Restriction device

Abstract

The present invention relates to an implantable hydraulic or pneumatic pump for pumping a fluid comprising:a reservoir, a sealed container comprising an actuator,a rigid outer wall, and an enclosed space, wherein:a first portion of the sealed container encloses a first container volume, and a second portion of the sealed container encloses a second container volume, wherein: the first portion of the sealed container comprises a connecting wall forming a portion of a wall enclosing the reservoir, wherein:the first portion of the sealed container comprises a first movable wall portion connected to the connecting wall,the second portion of the sealed container comprises a second movable wall portion.

Description

RESTRICTION DEVICETechnical field

[0001] The present invention relates to medical implants. More specifically the invention relates to medical implants for restricting luminary organs.Background

[0002] Restricting a luminary organ of a patient may be damaging to the restricted organ, it would therefore be advantageous to have a restriction device adapted to restrict a luminary organ of the patient in a less damaging way than the devices of the prior art.Summary

[0003] A support element for an implantable constriction device for constricting a luminary organ of a patient is provided. The support element is configured to form at least a portion of a surrounding structure configured to surround and support at least one operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough. The support element comprises at least one fluid conduit at least partially integrated in the support element. Integrating the fluid conduit in the support element enables the fluid entry to an operable hydraulic constriction element to be protected and encapsulated by the support element which reduces the space occupied by the operable hydraulic constriction element and reduces the amount of protruding portions thus reducing the risk of damaging the luminary organ.

[0004] The operable hydraulic constriction element configured to constrict the luminary organ may be an implantable hydraulic constriction element configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence.

[0005] In one embodiment, the at least one fluid conduit is completely integrated in the support element.

[0006] In one embodiment, the support element comprises a connection portion for connecting the support element to another support element for at least partially forming the surrounding structure. The support element may comprise a portion of a hinge for hingedly connecting the support element to another support element for at least partially forming the surrounding structure. In one embodiment, the support element comprises the portion of a hinge at a first end of the support element and the support element comprises another connection portion at a second end for connecting to another portion of the support element or another support element, for at least partially forming the surrounding structure.

[0007] In one embodiment, the support element comprises an inner surface configured to be directed towards the luminary organ, when implanted. The inner surface may comprise a fixation surface for fixating at least one operable hydraulic constriction element, and the fixation surface may comprise at least one outlet from the at least partially integrated fluid conduit, such that a fluid can flow through the at least partially integrated fluid conduit into the operable hydraulic constriction element for constricting the luminary organ. In one embodiment, the inner surface comprises a fixation surface for fixating at least two operable hydraulic constriction elements

[0008] In one embodiment, the support element comprises a second fluid conduit at least partially integrated in the support element. The first at least partially integrated fluid conduit is configured to conduct fluid to the first operable hydraulic constriction element and the second at least partially integrated fluid conduit is configured to conduct fluid to the second operable hydraulic constriction element.

[0009] In one embodiment, the support element comprises at least one operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough, and the at least one operable hydraulic constriction element is in fluid connection with the at least one fluid conduit at least partially integrated in the support element.

[0010] In one embodiment, the support element comprises a second operable hydraulic constriction element, and at least one second operable hydraulic constriction element is in fluid connection with the second fluid conduit at least partially integrated in the support element.

[0011] In one embodiment, the first operable hydraulic constriction element has a larger volume than the second operable hydraulic constriction element. The first operable hydraulic constriction element may have a volume which is at least 1,5 times larger than the volume of the second operable hydraulic constriction element, or may have a volume which is more than 2 times larger than the volume of the second operable hydraulic constriction element.

[0012] In one embodiment, the support element comprises an outer surface configured to be directed away from the luminary organ, when implanted. The outer surface may comprise at least one inlet to the at least one fluid conduit, and the at least one inlet may be configured to be in fluid connection with a hydraulic pump for pumping fluid to the operable hydraulic constriction element for constricting the luminary organ.

[0013] In one embodiment, the support element has a length in the axial direction of the luminary organ, when implanted, and at least one operable hydraulic constriction element has a length in the axial direction of the luminary organ U, when implanted. The length of the at least one operable hydraulic constriction element is longer than the length of the support element.

[0014] In one embodiment, the support element further comprises an electrode arrangement configured to be arranged between the support element and the luminary organ and to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.

[0015] The support element, or second, third or fourth support element in any of the embodiments herein may have at least one curvature adapted for the curvature of the luminary organ.

[0016] The support element, or second, third or fourth support element in any of the embodiments herein may have a curvature having a radius in the range 3mm - 50mm, or in the range 5mm - 30mm.

[0017] The support element, or second, third or fourth support element in any of the embodiments herein may have a first curvature having a first radius, and a second curvature having a second radius, wherein the first radius is smaller than the second radius.

[0018] The support element, or second, third or fourth support element in any of the embodiments herein may be substantially rigid and have a modulus of elasticity (E) in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa,. and a major portion of the support element could be made from a material having a modulus of elasticity (E) in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa.

[0019] A surrounding structure for an implantable constriction device for constricting a luminary organ of a patient is further provided. The surrounding structure is configured to surround the luminary organ when implanted and comprises at least one support element according to any of the embodiments herein comprising at least one fluid conduit at least partially integrated in the support element.

[0020] In one embodiment, the surrounding structure comprises a second support element, and the first and second support elements are configured to be connected and together form at least a portion of the surrounding structure. The first and second support elements may be configured for forming the surrounding structure and thereby surround the luminary organ.

[0021] In one embodiment, the first and second support elements are hingedly connected to each other for forming the surrounding structure, such that a periphery of the surrounding structure is possible to open, such that the surrounding structure can be placed around the luminary organ.

[0022] In one embodiment, the second support element comprises at least one operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough. The at least one operable hydraulic constriction element may be in fluid connection with at least one fluid conduit at least partially integrated in the second support element.

[0023] In one embodiment, the second support element comprises at least a second operable hydraulic constriction element, and the at least one second operable hydraulic constriction element is in fluid connection with a second fluid conduit at least partially integrated in the second support element.

[0024] In one embodiment, the second support element comprises at least one cushioning element configured to contact the luminary organ. The cushioning element may be more resilient and / or more elastic than the support element.

[0025] The surrounding structure may further comprise an electrode arrangement configured to be arranged between the surrounding structure and the luminary organ and to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.

[0026] A surrounding structure for an implantable constriction device for constricting a luminary organ of a patient is further provided. The surrounding structure may have a periphery surrounding the luminary organ when implanted. The surrounding structure comprises at least two support elements connected to each other for forming at least a portion of the periphery of the surrounding structure. At least one of the support elements are configured to support at least one first operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough. Having a surrounding structure supporting operable hydraulic constriction element(s) ensures that the operable hydraulic constriction element(s) have good support and counter force for exerting a pressure on the luminary organ. The surrounding structure may also serve as a mount for the operable hydraulic constriction element(s) and serve as a fluid conduit for conducting hydraulic fluid to the operable hydraulic constriction element(s).

[0027] The implantable constriction device configured to constrict the luminary organ may be an implantable constriction device configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence.

[0028] In one embodiment, the first and second support elements are configured for forming the surrounding structure and thereby surround the luminary organ. The support elements may be hingedly connected to each other for at least partially forming the surrounding structure, such that a periphery of the surrounding structure is possible to open, such that the surrounding structure can be placed around the luminary organ.

[0029] In one embodiment, the first support element comprises the first operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough, and in one embodiment, the first support element comprises at least one second operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough.

[0030] The first operable hydraulic constriction element may have a larger volume than the second operable hydraulic constriction element.

[0031] In one embodiment, the second support element comprises a third operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough and in one embodiment, the second support element comprises a fourth operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough.

[0032] The third operable hydraulic constriction element may have a larger volume than the fourth operable hydraulic constriction element.

[0033] In one embodiment, the second support element may comprise at least one cushioning element configured to contact the luminary organ and the cushioning element may be more resilient than at least one of the support elements.

[0034] In one embodiment, the surrounding structure has a length in the direction of the axial direction of the luminary organ, when implanted, and the at least one first operable hydraulic constriction element has a length in the direction of the axial direction of the luminary organ, when implanted, and the length of the at least one first operable hydraulic constriction element is longer than the length of the surrounding structure.

[0035] In one embodiment, the surrounding structure further comprises an electrode arrangement configured to be arranged between the surrounding structure and the luminary organ and to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.

[0036] The surrounding structure in any of the embodiments herein may have at least one curvature C adapted for the curvature of the luminary organ.

[0037] The surrounding structure in any of the embodiments herein may have a curvature having a radius in the range 3mm - 50mm, or in the range 5mm - 30mm.

[0038] The surrounding structure in any of the embodiments herein may have a first curvature having a first radius, and a second curvature having a second radius, wherein the first radius is smaller than the second radius.

[0039] The surrounding structure in any of the embodiments herein may be substantially rigid and have a modulus of elasticity (E) in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa,. and a major portion of the support element could be made from a material having a modulus of elasticity (E) in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa.

