to claim 43, wherein said pump comprises a movable wall of said reservoir for changing the volume of said chamber.

45. The apparatus according to claim 1, further comprising a wireless remote control for controlling said restriction device.

46. The apparatus according to claim 45, wherein said remote control comprises an external wireless hand-held remote control unit which is manually operable by the patient to control said restriction device to vary the restriction of the fecal passageway.

47. The apparatus according to claim 45, wherein said remote control comprises an external signal transmitter or receiver and a signal receiver or transmitter adapted to be implanted in the patient.

48. The apparatus according to claim 47, wherein said signal transmitter and signal receiver transmit and receive a wave signal.

49. The apparatus according to claim 48, wherein said wave signal comprises an electromagnetic wave signal, a sound wave signal or a carrier wave signal for a remote control signal.

50. The apparatus according to claim 47, wherein said signal receiver comprises a control unit for controlling said restriction device in response to a control signal received from said signal transmitter.

51. The apparatus according to claim 50, further comprising an energizer unit adapted to be implanted in the patient for providing electric energy to energy consuming implantable components of the apparatus.

52. The apparatus according to claim 51, further comprising an electric motor adapted to be implanted in the patient for driving said hydraulic operation device.

53. The apparatus according to claim 52, wherein said control unit controls said energizer unit to power said electric motor with electric energy in response to a control signal received from said signal transmitter.

54. The apparatus according to claim 51, wherein said energizer unit transfers energy from said control signal, as the latter is transmitted to said signal receiver, into electric energy.

55. The apparatus according to claim 54, wherein said energizer unit transfers the energy from said signal into a direct or alternating current.

56. The apparatus according to claim 54, further comprising a reversing device adapted to be implanted in the patient for reversing said electric motor.

57. The apparatus according to claim 47, wherein said signal transmitter and signal receiver transmit and receive a signal in the form of digital pulses.

58. The apparatus according to claim 57, wherein said digital pulses comprise a magnetic field or an electric field.

59. The apparatus according to claim 1, wherein said energy transfer means transfers wireless energy into electric energy that is supplied to energy consuming implantable components of the apparatus.

60. The apparatus according to claim 59, further comprising an electric motor adapted to be implanted in the patient for driving said hydraulic operation device, wherein said energy transfer means directly, during energy transfer, powers said electric motor with transferred electric energy.

61. The apparatus according to claim 60, wherein said energy transfer means transfers wireless energy in the form of a wave signal.

62. The apparatus according to claim 60, wherein said energy transfer means transfers wireless energy in the form of an electric field or a magnetic field.

63. The apparatus according to claim 45, wherein said remote control is capable of obtaining information related to important parameters from inside the patients body and of commanding said adjustment device to adjust said restriction device in response to obtained information.

64. The apparatus according to claim 45, wherein said remote control is capable of obtaining information from implanted components of the apparatus and of commanding said adjustment device to adjust said restriction device in response to obtained information.

65. The apparatus according to claim 1, further comprising a pressure sensor adapted to be implanted in the patient for directly or indirectly sensing the pressure against the restriction device.

66. The apparatus according to claim 1, further comprising a battery or accumulator adapted to be implanted in the patient for energizing energy consuming implantable components of the apparatus, wherein said battery or accumulator is adapted to be controlled from outside the patient'"'"'s body to release energy.

67. The apparatus according to claim 1, wherein energy consuming implantable components of the apparatus are adapted to be energized with energy wirelessly transmitted from outside the patient'"'"'s body.

68. The apparatus according to claim 67, further comprising an electric motor adapted to be implanted in the patient for driving said hydraulic operation device, wherein said energy wirelessly transmitted from outside the patient'"'"'s body comprises electric energy for powering said electric motor.

69. The apparatus according to claim 68, wherein said electric energy wirelessly transmitted comprises electromagnetic or sound waves.

70. The apparatus according to claim 1, further comprising an electric motor adapted to be implanted in the patient for driving said hydraulic operation device.

