Implantable MST Devices

Telemetric implants are among the most important applications of MST in medicine. MST components implanted into the human body include sensors of various types that measure specific health parameters, such as blood glucose [18] or blood pressure or flow [1, 4, 30]. The signals are then transferred via telemetric coils to readout device outside of the body. A good example for existing products in this field is cardiac pacemakers or defibrillators that are equipped with miniaturized telemetry units to send cardiac parameters and parameters or their electrical interaction with a heart outside of the body [28] (Fig. 11.1). The data are received by a readout device similar to a cellular GSM phone and then sent from there to a remote cardiovascular service center.

This allows improvement of patient monitoring and implant maintenance, without the need to see the patient regularly. These kinds of telemetrically enhanced cardiovascular implants based on MST are available on the market for clinical use; in addition to the product, advanced cardiovascular monitoring services are provided by the same manufacturer.

Other applications of intracorporeal MST include the use of telemetric sensors for diagnostic and disease monitoring purposes. Examples include the measure-

Fig. 11.5 A prototype of a tactile surgical instrument with the polymer sensor and force display system
Lymph Nodes Farm Animals
Fig. 11.6 Palpating an object simulating a lymph node at the mesenteric root (animal experiment)
Fig. 11.7 Microscanner for confocal fluorescence microscopy. Source: Medea Project, supported by the European Union

ment of intravesical pressure in paraplegic persons to avoid overfilling of the bladder and the urinary tract [6].

Our own group has been working with the company Sensocor, Ltd., Karlsruhe, Germany, in the development of an implantable telemetric blood pressure measurement sensor for the monitoring of hypertension (Fig. 11.9). The implant is an integrated device that

Fig. 11.8 Histological images obtained by fluorescence laser scanning microscopy technique (a), with conventional HE-stained histology (b). This experimental program has been conducted by a group of several research institutes, supported by grants from BMBF, Germany, and the European Union comprises several MST components such as a pressure sensor and miniaturized telemetry coils. The medical concept behind this device is to monitor blood pressure values and to better adjust antihypertensive medication in order to reach normal blood pressure values in a higher number of patients. Today only in a minority of patients normotensive blood pressure values are achieved due to a lack in adequate monitoring and patient management means.

This example underlines the principle that implantable sensory MST devices are mainly targeting secondary disease prevention by slowing down disease progression or avoiding complications through consequent and consistent monitoring. Thus, MST-based monitoring systems will may a major impact on the prevention of disease progression to the benefit of both the patient and the healthcare system.

Also on the therapeutic side, MST applications are important sources of innovation. Specific implants have been equipped with microsensors in order to monitor the function of the implant. Examples of this kind of application of MST in surgery include pressure sensors integrated into endovascular stent grafts in order to detect residual blood flow through the aneurysm sac in endovascular treatment of abdominal aortic aneu-

Human Blood Pressure Implanting
Fig. 11.9 Concept of an implantable blood pressure measurement. Source: Sensocor, Ltd., Karlsruhe, Germany. The implant is an integrated device that comprises several MST components such as pressure sensors and miniaturized telemetry coils

rysm [3]. Another approach is to use microsensors in implants to detect concomitant disease, such as detection of glaucoma through pressure sensors integrated into an intraocular lens graft implanted for the treatment of cataract [26].

Also, the field of replacing lost organ function, and organ stimulation MST-based implants are of interest. This includes the restoration of lost or impaired sensory functions of the ear [5] and the eye [12, 20], or of traumatized nerves [23-25].

Fig. 11.10 The E2 self-propelling endoscope is a pneumatically controlled inchworm that moves through the colon by a sequential adhering to the bowel wall and elongating/shortening the midsection. a Inchworm with imaging head and propelling body. b High flexibility

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