[0040] An implantable constriction device comprising the surrounding structure in any of the embodiments herein is further provided. The implantable constriction device further comprises at least one hydraulic pump and a control unit. The control unit is configured to control the flow of fluid from the hydraulic pump, such that the first operable hydraulic constriction element is inflated, and the secondoperable hydraulic constriction element is deflated, for constricting the luminary organ and restricting the flow of fluid therethrough.

[0041] In one embodiment, the control unit is further configured to control the flow of fluid from the hydraulic pump, such that the third operable hydraulic constriction element is inflated, and the fourth operable hydraulic constriction element is deflated, for constricting the luminary organ and restricting the flow of fluid therethrough.

[0042] In one embodiment, the control unit is further configured to control the flow of fluid from the hydraulic pump, such that: the first operable hydraulic constriction element is deflated, and the second operable hydraulic constriction element is inflated, for releasing the constriction of the luminary organ for restoring the flow of fluid therethrough.

[0043] In one embodiment, the control unit is further configured to control the flow of fluid from the hydraulic pump, such that: the third operable hydraulic constriction element is deflated, and the fourth operable hydraulic constriction element is inflated, for releasing the constriction of the luminary organ for restoring the flow of fluid therethrough.

[0044] In one embodiment, the implantable constriction device further comprises an electrode arrangement configured to be arranged between the implantable constriction device and the luminary organ and configured to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.

[0045] In one embodiment, the implantable constriction device comprises a first, second and third luminary organ contacting elements. The first luminary organ contacting element comprises a first operable hydraulic constriction element configured to be inflated to constrict the luminary organ for restricting the flow of fluid therethrough, the second luminary organ contacting element comprises a second operable hydraulic constriction element configured to be inflated to assist in releasing the constriction of the luminary organ for restoring the flow of fluid therethrough, and the third luminary organ contacting element comprises at least one cushioning element configured to contact the luminary organ.

[0046] In one embodiment, the implantable constriction device comprises a surrounding structure having a periphery surrounding the luminary organ when implanted, and at least one of the first, second and third luminary organ contacting elements may be connected to the surrounding structure.

[0047] In one embodiment, the surrounding structure could be the surrounding structure in any of the embodiments herein and could be comprised of at least a first and a second support element.

[0048] In one embodiment, the first luminary organ contacting element is connected to the first supporting element and the second luminary organ contacting element is connected to the second support element.

[0049] In one embodiment, the third luminary organ contacting element is connected to the second support element.

[0050] In one embodiment, the first luminary organ contacting element is connected to the first support element, the second luminary organ contacting element is connected to the second support element and the third luminary organ contacting element is connected to a third support element.

[0051] In one embodiment, at least one of the first, second and third support elements have a curvature adapted for the curvature of the luminary organ and the curvature may have a radius in the range 3mm - 50mm or in the range 5mm - 30mm.

[0052] For forming the surrounding structure, at least two of the support elements may be hingedly connected to each other.

[0053] The implantable constriction device may further comprise at least one hydraulic pump and a controller configured to control the flow of fluid from the hydraulic pump, such that the first operable hydraulic constriction element is inflated, and the second operable hydraulic constriction element is deflated, for constricting the luminary organ and restricting the flow of fluid therethrough.

[0054] In one embodiment, the controller is further configured to control the flow of fluid from the hydraulic pump, such that the first operable hydraulic constriction element is deflated, and the second operable hydraulic constriction element is inflated, for releasing the constriction of the luminary organ for restoring the flow of fluid therethrough.

[0055] In one embodiment, the first and second operable hydraulic constriction elements are connected to a shared hydraulic system, such that the hydraulic fluid is pumped from the first operable hydraulic constriction element to the second operable hydraulic constriction element for releasing the constriction of the luminary organ for restoring the flow of fluid therethrough, and pumped from the second operable hydraulic constriction element to the first operable hydraulic constriction element for constricting the luminary organ and restricting the flow of fluid therethrough.

[0056] In one embodiment, the surrounding structure has a length in the axial direction of the luminary organ, when implanted, and at least one of the first, second and third luminary organ contacting element has a length in the axial direction of the luminary organ, when implanted, and the length of at least one of the first, second and third luminary organ contacting element is longer than the length of the surrounding structure.

[0057] The implantable constriction device 10 according to any one of the preceding claims, wherein the implantable constriction device 10 further comprises an electrode arrangement configured to be arranged between the implantable constriction device 10 and the luminary organ U and to engage and electrically stimulate muscle tissue of the luminary organ U to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device 10.

[0058] A kit for a surrounding structure for an implantable constriction device for constricting a luminary organ of a patient is further provided. The surrounding structure is configured to have a periphery surrounding the luminary organ when implanted. The kit comprises at least a first, second and third support element, and the second support element is configured to be connected to the first support element for forming at least a portion of the surrounding structure. The third support element is configured to be connected to the first support element for forming at least a portion of the surrounding structure, and at least one of the second and third support element is connected to the first support element for forming at least a portion of the surrounding structure when the surrounding structure is implanted. By providing a kit of support elements, the surrounding structure can be easily adapted for different luminary organs and more complex parts of the implantable constriction device could remain the same whereas more simple parts are replaced for adapting the implantable constriction device to a specific patient.

[0059] The implantable constriction device configured to constrict the luminary organ may be an implantable constriction device configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence.

[0060] In one embodiment, the first support element is configured to support at least one first operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough.

[0061] In one embodiment, at least one of the first, second and third support elements have a curvature adapted for the curvature of the luminary organ and the curvature may have a radius in the range 3mm - 50mm or in the range 5mm - 30mm.

[0062] In one embodiment, the second support element comprises a second curvature adapted for the curvature of a first luminary organ, the third support element comprises a third curvature adapted for the curvature of a second luminary organ, and the second curvature is different than the third curvature. As such luminary organs having different curvatures can be supported be assembly of the kit in different ways.

[0063] In one embodiment, the second curvature has a second radius, the third curvature has a third radius, and the second radius is larger than the third radius. The second radius could be more than 1,2 times as large as the third radius.

[0064] In one embodiment, the second support element has a second length configured to extend along a portion of the periphery of the surrounding structure, the third support element has a third length extending along a portion of the periphery of the surrounding structure, and the third length is longer than the second length.

[0065] The surrounding structure could have a modulus of elasticity (E), radially, in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa and a major portion of at least one of the first, second and third support structures of the kit could be made from a material having a modulus of elasticity E in the range 0,2 GPa - 1000 GPa or in the range 1 GPa - 400 GPa

[0066] In one embodiment, the first and second support elements could be configured to form the surrounding structure and thereby surround the luminary organ, or the first and third support elements could be configured to form the surrounding structure and thereby surround the luminary organ.

[0067] The second and third support elements may be configured to be hingedly connected to the first support element at least partially forming the surrounding structure, such that a periphery of the surrounding structure is possible to open, such that the surrounding structure can be placed around the luminary organ.

[0068] The first support element may comprise the first operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough. In one embodiment, the first support element comprises at least one second operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough.

[0069] In one embodiment, the first operable hydraulic constriction element has a larger volume than the second operable hydraulic constriction element.

[0070] In one embodiment, at least one of the second and third support elements comprises a third operable hydraulic constriction element configured to constrict the luminary organ for restricting the flow of fluid therethrough.

[0071] In one embodiment, at least one of the second and third support elements comprises at least one cushioning element configured to contact the luminary organ, and the cushioning element may be more resilient and / or elastic than at least one of the support elements.

[0072] In one embodiment, the surrounding structure has a length in the axial direction of the luminary organ, when implanted, and the at least one first operable hydraulic constriction element has a length in the axial direction of the luminary organ, when implanted, and the length of the at least one first operable hydraulic constriction element is longer than the length of the surrounding structure.

[0073] In one embodiment, at least one of the first, second and third support elements comprises an electrode arrangement configured to be arranged between at least one of the first, second and third support elements and the luminary organ and to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.

[0074] In one embodiment, the implantable constriction device comprises a first operable hydraulic constriction element configured to be inflated to constrict the luminary organ for restricting the flow of fluid therethrough, a second operable hydraulic constriction element configured to be inflated to constrict the luminary organ for restricting the flow of fluid therethrough, and an interconnecting fluid conduit fluidly connecting the first operable hydraulic constriction element to the second operable hydraulic constriction element. The first operable hydraulic constriction element is configured to be placed at a first portion of the luminary organ for constricting the first portion of the luminary organ for restricting the flow of fluid therethrough, the second operable hydraulic constriction element is configured to be placed at a second portion of the luminary organ, downstream the first portion, for constricting the second portion of the luminary organ for restricting the flow of fluid therethrough, and the interconnecting fluid conduit is configured to conduct fluid from the first operable hydraulic constriction element to the second operable hydraulic constriction element when the pressure increases in the first operable hydraulic constriction element, such that second operable hydraulic constriction element constricts the second portion of the luminary organ further.