71. An anal incontinence treatment apparatus, comprising:

an adjustable non-inflatable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

a hydraulic adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and to enlarge the fecal passageway to allow feces to readily pass therethrough,

an implantable reservoir containing a predetermined amount of hydraulic fluid,

an implantable conduit providing fluid connection between said reservoir and said hydraulic adjustment device,

an operation device adapted to be implanted in the patient for operating said hydraulic adjustment device by distributing hydraulic fluid through said conduit between said reservoir and said hydraulic adjustment device, and

energy transfer means for transferring, directly or indirectly, wireless energy into an energy form suited for powering said operation device.

72. The apparatus according to claim 71, wherein said operation device is a hydraulic operation device and said conduit, hydraulic adjustment device and hydraulic operation device are devoid of any non-return valve to permit free flow of hydraulic fluid in both directions in said conduit.

73. The apparatus according to claim 72, wherein said operation device comprises a pump for distributing fluid in said conduit between said reservoir and said hydraulic adjustment device.

74. The apparatus according to claim 73, wherein said operation device comprises an electric motor for driving said pump.

75. The apparatus according to claim 71, further comprising a wireless remote control for controlling said restriction device.

76. The apparatus according to claim 71, wherein energy consuming implantable components of the apparatus are adapted to be energized with energy wirelessly transmitted from outside the patient'"'"'s body.

77. The apparatus according to claim 71, further comprising a battery or accumulator adapted to be implanted in the patient for energizing energy consuming implantable components of the apparatus, wherein said battery or accumulator is adapted to be controlled from outside the patient'"'"'s body to release energy.

78. An anal incontinence treatment apparatus, comprising:

an adjustable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

an adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and enlarge the fecal passageway to allow feces to readily pass therethrough, and

energy transfer means for transferring, directly or indirectly, wireless energy into an energy form suited for powering said adjustment device,

wherein said adjustment device comprises a servo device.

79. The apparatus according to claim 78, further comprising a powered operation device adapted to be implanted in the patient for operating said adjustment device.

80. The apparatus according to claim 78, wherein said servo device comprises a hydraulic operation device.

81. The apparatus according to claim 80, wherein said servo device comprises a servo reservoir defining a chamber containing servo fluid, and said hydraulic operation device comprises first and second wall portions of said servo reservoir, which are displaceable relative to each other to change the volume of said chamber of said servo reservoir.

82. The apparatus according to claim 81, wherein said first and second wall portions of said servo reservoir are displaceable relative to each other by manual manipulation.

83. The apparatus according to claim 81, wherein said first and second wall portions of said servo reservoir are displaceable relative to each other by a magnetic device, hydraulic device, or electric control device.

84. The apparatus according to claim 80, wherein said servo device comprises a servo reservoir and a fluid supply reservoir connected in a closed system and containing a predetermined amount of fluid.

85. The apparatus according to claim 84, wherein said fluid supply reservoir defines a chamber for the predetermined amount of fluid and said hydraulic operation device changes the volume of said chamber of said supply reservoir and thereby controls the amount of fluid in said servo reservoir.

86. The apparatus according to claim 85, wherein said fluid supply reservoir comprises first and second wall portions, which are displaceable relative to each other to change the volume of said chamber of said fluid supply reservoir.

87. The apparatus according to claim 86, wherein said fluid supply reservoir increases the amount of fluid in said servo reservoir in response to a predetermined first displacement of said first wall portion of said fluid supply reservoir relative to said second wall portion of said fluid supply reservoir and decreases the amount of fluid in said servo reservoir in response to a predetermined second displacement of said first wall portion of said fluid supply reservoir relative to said second wall portion of said fluid supply reservoir.

88. The apparatus according to claim 78, wherein said servo device comprises a magnetic device, or an electric device.

89. The apparatus according to claim 78, wherein said servo means comprises hydraulic device.

90. The apparatus according to claim 78, wherein said restriction device is non-inflatable.

91. An anal incontinence treatment apparatus, comprising:

an adjustable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

an adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and to enlarge the fecal passageway to allow feces to readily pass therethrough, and

an energy transfer device adapted to be implanted in the patient for transferring wireless energy directly or indirectly into kinetic energy for energizing said adjustment device to adjust said restriction;

device,

wherein said operation device is devoid of operating permanent magnets.

92. The apparatus according to claim 91, further comprising a wireless remote control for controlling said restriction device.

93. The apparatus according to claim 91, wherein energy consuming implantable components of the apparatus are adapted to be energized with energy wirelessly transmitted from outside the patient'"'"'s body.

