Microtechnology plays an important role in the development of medical and surgical devices. Since the early 1990s [13], there has been growing interest in using microtechnology for miniaturization of medical devices or for increasing their functionality through the integration of smart components and sensors.

Microsystems technology (MST), as it is called in Europe, or microelectromechanical systems (MEMS), as it is called in the United States, combine electronic with mechanical components at a very high level of systems integration. Microsystems are smart devices that integrate sensors, actuators, and intelligent electronics for on-board signal processing [27]. In the industrial area these technologies are used to make various kinds of sensor elements, such as accelerometers for airbags in cars, microfluidic components, such as inkjet print heads, and other elements. In the medical field, MST is used in a number of products such as pacemakers or hearing implants [5]. While most MST components are produced using semiconductor processes [27], there are a number of alternative technologies enabling the production of a broad variety of microdevices and components in virtually all industry sectors. The potential of MST for medical use was recognized more than a decade ago [13, 14], and has since then led to the development of numerous practical applications [21].

Sometimes MST and nanotechnology are terms that are used synonymously since both concern miniaturized devices. However, both technologies are entirely different. While MST deals with components in the submillimeter size, nanotechnology concerns submi-crometer structures. Nanotechnology mainly refers to innovating material properties such as nanostructured surfaces with special biocompatibility features and may be an important enabler for future biomedical products in the future, also combined with MST devices.

Based on the high density of functional integration and the small space requirements, MST components are enhancing surgical devices in different areas, and can be subdivided into the following applications:

• Extracorporeal devices such as telemetric health monitoring systems (e.g., wearable electrocardiogram [ECG] monitors)

• Intracorporeal devices such as intelligent surgical instruments (e.g., tactile laparoscopic instruments)

• Implantable devices such as telemetric implants (e.g., cardiac pacemakers)

• Endoscopic diagnostic and interventional systems such as telemetric capsule endoscopes

Recently there has been an increase in medical MST-related research and development (R&D) activities, both on the side of research institutes and industry. While routine clinical applications of MST-en-hanced surgical devices are still limited to a number of larger volume applications such as pacemakers [28] (Fig. 11.1), a number of developments are in later-stage experimental research or in clinical studies. Medical applications of MST technologies are growing at double-digit compounded growth rates [17], which led to a forecasted global market volume of over $ 1 billion in 2006.

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