[0075] In one embodiment, a lumen of the first operable hydraulic constriction element has a larger volume than a lumen of the second operable hydraulic constriction element.

[0076] In one embodiment, the lumen of the first operable hydraulic constriction element has a volume which is more than 1,5 times larger than the volume of the lumen of the second operable hydraulic constriction element.

[0077] The first interconnecting fluid conduit may in any of the embodiments herein comprise a first electrically operable valve, such that a flow of fluid between the first operable hydraulic constriction element and the second operable hydraulic constriction element can be controlled. The electrically operable valve could be a solenoid valve.

[0078] The first interconnecting fluid conduit may in any of the embodiments herein comprise a check valve, such that fluid can flow in a direction from the first operable hydraulic constriction element to the second operable hydraulic constriction element, but not in a direction from the second operable hydraulic constriction element to the first operable hydraulic constriction element.

[0079] In one embodiment, the implantable constriction device further comprises a second interconnecting fluid conduit fluidly connecting the first operable hydraulic constriction element to thesecond operable hydraulic constriction element. A cross-section of a tubular lumen of the second interconnecting fluid conduit has an area which is less than 0,5 times a cross section area of a tubular lumen of the first interconnecting fluid conduit.

[0080] The implantable constriction device according to any one of the preceding claims further comprises a hydraulic pump, a reservoir for holding hydraulic fluid, and a first reservoir conduit fluidly connecting the reservoir to the first operable hydraulic constriction element. The hydraulic pump may be configured to pump fluid from the reservoir to the first operable hydraulic constriction element through the first reservoir conduit for constricting the first portion of the luminary organ for restricting the flow of fluid therethrough.

[0081] The first reservoir conduit may in any of the embodiments herein comprise a second electrically operable valve, such that a flow of fluid between the reservoir and the first operable hydraulic constriction element can be controlled.

[0082] In one embodiment, the implantable constriction device further comprises a second reservoir conduit fluidly connecting the reservoir to the second operable hydraulic constriction element.

[0083] The second reservoir conduit may in any one of the embodiments herein comprise a check valve such that fluid can flow in a direction from the reservoir to the second operable hydraulic constriction element but not in a direction from the second operable hydraulic constriction element to the reservoir.

[0084] The implantable constriction device may further comprise an injection port in fluid connection with the reservoir, for injecting fluid into the reservoir when the reservoir is implanted.

[0085] In one embodiment, the injection port is configured to be placed subcutaneously, and the implantable constriction device may further comprise an injection port conduit fluidly connecting the injection port to the reservoir.

[0086] The implantable constriction device may further comprise at least one of a first pressure sensor configured to sense the pressure in the first operable hydraulic constriction element, and a second pressure sensor configured to sense the pressure in the second operable hydraulic constriction element.

[0087] In one embodiment, the implantable constriction device further comprises a controller configured to receive a pressure sensor signal from at least one of the first and second pressure sensor, and control at least one of: the first electrically operable valve and the second operable valve and the hydraulic pump, on the basis of the received pressure sensor signal.

[0088] In one embodiment, the controller comprises a pressure threshold value, and the controller is configured to open the first electrically operable valve if the received pressure sensor signal from the second pressure sensor exceeds the pressure threshold value.

[0089] In one embodiment, the implantable constriction device further comprises a supporting operable hydraulic constriction element configured to be placed along at least a portion of the first portion of the luminary organ and along at least a portion of the second portion of the luminary organ, and further configured to assist in the constriction of the first and second portions of the luminary organ.

[0090] The supporting operable hydraulic constriction element may in any one of the embodiments herein be connected to the first and second operable hydraulic constriction elements. The supporting operable hydraulic constriction element may be less resilient than at least one of the first and second operable hydraulic constriction element, for making the combined operable hydraulic constrictionelement (made up the operable hydraulic constriction element and the supporting operable hydraulic constriction element) more rigid and less prone to deformation.

[0091] In one embodiment, each of the first, second and supporting operable hydraulic constriction elements comprises a lumen surrounded by a resilient wall. The resilient wall of the supporting operable hydraulic constriction element may be thicker than the wall of at least one of the first and second operable hydraulic constriction element.

[0092] In one embodiment, the implantable constriction device further comprises a second hydraulic pump, a second reservoir for holding hydraulic fluid, and a supporting reservoir conduit fluidly connecting the second reservoir to the supporting operable hydraulic constriction element. The second hydraulic pump is configured to pump fluid from the second reservoir to the supporting operable hydraulic constriction element through the supporting reservoir conduit, for assisting in the constriction of the luminary organ.

[0093] The implantable constriction device may further comprise a third pressure sensor configured to sense the pressure in the supporting operable hydraulic constriction element.

[0094] The implantable constriction device may further comprise a second injection port in fluid connection with the second reservoir, for injecting fluid into the second reservoir when the second reservoir is implanted. The second injection port may be configured to be placed subcutaneously, and the implantable constriction device may further comprise a second injection port conduit fluidly connecting the second injection port to the second reservoir.

[0095] In one embodiment, the supporting operable hydraulic constriction element has a length in the axial direction of the luminary organ, when implanted, and the first and second operable hydraulic constriction element has a combined length in the axial direction of the luminary organ. The combined length is longer than the length of the supporting operable hydraulic constriction element.

[0096] The surrounding structure may in any of the embodiments herein comprise an inner surface configured to face the luminary organ, when implanted, and the supporting operable hydraulic constriction device may be fixated to the inner surface of the surrounding structure, such that the supporting operable hydraulic constriction device can use the surrounding structure as support for constricting the luminary organ.

[0097] The implantable constriction device may further comprise at least one cushioning element configured to contact the luminary organ, and the cushioning element may be fixated to the inner surface of the surrounding structure and be more resilient than the surrounding structure.

[0098] The surrounding structure may in any of the embodiment herein be comprised of at least a first and a second supporting element configured to be connected to each other for forming at least a portion of the periphery of the surrounding structure.