94. The apparatus according to claim 91, further comprising a battery or accumulator adapted to be implanted in the patient for energizing energy consuming implantable components of the apparatus, wherein said battery or accumulator is adapted to be controlled from outside the patient'"'"'s body to release energy.

95. An anal incontinence treatment apparatus, comprising:

an adjustable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

an adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and enlarge the fecal passageway to allow feces to readily pass therethrough,

an electrically powered hydraulic operation device adapted to be implanted in the patient for operating said adjustment device, and

an energy transfer means for transferring wireless energy into electric energy for powering said hydraulic operation device.

96. The apparatus according to claim 95, wherein said energy transfer means directly, during energy transfer, powers said hydraulic operation device with transferred electric energy.

97. The apparatus according to claim 95, wherein said energy transfer means transfers wireless energy in the form of a wave signal.

98. The apparatus according to claim 97, wherein said wave signal comprises an electromagnetic wave signal, a sound wave signal or a carrier wave signal for a remote control signal.

99. The apparatus according to claim 95, wherein said energy transfer means transfers wireless energy in the form of an electric field or a magnetic field.

100. The apparatus according to claim 95, further comprising a stabilizer adapted to be implanted in the patient for stabilizing the electric energy transferred by said energy transfer device.

101. The apparatus according to claim 100, wherein said stabilizer comprises a capacitor.

102. The apparatus according to claim 95, further comprising an electric motor adapted to be implanted in the patient for driving said hydraulic operation device.

103. The apparatus according to claim 95, wherein said hydraulic operation device comprises a pump.

104. An anal incontinence treatment apparatus, comprising:

an adjustable restriction device adapted to be implanted in a patient, who suffers from anal incontinence, to constrict the colon or rectum or the prolongation thereof to restrict the fecal passageway therein,

an adjustment device adapted to be implanted in the patient for adjusting said restriction device to restrict the fecal passageway to prevent feces from passing therethrough and enlarge the fecal passageway to allow feces to readily pass therethrough,

an operation device adapted to be implanted in the patient for operating said adjustment device,

a wireless energy transmission device for transmitting sound energy, including ultrasonic or infrasonic energy, and

energy transfer means for transferring, directly or indirectly, the transmitted sound energy into an energy form suited for powering said operation device.

105. The apparatus according to claim 104, wherein said operation device comprises a motor or pump.

106. The apparatus according to claim 104, further comprising an implantable accumulator or rechargeable battery, and an energy transfer device adapted to transfer said sound energy into electric energy for charging said accumulator or rechargeable battery.

107. A surgical method for treating anal incontinence, comprising:

implanting in the body of a patient suffering from anal incontinence an adjustable restriction device engaging the colon or rectum or the prolongation thereof to restrict the fecal passageway therein to prevent feces from passing therethrough,

implanting an adjustment device for adjusting the restriction device,

implanting an electrically powered hydraulic operation device for operating the adjustment device,

transmitting wireless energy and transferring the wireless energy directly or indirectly into electric energy for powering the hydraulic operation device, and

when desired to achieve defecation powering the hydraulic operation device with electric energy to operate the adjusting device to adjust the restriction device to temporarily enlarge the fecal passageway to allow feces to readily pass therethrough.

108. A surgical method as recited in claim 107, further comprising implanting an elongated restriction member of the restriction device around the colon or rectum or the prolongation thereof.

109. A surgical method as recited in claim 107, further comprising implanting the restriction device in the distal part of the rectum of the patient.

110. A surgical method as recited in claim 107, wherein the adjustment device comprises a servo means.

111. A surgical method as recited in claim 107, further comprising implanting an electric source of energy in the patient and providing a control device for controlling the source of energy from outside the patient'"'"'s body to supply electric energy to the electrically powered hydraulic operation device.

112. A surgical method as recited in claim 107, comprising implanting in the body of the patient at least two adjustable restriction devices in engagement with the colon or rectum or the prolongation thereof to restrict the fecal passageway therein.