[0099] The supporting operable hydraulic constriction device may be fixated to the first supporting element, and the at least one cushioning element may be fixated to the second supporting element. [000100] An implantable constriction device for constricting a luminary organ of a patient is further provided. The luminary organ is a tubular, luminary organ having a substantially circular cross section and being elongated in an axial direction. The implantable constriction device may comprise a first operable hydraulic constriction element configured to be inflated and thereby expand in a first direction towards the luminary organ to constrict a first portion of the luminary organ for restricting the flow offluid therethrough. The implantable constriction device may further comprise a supporting operable hydraulic constriction element configured to be inflated and thereby expand in the first direction towards the luminary organ to support the first operable hydraulic constriction element in constricting the first portion of the luminary organ for restricting the flow of fluid therethrough. The combination of the first operable hydraulic constriction element and the supporting operable hydraulic constriction element may make the combined operable hydraulic constriction element more rigid which means that the compression of the luminary organ will be more accurate and the risk of leakage when the implantable constriction device is closed will be reduced.[000101] The supporting operable hydraulic constriction element may in one embodiment be connected to the first operable hydraulic constriction element.[000102] In one embodiment of the implantable constriction device, the supporting operable hydraulic constriction element may be less resilient than the first operable hydraulic constriction element.[000103] In one embodiment, the first operable hydraulic constriction element may comprise a lumen surrounded by a resilient wall and the supporting operable hydraulic constriction element may comprise a lumen surrounded by a resilient wall. A portion of the resilient wall of the supporting operable hydraulic constriction element may be thicker than a portion of the resilient wall of the first operable hydraulic constriction element.[000104] In one embodiment, a portion of the resilient wall of the supporting operable hydraulic constriction element may be more than 1,5 times thicker than a portion of the resilient wall of the first operable hydraulic constriction element, and in one embodiment, a portion of the resilient wall of the supporting operable hydraulic constriction element is more than 2 times as thick as a portion of the resilient wall of the first operable hydraulic constriction element.[000105] In one embodiment, the first operable hydraulic constriction element comprises a lumen surrounded by a resilient wall and the supporting operable hydraulic constriction element comprises a lumen surrounded by a resilient wall, and a portion of the resilient wall of the first operable hydraulic constriction element comprises a first material, and a portion of the resilient wall of the supporting operable hydraulic constriction element may comprise a second material. The second material may have a modulus of elasticity which is higher than a modulus of elasticity of the first material.[000106] In one embodiment, the modulus of elasticity of the second material is more than 1,5 times as high as the modulus of elasticity of the first material and in another embodiment, the modulus of elasticity of the second material is more than 2 times as high as the modulus of elasticity of the first material.[000107] In one embodiment, the implantable constriction device further comprises a first hydraulic pump, a second hydraulic pump, a first reservoir for holding hydraulic fluid, a second reservoir for holding hydraulic fluid, a first reservoir conduit, fluidly connecting the first reservoir to the first operable hydraulic constriction element, and a supporting reservoir conduit, fluidly connecting the second reservoir to the supporting operable hydraulic constriction element. The first hydraulic pump may be configured to pump fluid from the first reservoir to the first operable hydraulic constriction element through the first reservoir conduit for constricting the luminary organ, and the second hydraulic pump may be configured to pump fluid from the second reservoir to the supporting operable hydraulicconstriction element through the supporting reservoir conduit, for assisting in the constriction of the luminary organ.[000108] The implantable constriction device may further comprise a first pressure sensor configured to sense the pressure in the first operable hydraulic constriction element. The implantable constriction device may further comprise a second pressure sensor configured to sense the pressure in the supporting operable hydraulic constriction element.[000109] The implantable constriction device may in any of the embodiments herein further comprise an implantable controller configured to control at least one of the first hydraulic pump, on the basis of input from the first pressure sensor, and the second hydraulic pump, on the basis of input from the second pressure sensor.[000110] The first reservoir conduit may in any of the embodiments herein comprise an electrically operable valve, and the second reservoir conduit may comprise an electrically operable valve. The controller may be configured to control at least one of the electrically operable valve on the first reservoir conduit, on the basis of input from the first pressure sensor, and the electrically operable valve on the second reservoir conduit, on the basis of input from the second pressure sensor.[000111] At least one of the first reservoir conduit and the second reservoir conduit may further comprise a check valve.[000112] In one embodiment, the implantable constriction device further comprises a first injection port in fluid connection with the first reservoir for injecting fluid into the first reservoir when the first reservoir is implanted.[000113] The implantable constriction device may further comprise a second injection port in fluid connection with the second reservoir, for injecting fluid into the second reservoir when the second reservoir is implanted. At least one of the first and second injection port may be placed subcutaneously, and the implantable constriction device further comprises a first and / or second injection port conduit fluidly connecting the first injection port to the first reservoir and / or fluidly connecting the second injection port to the second reservoir.[000114] In one embodiment, the supporting operable hydraulic constriction element has a length in the axial direction of the luminary organ, when implanted, and the first operable hydraulic constriction element has a length in the axial direction of the luminary organ. The length of the first operable hydraulic constriction element may be longer than the length of the supporting operable hydraulic constriction element.[000115] In one embodiment, the implantable constriction device comprises a first operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ in a first direction to constrict a first portion of the luminary organ for restricting the flow of fluid therethrough, a second operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ in a second direction to constrict the first portion of the luminary organ for restricting the flow of fluid therethrough, and a first hydraulic system in fluid connection with the first operable hydraulic constriction element, and a second hydraulic system in fluid connection with the second operable hydraulic constriction element. The first and second operable hydraulic constriction elements are adjustable independently from each other. In one embodiment, the second direction is substantially opposite to the first direction.[000116] In one embodiment, the first hydraulic system comprises a first hydraulic pump and the second hydraulic systems comprises a second hydraulic pump. Each of the first and second hydraulic systems may comprise a reservoir for holding hydraulic fluid and the first and second hydraulic systems may be connected to a reservoir for holding hydraulic fluid.[000117] Each of the first and second hydraulic systems may comprise an injection port for injecting hydraulic fluid into the respective first and second hydraulic systems. The injection ports may be configured to be placed subcutaneously, and the implantable constriction device may further comprise injection port conduits fluidly connecting the injection ports to the first and second hydraulic systems. [000118] In one embodiment, the first operable hydraulic constriction element lacks a fluid connection to the second operable hydraulic constriction element. In such embodiments the two hydraulic systems may be completely separated, which increases the redundancy.[000119] The implantable constriction device may further comprise a first pressure sensor configured to sense the pressure in the first operable hydraulic constriction element and / or a second pressure sensor configured to sense the pressure in the second operable hydraulic constriction element.[000120] The implantable constriction device may further comprise a controller configured to receive a pressure sensor signal from at least one of the first and second pressure sensor and control at least one of: the first hydraulic pump and the second hydraulic pump on the basis of the received pressure sensor signal.[000121] The implantable constriction device may comprise a surrounding structure having a periphery surrounding the luminary organ when implanted and the surrounding structure may be substantially rigid. [000122] An implantable constriction device for constricting a luminary organ of a patient is further provided. The implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ, a hydraulic reservoir for holding a hydraulic fluid and a hydraulic pump for pumping fluid from the hydraulic reservoir to the operable hydraulic constriction element. The implantable constriction device may further comprise a first fluid conduit creating a fluid connection between the hydraulic reservoir and the hydraulic pump and a second fluid conduit creating a fluid connection between the hydraulic pump and the operable hydraulic constriction element. The implantable constriction device may further comprise an injection port for injecting and removing hydraulic fluid from the implantable constriction device, when implanted, and a third fluid conduit creating a fluid connection between the injection port and at least one of the second fluid conduit and the operable hydraulic constriction element, such that hydraulic fluid can be removed from the operable hydraulic constriction element through the injection port.[000123] One advantage of having the injection ports being directly in fluid connection with the first and supporting operable hydraulic constriction elements is that the injection ports can be used as a safety system through which the hydraulic fluid can be removed from the first and supporting operable hydraulic constriction elements in case there is a malfunction to the pumps of the electrically operable valves. I.e. if there is a malfunction to the pumps or valves, an injection needle can be inserted into the injection ports and fluid withdrawn from the first and supporting operable hydraulic constriction elements such that the luminary organ is left unrestricted even if the constriction device does not function.[000124] In one embodiment, the implantable constriction device further comprises a supporting operable hydraulic constriction element configured to be inflated to support the first operable hydraulic constriction element in constricting the luminary organ for restricting the flow of fluid therethrough. [000125] The implantable constriction device may further comprise a second hydraulic reservoir for holding a hydraulic fluid, a second hydraulic pump for pumping fluid from the hydraulic reservoir to the supporting operable hydraulic constriction element, a fourth fluid conduit creating a fluid connection between the second hydraulic reservoir and the second hydraulic pump, and a fifth fluid conduit creating a fluid connection between the second hydraulic pump and the supporting operable hydraulic constriction element. The implantable constriction device may further comprise a second injection port for injecting and removing hydraulic fluid from the implantable constriction device, when implanted, and a sixth fluid conduit creating a fluid connection between the second injection port and at least one of the second fluid conduit and the supporting operable hydraulic constriction element, such that hydraulic fluid can be removed from the supporting operable hydraulic constriction element through the second injection port. [000126] The supporting operable hydraulic constriction element may in any of the embodiments herein be connected to the first operable hydraulic constriction element.[000127] The supporting operable hydraulic constriction element may be less resilient than the first operable hydraulic constriction element.[000128] In one embodiment of the implantable constriction device, the first operable hydraulic constriction element comprises a lumen surrounded by a resilient wall and the supporting operable hydraulic constriction element comprises a lumen surrounded by a resilient wall. A portion of the resilient wall of the supporting operable hydraulic constriction element is thicker than a portion of the resilient wall of the first operable hydraulic constriction element. A portion of the resilient wall of the supporting operable hydraulic constriction element may be more than 1,5 times as thick as a portion of the resilient wall of the first operable hydraulic constriction element.[000129] In one embodiment, the first operable hydraulic constriction element comprises a lumen surrounded by a resilient wall, and the supporting operable hydraulic constriction element comprises a lumen surrounded by a resilient wall. A portion of the resilient wall of the first operable hydraulic constriction element comprises a first material, and a portion of the resilient wall of the supporting operable hydraulic constriction element comprises a second material. The second material may have a modulus of elasticity which is higher than a modulus of elasticity of the first material. In one embodiment, the modulus of elasticity of the second material is more than 1,5 times higher than the modulus of elasticity of the first material.[000130] In one embodiment, the implantable constriction device could further comprise a first pressure sensor configured to sense the pressure in the first operable hydraulic constriction element and / or a second pressure sensor configured to sense the pressure in the supporting operable hydraulic constriction element.[000131] The implantable constriction device may further comprise an implantable controller configured to control at least one of the first hydraulic pump on the basis of input from the first pressure sensor, and the second hydraulic pump on the basis of input from the second pressure sensor.[000132] At least one of the first reservoir conduit and the second reservoir conduit may comprise an electrically operable valve. The controller may be configured to control at least one of the electricallyoperable valve on the first reservoir conduit, on the basis of input from the first pressure sensor, and the electrically operable valve on the second reservoir conduit, on the basis of input from the second pressure sensor.[000133] The implantable constriction device may further comprise an implantable controller and the implantable controller may be configured to provide a feedback signal to the patient if the pressure in at least one of the operable hydraulic constriction element and the supporting operable hydraulic constriction element exceeds a threshold value.[000134] At least one of the first injection port and the second injection port may be configured to be placed subcutaneously.[000135] In one embodiment, the supporting operable hydraulic constriction element has a length in the axial direction of the luminary organ U, when implanted, and the first operable hydraulic constriction element has a length in the axial direction of the luminary organ. The length of the first operable hydraulic constriction element may be longer than the supporting operable hydraulic constriction element.[000136] The implantable constriction device may comprise a surrounding structure having a periphery surrounding the luminary organ when implanted, which may be substantially rigid.[000137] In one embodiment, the implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ and a hydraulic reservoir for holding a hydraulic fluid. The implantable constriction device further comprises a hydraulic pump for pumping fluid from the hydraulic reservoir to the operable hydraulic constriction element, a first fluid conduit creating a fluid connection between the hydraulic reservoir and the hydraulic pump, and an electrode arrangement configured to be arranged between the implantable constriction device and the luminary organ and to engage and electrically stimulate muscle tissue of the luminary organ to exercise the muscle tissue to improve the conditions for long term implantation of the implantable constriction device.[000138] The electrode arrangement may be arranged on an outer surface of the operable hydraulic constriction element.[000139] In one embodiment, the electrode arrangement comprises a plurality of electrode elements, each of which being configured to engage and electrically stimulate tissue of the luminary organ.[000140] In one embodiment, the electrode arrangement comprises a coiled wire for increasing a contact surface between the electrode arrangement and the tissue of the luminary organ and for allowing the electrode arrangement to follow contraction and relaxation of the tissue of the luminary organ.[000141] The electrode arrangement may comprise a bare electrode portion configured to form a metaltissue interface with the tissue of the luminary organ, thereby allowing faradaic charge transfer to the be predominant charge transfer mechanism over said interface.[000142] In one embodiment, the electrode arrangement comprises an electrode portion at least partly covered by a dielectric material configured to form a dielectric-tissue interface with the tissue of the luminary organ, thereby allowing for a faradaic portion of the charge transfer mechanism over said interface to be reduced.[000143] The electrode arrangement may further comprise at least two electrode elements configured to be arranged on opposing sides of the luminary organ.[000144] The implantable constriction device may further comprise a stimulation controller configured to be operably connected to the electrode arrangement for controlling the electrical stimulation of the tissue of the luminary organ. The stimulation controller may be configured to control the electrical stimulation such that the tissue of the luminary organ is stimulated by a series of electrical pulses.[000145] In one embodiment, the stimulation controller may be configured to control the electrical stimulation such that a pulse of a first polarity is followed by a pulse of a second, reversed polarity. [000146] The stimulation controller may further be configured to generate a pulsed electrical stimulation signal comprising a pulse frequency of 0.01-150 Hz and may comprises a pulse duration of 0.01-100 ms and may comprise a pulse amplitude of 1-15 mA.[000147] In one embodiment, the electrical stimulation signal may comprise a pulse frequency of 0.15- 0.25 Hz, a pulse duration of 20-30 ms and a pulse amplitude of 3-10 mA.[000148] In one embodiment, the electrical stimulation signal comprises a build-up period of 0.01-2 s in which the amplitude is gradually increasing, a stimulation period of 1-60 s, and a stimulation pause of 0.01-60 s, wherein the electrical signal comprises a pulse frequency of 1-50 Hz and a pulse duration of 0.1-10 ms.[000149] In one embodiment, the stimulation controller is configured to receive input from a wireless remote control. The implantable constriction device may further comprise an implantable sensor configured to sense actions potentials generated by pacemaker cells of the tissue of the luminary organ, and the stimulation controller may be configured to control the electrical simulation based at least partly on the sensed action potentials.[000150] In one embodiment, the stimulation controller may be configured to generate electrical pulses amplifying the sensed action potentials.[000151] In one embodiment, the implantable constriction device may comprise a surrounding structure having a periphery surrounding the luminary organ when implanted and the electrode arrangement may be connected to the surrounding structure.[000152] The surrounding structure may comprise at least one cushioning element, and at least one electrode element of the electrode arrangement may be placed on the surface of the cushioning element. [000153] In one embodiment, the implantable constriction device may comprise a first operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ, and a second operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ. The implantable constriction device may further comprise a first hydraulic pump for pumping fluid to the operable hydraulic constriction element, a second hydraulic pump for pumping fluid to the operable hydraulic constriction element, and a motor MO. The motor MOay be mechanically connected to the first and second hydraulic pump for propelling the first and second hydraulic pump. The motor MO could for example be an electrical motor, such as a brushless implantable DC motor.[000154] In one embodiment, the implantable constriction device further comprises a gear system placed between the motor and the first and second hydraulic pump. The gear system is configured to reduce the velocity and increase the force of the movement generated by the motor for propelling the first and second hydraulic pump with a mechanical force with a lower velocity and a greater force.[000155] In one embodiment, the motor is configured to generate a rotating force and propel the first and second hydraulic pump with a rotating mechanical force. A rotating force output of the motor MOaybe connected to a force input of the gear system, and a rotating force output of the gear system, may be connected to the first and second hydraulic pump.[000156] The at least one first and second hydraulic pump may comprise a gear pump, a peristaltic pump, a gerotor pump or a pump comprising at least one compressible hydraulic reservoir.[000157] In one embodiment, the first hydraulic pump comprises a first gerotor pump, the second hydraulic pump comprises a second gerotor pump and the implantable constriction device further comprises a common rotating shaft mechanically connected to the motor. An inner rotor of the first gerotor pump may be mechanically connected to the common rotating shaft, and an inner rotor of the second gerotor pump may be mechanically connected to the common rotating shaft, such that the motor propels the first and second gerotor pump. At least one of the first and second hydraulic pump may be connected to the implantable reservoir.[000158] In one embodiment, the implantable constriction device further comprises a first implantable reservoir and a second implantable reservoir, and the first hydraulic pump is connected to the first implantable reservoir, and the second hydraulic pump is connected to the second implantable reservoir. [000159] In one embodiment, the implantable constriction device further comprises an implantable reservoir and the first and second hydraulic pump may be connected to the implantable reservoir, for pumping hydraulic fluid from the first reservoir to the first operable hydraulic constriction element and from the second reservoir to the second operable hydraulic constriction element.[000160] In one embodiment, the first operable hydraulic constriction element is configured to be inflated and thereby expand in a first direction towards the luminary organ to constrict a first portion of the luminary organ for restricting the flow of fluid therethrough, and the second operable hydraulic constriction element is a supporting operable hydraulic constriction element configured to be inflated and thereby expand in the first direction dl towards the luminary organ to support the first operable hydraulic constriction element in constricting the first portion of the luminary organ for restricting the flow of fluid therethrough. The supporting operable hydraulic constriction element may be connected to the first operable hydraulic constriction element and the supporting operable hydraulic constriction element may be less resilient than the first operable hydraulic constriction element.[000161] In one embodiment, the first operable hydraulic constriction element comprises a lumen surrounded by a resilient wall and the supporting operable hydraulic constriction element comprises a lumen surrounded by a resilient wall. A portion of the resilient wall of the supporting operable hydraulic constriction element is thicker than a portion of the resilient wall of the first operable hydraulic constriction element.[000162] In one embodiment, the implantable constriction device may further comprise a first pressure sensor configured to sense the pressure in the first operable hydraulic constriction element and / or a second pressure sensor configured to sense the pressure in the second operable hydraulic constriction element.[000163] In one embodiment, the implantable constriction device may further comprise an implantable controller configured to control at least one of the first hydraulic pump on the basis of input from the first pressure sensor, and the second hydraulic pump on the basis of input from the second pressure sensor.[000164] In one embodiment, the implantable constriction device may further comprise a first and / or a second implantable injection port in fluid connection with the first operable hydraulic constriction element.