113. A laparoscopical surgical method for treating anal incontinence, comprising:

placing at least two laparoscopical trocars in a patient suffering from anal incontinence,

inserting a dissecting tool through the trocars and dissecting an area of the colon or rectum or the prolongation thereof,

implanting through the trocars an adjustable restriction device in engagement with the colon or rectum or the prolongation thereof to restrict the fecal passageway therein to prevent feces from passing therethrough,

implanting a powered operation device in the patient for operating the restriction device,

transmitting wireless energy and transferring the wireless energy into a form suited for powering the operation device, and

when desired to achieve defecation adjusting the restriction device to temporarily enlarge the fecal passageway to allow feces to readily pass therethrough.

114. A surgical method as recited in claim 113, wherein said adjustment device is operated in a non-manual manner.

115. A surgical method as recited in claim 113, further comprising implanting a servo means for operating said restriction device.

116. A surgical method as recited in claim 113, further comprising implanting an electric source of energy in the patient and controlling the source of energy from outside the patient'"'"'s body to supply electric energy to the electrically powered operation device.

117. A surgical method as recited in claim 113, wherein the operation device is electrically powered and further comprising transferring the wireless energy into electric energy.

118. A surgical method according to claim 113, further comprising implanting an internal control unit, and using the internal control unit to control the restriction device to change the restriction of the fecal passageway.

119. A method of treating a patient having anal incontinence disease, comprising:

(a) surgically implanting in the patient an operable restriction device engaging the patient'"'"'s colon or rectum or the prolongation thereof to restrict the fecal passageway therein to prevent feces from passing therethrough,

(b) implanting an internal energy source in the patient,

(c) transmitting wireless energy from outside the patient'"'"'s body,

(d) transferring the wireless energy into storable energy and storing the storable energy in the internal source of energy, and

(e) when desired to achieve defecation supplying energy from the internal energy source for operating the restriction device to temporarily enlarge the fecal passageway to allow feces to readily pass therethrough.

120. A surgical method according to claim 119, further comprising implanting an internal control unit, and using the internal control unit to control the restriction device to change the restriction of the fecal passageway.

121. A surgical method according to claim 119, further comprising implanting a motor or pump in the patient for operating the restriction device and controlling the motor or pump to operate the restriction device to change the restriction of the fecal passageway.

122. A laparoscopical surgical method for treating anal incontinence, comprising:

placing at least two laparoscopical trocars in a patient suffering from anal incontinence,

inserting a dissecting tool through the trocars and dissecting an area of the colon or rectum or the prolongation thereof, implanting th rough the trocars an adjust able restriction device in engagement with the colon or rectum or the prolongation thereof to restrict the fecal passageway therein to prevent feces from passing therethrough,

implanting an internal source of energy in the patient,

transmitting wireless energy from outside the patient'"'"'s body,

transferring the wireless energy into storable energy and storing the storable energy in the internal source of energy, and

when desired to achieve defecation supplying energy from the internal energy source for operating the restriction device to temporarily enlarge the fecal passageway to allow feces to readily pass therethrough.

123. A surgical method according to claim 122, further comprising implanting an internal control unit, and using the internal control unit to control the restriction device to change the restriction of the fecal passageway.

124. A surgical method according to claim 122, further comprising implanting a motor or pump in the patient for operating the restriction device and controlling the motor or pump to operate the restriction device to change the restriction of the fecal passageway.

125. A surgical method for treating anal incontinence, comprising:

implanting in the body of a patient suffering from anal incontinence an adjustable non-inflatable restriction device engaging the colon or rectum or the prolongation thereof to restrict the fecal passageway therein to prevent feces from passing therethrough,

implanting an adjustment device for adjusting the restriction device,

implanting an electrically powered operation device for operating the non-inflatable adjustment device,

transmitting wireless energy and transferring the wireless energy into a form suited for powering, directly or indirectly, the operation device, and

when desired to achieve defecation powering the operation device with electric energy to operate the adjusting device to adjust the restriction device to temporarily enlarge the fecal passageway to allow feces to readily pass therethrough.

126. A surgical method as recited in claim 125, further comprising implanting an elongated restriction member of the restriction device around the colon or rectum or the prolongation thereof.

127. A surgical method as recited in claim 125, further comprising implanting an electric source of energy in the patient and controlling the source of energy from outside the patient'"'"'s body to supply electric energy to the electrically powered operation device.