[000165] In one embodiment, the second operable hydraulic constriction element has a length in the axial direction of the luminary organ, when implanted, and the first operable hydraulic constriction element has a length in the axial direction of the luminary organ. The length of the first operable hydraulic constriction element is longer than the length of the second operable hydraulic constriction element.[000166] In one embodiment, the implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ, a pressure sensor configured to sense the pressure in the operable hydraulic constriction element, a hydraulic pump for pumping a hydraulic fluid to the operable hydraulic constriction element, and a controller configured to receive pressure sensor input from the pressure sensor and control the hydraulic pump on the basis of the received pressure sensor input. The pressure sensor may comprises a diaphragm in fluid connection with the hydraulic fluid in the operable hydraulic constriction element and connected to a pressure sensing element of the pressure sensor, such that the pressure sensing element is separated from the hydraulic fluid in the operable hydraulic constriction element by the diaphragm.[000167] The implantable constriction device configured to constrict the luminary organ may be an implantable constriction device configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence.[000168] The pressure sensor may comprise a strain gauge-based pressure sensor, which may be a piezoresistive or piezoelectric strain gauge-based pressure sensor, or an optical strain gauge-based pressure sensor.[000169] In the alternative, the pressure sensor may comprise a capacitive pressure sensor, which may be an electromagnetic pressure sensor.[000170] In one embodiment, the diaphragm is in connection with an enclosed lumen configured to hold a gaseous fluid, and the pressure sensing element is configured to sense the pressure of the gaseous fluid.[000171] The implantable constriction device may further comprise an electrically controllable valve connected to the controller, and the controller may be configured to control the electrically controllable valve on the basis of the received pressure sensor input.[000172] In one embodiment, the implantable constriction device may further comprise a reservoir for holding a hydraulic fluid, and the reservoir may be in fluid connection with the operable hydraulic constriction element. The electrically controllable valve may be configured to open and close the fluid connection between the reservoir and the operable hydraulic constriction element. The implantable constriction device may further comprise a second operable hydraulic constriction element and a second pressure sensor configured to sense the pressure in the second operable hydraulic constriction element. [000173] The implantable constriction device may further comprise a second hydraulic pump for pumping hydraulic fluid to the second operable hydraulic constriction element, and the controller may be configured to receive pressure sensor input from the second pressure sensor and control the second hydraulic pump on the basis of the received pressure sensor input.[000174] In one embodiment, the implantable constriction device further comprises a second electrically controllable valve connected to the controller, and the controller is configured to control the second electrically controllable valve on the basis of the received pressure sensor input.[000175] In one embodiment, the implantable constriction device further comprises a second reservoir for holding a hydraulic fluid. The second reservoir may be in fluid connection with the second operable hydraulic constriction element, and the second electrically controllable valve may be configured to open and close the fluid connection between the reservoir and second the operable hydraulic constriction element.[000176] In one embodiment, the diaphragm comprises a medical grade silicone material.[000177] In one embodiment, the diaphragm makes up a portion of a wall of at least one of the operable hydraulic constriction element and the reservoir.[000178] In one embodiment, the implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ and a hydraulic pump for pumping a hydraulic fluid to the operable hydraulic constriction element. The hydraulic pump may comprise a compressible reservoir configured to hold a hydraulic fluid to be moved to the operable hydraulic constriction element. The implantable constriction device further comprises a motor comprising a shaft. The motor MOay be configured to generate force in a radial direction by rotation of the shaft. The implantable constriction device further comprises a transmission configured to transfer the force in the radial direction to a force substantially in an axial direction of the shaft for compressing the compressible reservoir. The implantable constriction device further comprises at least one bearing for the shaft, wherein the bearing is configured to withhold at least half of the force in the axial direction, for reducing the axial load on at least one of the motor and a gear system, caused by the compression of the reservoir.[000179] The at least one bearing could comprise at least one of a ball bearing and a roller bearing, and the bearing may be placed between the gear system and the compressible reservoir for reducing the axial load on the gear system caused by the compression of the reservoir.[000180] In one embodiment, the compressible reservoir comprises a first resilient wall portion, and the shaft may be directly or indirectly connected to the first resilient wall portion.[000181] The compressible reservoir may comprise a first resilient wall portion and a second resilient wall portion, and the first resilient wall portion may be more resilient than the second resilient wall portion.[000182] The implantable constriction device may further comprise a gear system connected to the motor and adapted to receive mechanical work via the shaft having a force and a velocity, and output mechanical work having a stronger force and a lower velocity.[000183] The gear system may be placed between the motor and the transmission.[000184] The shaft may comprise a threaded portion, and the implantable constriction device may further comprise a compression member directly or indirectly connected to the first resilient wall portion. The compression member may comprise a corresponding threaded portion such that the threaded portions of the shaft and the compression member together creates the transmission. The compression member may be integrated in the first resilient wall portion.[000185] The implantable constriction device may further comprise a pressure sensor configured to sense the pressure in the compressible reservoir, and the pressure sensor may be integrated in a wall portion of the compressible reservoir. The pressure sensor may comprise a strain gauge-based pressure sensor.[000186] The first resilient wall portion may comprise a convex portion configured to be compressed and thus inverted, for creating a concave portion, and the second resilient wall portion may comprise a concave portion towards the lumen of the compressible reservoir. The first resilient wall portion may be configured to be compressed and thus inverted into the concave portion of the second resilient wall portion.[000187] The compression member may comprise a convex portion configured to engage the first resilient wall portion for facilitating the inversion of the convex portion of the first resilient wall portion. The implantable constriction device may further comprise a shaft sealing configured to engage the shaft and provide a seal between the transmission at least one of the motor and a gear system.[000188] The implantable constriction device may further comprise an elastic element configured to exert an elastic force on the shaft sealing, such that the shaft sealing exerts a sealing force on the shaft. The shaft sealing may comprises a self-lubricating polymer material such as PTFE.[000189] An implantable hydraulic pump for pumping a hydraulic fluid to an implantable operable hydraulic element, for exerting a force in a body of a patient, is further provided. The hydraulic pump comprises a compressible reservoir configured to hold a hydraulic fluid to be moved to the implantable operable hydraulic element, a motor comprising a shaft, wherein the motor is configured to generate force in a radial direction by rotation of the shaft. The implantable hydraulic pump may further comprise a transmission configured to transfer the force in the radial direction to a force substantially in an axial direction of the shaft for compressing the compressible reservoir. The implantable hydraulic pump may further comprise at least one bearing for the shaft. The bearing may be configured to withhold at least half of the force in the axial direction, for reducing the axial load on at least one of the motor and a gear system, caused by the compression of the reservoir.[000190] The at least one bearing could comprise at least one of a ball bearing and a roller bearing, and the bearing may be placed between the gear system and the compressible reservoir for reducing the axial load on the gear system caused by the compression of the reservoir.[000191] In one embodiment, the compressible reservoir comprises a first resilient wall portion, and the shaft may be directly or indirectly connected to the first resilient wall portion.[000192] The compressible reservoir may comprise a first resilient wall portion and a second resilient wall portion, and the first resilient wall portion may be more resilient than the second resilient wall portion.[000193] The implantable hydraulic pump may further comprise the gear system connected to the motor and adapted to receive mechanical work via the shaft having a force and a velocity, and output mechanical work having a stronger force and a lower velocity. The gear system may be placed between the motor and the transmission.[000194] The shaft may comprise a threaded portion, and the implantable hydraulic pump may further comprise a compression member directly or indirectly connected to the first resilient wall portion. Thecompression member may comprise a corresponding threaded portion such that the threaded portions of the shaft and the compression member together creates the transmission.[000195] In one embodiment of the implantable hydraulic pump, the compression member is integrated in the first resilient wall portion.[000196] The implantable hydraulic pump may further comprise a pressure sensor configured to sense the pressure in the compressible reservoir. The pressure sensor may be integrated in a wall portion of the compressible reservoir and the pressure sensor may comprise a strain gauge-based pressure sensor. In one embodiment, the first resilient wall portion comprises a convex portion configured to be compressed and thus inverted, for creating a concave portion.[000197] The second resilient wall portion may comprise a concave portion towards the lumen of the compressible reservoir, and the first resilient wall portion may be configured to be compressed and thus inverted into the concave portion of the second resilient wall portion.[000198] The compression member may comprise a convex portion configured to engage the first resilient wall portion for facilitating the inversion of the convex portion of the first resilient wall portion. [000199] The implantable hydraulic pump may further comprise a shaft sealing configured to engage the shaft and provide a seal between the transmission at least one of the motor and a gear system.[000200] The implantable constriction device may further comprise an elastic element configured to exert an elastic force on the shaft sealing, such that the shaft sealing exerts a sealing force on the shaft. The shaft sealing comprises a self-lubricating polymer material such as PTFE.[000201] In one embodiment the implantable operable hydraulic constriction element comprises a contacting wall portion configured to engage the luminary organ for exerting force thereon, a withholding wall portion configured to be connected to a withholding structure for withholding the force exerted on the luminary organ, such that the luminary organ U is constricted, and a connecting wall portion, connecting the contacting wall portion to the withholding wall portion. A first portion of the connecting wall portion is connected to the contacting wall portion, a second portion of the connecting wall portion is connected to the withholding wall portion. The first portion of the connecting wall portion is more resilient than the second portion of the connecting wall portion.[000202] The operable hydraulic constriction element configured to constrict the luminary organ may be an operable hydraulic constriction element configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence. [000203] In one embodiment, the first portion of the connecting wall portion has a lower average wall thickness than the average wall thickness of the second portion of the connecting wall portion.[000204] The first portion of the connecting wall portion has an average wall thickness which is less than 0,8 times the average wall thickness of the second portion of the connecting wall portion.[000205] In one embodiment, the first portion of the connecting wall portion comprises a first and a second sub portion and the first sub portion of the first portion is connected to the contacting wall portion, and the second portion of the connecting wall portion comprises a first and a second sub portion. The second sub portion of the second portion is connected to the withholding wall portion, the first sub portion of the first portion is more resilient than the second sub portion of the first portion.[000206] In one embodiment, the first sub portion of the first portion has a lower average wall thickness than the average wall thickness of the second sub portion of the first portion.[000207] The first sub portion of the first portion may have an average wall thickness which is less than 0,9 times the average wall thickness of the second sub portion of the first portion.[000208] The first sub portion of the first portion may be more resilient than the second sub portion of the first portion.[000209] The first sub portion of the second portion may have a lower average wall thickness than the average wall thickness of the second sub portion of the second portion, and in one embodiment, the first sub portion of the second portion has an average wall thickness which is less than 0,9 times the average wall thickness of the second sub portion of the second portion.[000210] In one embodiment, the first portion of the connecting wall portion may comprise a first material and the second portion of the connecting wall portion may comprises a second material. The first material may have a lower modulus of elasticity than the first material. In one embodiment, the modulus of elasticity of the first material is less than 0,8 times the modulus of elasticity of the second material.[000211] The withholding structure in any of the embodiments herein may comprise a surrounding structure configured to surround the luminary organ. The surrounding structure may be comprised of a first and second support element configured to be connected to each other for forming the surrounding structure, and the first and second support element may be hingedly connected to each other.[000212] The surrounding structure may comprise at least one cushioning element configured to contact the luminary organ, and the cushioning element may be more resilient than the surrounding structure.[000213] In one embodiment, the implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ U, a hydraulic pump for pumping a hydraulic fluid to the operable hydraulic constriction element, an implantable energy storage, a capacitor connected to the implantable energy storage unit and connected to the hydraulic pump. The capacitor is configured to be charged by the implantable energy storage unit and to provide the hydraulic pump with electrical power. By having the implantable energy storage unit charge a capacitor, an implantable energy storage unit with high energy density but low maximum output current can be used to operate a hydraulic pump requiring a relatively high current.[000214] The implantable energy storage unit may be a re-chargeable battery, a solid-state battery and / or a tionyl-chlorid battery.[000215] The implantable energy storage unit may be connected to the hydraulic pump and configured to power the hydraulic pump after it has been started using the capacitor.[000216] The capacitor may be configured to store energy to provide a burst of energy to the hydraulic pump. The capacitor may be a start capacitor, a run capacitor or a dual run capacitor.[000217] In one embodiment, the implantable constriction device further comprises a second capacitor configured to be charged by the implantable energy storage unit and to provide the hydraulic pump with electrical power.[000218] The capacitor could for example be a supercapacitor which has a high capacitance in relation to its size, which is of importance for keeping the implant small.[000219] In one embodiment, the hydraulic pump could comprise an electrical motor for operating a hydraulic pump and the capacitor could further be configured to provide electrical power to at least oneof a device for providing electrical stimulation to a tissue portion of the body of the patient, a CPU for encrypting information, a transmitting and / or receiving unit for communication with an external unit, a measurement unit or a sensor, a data collection unit, a solenoid, a piezo-electrical element and / or a memory metal unit.[000220] In one embodiment, the capacitor is further configured to provide electrical power to a valve. [000221] The capacitor may further be configured to provide electrical power to a control unit for controlling at least a part of the medical implant.[000222] The implantable constriction device may further comprise an external energy storage unit configured be arranged outside of the patient’s body and configured to provide energy to the implantable energy storage unit and an implantable energy receiver configured to be electrically connected to the implantable energy storage unit and enable charging of the implantable energy storage unit by the external energy storage unit.[000223] In one embodiment, the implantable constriction device further comprises a temperature sensor for sensing a temperature of the implantable energy storage unit and / or a temperature sensor for sensing a temperature of the capacitor.[000224] In one embodiment, the implantable constriction device comprises an operable hydraulic constriction element configured to be inflated to exert a pressure on the luminary organ, a hydraulic pump for pumping a hydraulic fluid to the operable hydraulic constriction element, and an internal control unit configured to control the hydraulic pump. The internal control unit may comprise a sensor adapted to detect a magnetic field and a processing unit having a sleep mode and an active mode. By having a sleep mode, the internal control unit could consume very little energy when not active.[000225] The operable hydraulic constriction element configured to constrict the luminary organ may be an implantable hydraulic constriction element configured to be positioned in relation to the urethra of a patient and configured to restrict the flow of urine through the urethra for treating urinary incontinence. [000226] The external control unit may be adapted to be arranged outside of the patient’s body and may comprise a first coil adapted to create a magnetic field detectable by the internal sensor. The internal control unit may further be configured to, in response to a detected magnetic field exceeding a predetermined value, setting the processing unit in an active mode.[000227] In one embodiment, the sensor may be one of: a hall effect sensor, a fluxgate sensor, an ultrasensitive magnetic field sensor or a magneto-resistive sensor.[000228] The frequency of the magnetic field generated by the coil may be 9-315 kHz.[000229] In one embodiment, the frequency of the magnetic field generated by the coil is less than or equal to 125kHz, preferably less than 58kHz.[000230] In one embodiment, the internal control unit comprises a receiver unit, and the internal control unit and the external control unit are configured to transmit and / or receive data via the receiver unit and the first coil via magnetic induction.[000231] In one embodiment, the receiver unit comprises a high-sensitivity magnetic field detector. [000232] In one embodiment, the receiver unit comprises a second coil.[000233] In one embodiment, the implantable constriction device further comprises an implantable energy storage unit electrically connected to the receiver unit, and the implantable energy storage unit is adapted to be charged by the external control unit via the receiver unit.[000234] The implantable energy storage unit may be configured to be charged via magnetic induction between the first and the second coils.[000235] The receiver unit may be configured to control the charging of the implantable energy storage unit by controlling the receipt of electrical power from the external control unit at the internal receiver. [000236] The internal receiver unit may be configured to control the charging of the implantable energy storage unit by controlling a transmission of electrical power from the external control unit to the receiver unit.[000237] In one embodiment, the implantable constriction device further comprises a sensation generator adapted to generate a sensation detectable by a sense of the patient, the sensation generator being connected to the internal control unit or the external control unit, and being configured to, upon request, generate the sensation when implanted in a patient.[000238] In one embodiment, the sensation generator is configured to receive the request from the internal control unit or the medical implant, and the sensation generator may be configured to receive the request from an external device.[000239] In one embodiment, the sensation generator may be configured to create the sensation comprising a plurality of sensation components. The sensation generator may be configured to create the sensation or sensation components by at least one of: vibration of the sensation generator, producing a sound providing a photonic signal, providing a light signal, providing an electric signal, and a heat signal.[000240] In one embodiment, the sensation generator may be adapted to be implanted in the patient and in another embodiment the sensation generator is configured to be worn in contact with the skin of the patient. The sensation generator may be configured to generate the sensation without being in physical contact with the patient.[000241] The external control unit may comprise a wireless remote control and the wireless remote control may comprise an external signal transmitter. The internal receiver may further be configured to receive a signal transmitted by the external signal transmitter and to control an operation of the apparatus based on said signal, when the processing unit is in the active state.[000242] The signal may in any of the embodiment be selected from the group consisting of: a sound signal, an ultrasound signal, an electromagnetic signal, and infrared signal, a visible light signal, an ultra violet light signal, a laser signal, a microwave signal, a radio wave signal, an X-ray radiation signal and a gamma radiation signal.[000243] A method of implanting the implantable constriction device in any of the embodiment herein is further provided. The method comprises the steps of placing at least two laparoscopic trocars in the body of a patient, inserting a dissecting tool through the trocars and dissecting an area of the luminary organ, placing the implantable constriction device in the dissected area engaging the luminary organ. The method may further comprise the step of adjusting the implantable constriction device to normally restrict the fluid passageway in the luminary organ, and adjusting the implantable constriction device to open the fluid passageway when desired or requested.[000244] The method may further comprise implanting a source of energy in the patient and providing a controller for controlling the source of energy from outside the patient’s body to supply energy for the adjustment of the implantable constriction device.[000245] A method of implanting the implantable constriction device in any of the embodiment herein is further provided. The method comprises the steps of making an incision in the abdomen of the patient, for accessing the subperitoneal space and thus the luminary organ, dissecting a portion of the luminary organ, inserting an implantable constriction device according to any one of the embodiments herein into the body of the patient, placing the implantable constriction device around the luminary organ of the patient, which in some embodiments includes closing a locking or fixation device of the implantable constriction device around the luminary organ to position and fixate the implantable constriction device to the luminary organ of the patient, optionally securing the implantable constriction device additionally for example by means of sutures, stapler or a tissue growth promoting structure, such as a mesh configured to cover a part of the implantable constriction device such that the growth of fibrotic tissue fixates the implantable constriction device. In one embodiment, the method further comprises inserting an implantable controller, fixated to or fixatable to the implantable constriction device, into the body of the patient and fixating the implantable controller to tissue or bone in the body of the patient. In one embodiment, the method further comprises the step of inserting an operation device, fixated to or fixatable to the implantable constriction device. The operation device may comprise at least one implantable hydraulic pump and / or at least one implantable valve, fixating the implantable operation device to tissue or bone in the body of the patient. In one embodiment, the controller may be integrated in the operation device. The method may further comprise the step of implanting and fixating at least one injection port in fluid connection with the operation device. The step of fixating at least one injection port may include fixating the injection port subcutaneously. The method may further comprise at least one of the steps of calibrating the fluid level in the implantable constriction device, calibrating the pressure exerted by the implantable constriction device on the luminary organ, which may include calibrating the controller to control the pumps and / or valves accordingly, calibrate the time during which implantable constriction device is to remain open after activation, calibrate the time during which implantable constriction device is to remain open after activation before bed time, calibrate the speed with which the implantable constriction device should constrict the luminary organ, calibrate the pressure exerted on the luminary organ relative to the blood pressure if the patient, which may include calibrating the pressure exerted on the luminary organ relative to the systolic blood pressure and / or relative to the diastolic blood pressure, calibrating the pressure exerted on the luminary organ by the implantable constriction device by means of a pressure sensitive catheter, placing the implantable constriction device in a fully open catheter mode, testing the feedback function by providing sensory feedback to the patient, placing the implantable constriction device in a post-operative mode for enabling healing and / or growth of fibrotic tissue, testing and / or calibrating the electrical stimulation of the tissue of the luminary organ. [000246] The luminary organ may be the urethra of a patient and the implantable constriction device may be configured to restrict the flow of urine through the urethra for treating urinary incontinence.[000247] An implantable operation device for operating an implantable element configured to exert a force on a body portion of a patient is further provided. The implantable operation device comprising: a housing comprising a first and a second chamber separated from each other. The first chamber comprises a first liquid and the second chamber comprises a second liquid, and wherein the second liquid is a hydraulic liquid configured to transfer force to the implantable element configured to exert the force on the body portion of the patient.[000248] According to one embodiment, the implantable operation device comprises a motor housed in the first chamber, the motor is configured for transforming electrical energy to mechanical work. The implantable operation device may further comprise a hydraulic pump configured to pump the hydraulic liquid from the operation device to the implantable element configured to exert the force on the body portion of the patient. The hydraulic pump may comprise a gear pump, a peristaltic pump, a pump comprising at least one compressible hydraulic reservoir, or a gerotor pump.[000249] The implantable operation device may further comprise a transmission coupled between the motor and the hydraulic pump. The transmission may be configured to transfer a week force with a high velocity into a stronger force with lower velocity and / or configured to rotating force into a linear force. The transmission may comprise a gear system. A fluid chamber of the hydraulic pump forms a portion of the second chamber.[000250] According to one embodiment, the implantable operation device may further comprise an implantable energy storage unit housed in the first chamber.[000251] According to one embodiment, the implantable operation device further comprising a controller housed in the first chamber.[000252] A wall portion of the first chamber may be resilient to allow an expansion of the first chamber, the wall portion may comprise a resilient membrane.[000253] According to one embodiment, the first liquid is a non-conductive liquid.[000254] According to one embodiment, the first liquid is a lubricating liquid.[000255] According to one embodiment, the first liquid is an oil-based liquid, such as a mineral oil or a silicone oil.[000256] According to one embodiment, the second liquid is an isotone liquid.[000257] According to one embodiment, the housing comprises a metallic material, such as titanium.[000258] According to one embodiment, the implantable operation device further comprising a conduit for electrical transfer between the first and a second chamber.[000259] A wall separating the first chamber from the second chamber may comprise a portion comprising an electrically insulating material, and a conduit may pass from the first chamber to the second chamber through the portion comprising the electrically insulating material. The electrically insulating material comprises a ceramic material.[000260] An implantable device for exerting a force on a body portion of the patient is further provided. The implantable device comprises the implantable operation device according to any one of the embodiments herein and an implantable element configured to exert a force on a body portion of the patient. The implantable hydraulic constriction device may comprise an implantable hydraulic constriction device for constricting the luminary organ of the patient.[000261] An implantable operation device for operating an implantable element configured to exert a force on a body portion of a patient is further provided. The implantable operation device comprising a housing comprising a first and a second chamber separated from each other, a motor housed in the first chamber, wherein the motor is configured for transforming electrical energy to mechanical work. The implantable operation device further comprising an actuator housed in the second chamber. The actuator is connected to the implantable element configured to exert a force on a body portion of a patient. Theimplantable operation device further comprises a magnetic coupling for transferring mechanical work from the motor to the actuator through a barrier separating the first chamber from the second chamber. [000262] According to one embodiment, the housing comprises a metallic material such as titanium. [000263] The actuator may in any of the embodiments be a hydraulic pump configured to transfer mechanical force to hydraulic force. The hydraulic pump may comprise a gear pump, a peristaltic pump, a pump comprising at least one compressible hydraulic reservoir, or a gerotor pump.[000264] The actuator may be a mechanical actuator configured to transfer mechanical force from the magnetic coupling to the implantable element configured to exert a force on a body portion of a patient. The mechanical actuator may be configured to transfer a rotating force into a linear force.[000265] According to one embodiment, the magnetic coupling comprises a first coupling part comprising magnets or magnetic material and being comprised in the first chamber, connected to the motor, and configured to perform a rotating movement. The magnetic coupling may further comprise a second coupling part comprising magnets or magnetic material being comprised in the second chamber, connected to the actuator, and configured to be propelled by the rotating movement of the first coupling part.[000266] The first coupling part may comprise magnets or magnetic material being placed radially along an outer periphery of the first coupling part, and the second coupling part comprises magnets or magnetic material being placed radially, such that the radially placed magnets or magnetic material of the first coupling part magnetically connects to the radially placed magnets or magnetic material of the second coupling part.[000267] According to one embodiment, the first coupling part comprises magnets or magnetic material being placed axially on a surface of the first coupling part, and the second coupling part comprises magnets or magnetic material being placed axially on a surface of the first coupling part, such that the axially placed magnets or magnetic material of the first coupling part magnetically connects to the axially placed magnets or magnetic material of the second coupling part.[000268] According to one embodiment, the implantable operation device according to any one of the preceding claims further comprises a transmission coupled between the motor and the magnetic coupling, the transmission being configured to transfer a week force with a high velocity into a stronger force with lower velocity. The transmission may comprise a gear system.[000269] An implantable device for exerting a force on a body portion of the patient is further provided. The implantable device comprising the implantable operation device according to any one of the embodiments herein, and an implantable element configured to exert a force on a body portion of the patient.[000270] According to one embodiment, the implantable element configured to exert a force on a body portion of the patient is an implantable hydraulic constriction device for constricting a luminary organ of the patient.[000271] The implantable hydraulic constriction device may comprise an implantable hydraulic constriction device for constricting the luminary organ of the patient.[000272] An implantable hydraulic force transfer device is further provided. The implantable hydraulic force transfer device comprises a first chamber configured to house a first fluid, the first chamber comprising a first fluid connection for fluidly connecting the first chamber to an implantable operationdevice, and at least one movable wall portion for varying the size of the first chamber. The implantable hydraulic force transfer device further comprises a second chamber configured to house a second fluid, the second chamber comprising a second fluid connection for fluidly connecting the second chamber to an implantable element configured to exert a force on a body portion of the patient, and at least one movable wall portion for varying the size of the second chamber. The implantable hydraulic force transfer device may be configured to transfer hydraulic force from the implantable operation device to the implantable element configured to exert a force on a body portion of the patient without mixing the first and second fluids.[000273] According to one embodiment, the implantable hydraulic force transfer device may comprise a common movable wall portion, and at least a portion of the movable wall of the first chamber comprises the common movable wall portion, and at least a portion of the movable wall of the second chamber comprises the common movable wall portion.[000274] The at least one of the movable wall portions may comprise a piston, and a first side of the piston may be facing the first chamber and a second side of the piston may be facing the second chamber.[000275] According to one embodiment, at least one of the movable wall portions comprises a flexible wall portion, which may be an elastic wall portion and / or a pleated wall portion.[000276] According to one embodiment, at least one of the first and second chambers comprises a bellows.[000277] According to one embodiment, the first chamber is configured to house an oil-based fluid. [000278] According to one embodiment, the second chamber is configured to house an isotone fluid. [000279] An implantable device for exerting a force on a body portion of the patient is further provided. The implantable device may comprise an implantable operation device and an implantable element configured to exert a force on a body portion of the patient. The implantable device may further comprise the implantable hydraulic force transfer device according to any one of claims 1 - 10, a first fluid conduit configured to fluidly connect the implantable operation device to the first chamber of the implantable hydraulic force transfer device, and a second fluid conduit configured to fluidly connect the implantable element configured to exert a force on a body portion of the patient to the second chamber of the implantable hydraulic force transfer device.[000280] According to one embodiment, the operation device comprises a hydraulic pump for pumping hydraulic fluid from the operation device to the first chamber of the implantable hydraulic force transfer device. The implantable hydraulic constriction device in any of the embodiments herein may comprise an implantable hydraulic constriction device for constricting the luminary organ of the patient.[000281] The implantable device according to any one of the embodiments may further comprise a first fluid configured to be transferred between the operation device and the first chamber of the implantable hydraulic force transfer device and a second different fluid configured to be transferred between the second chamber and the implantable element configured to exert a force on a body portion of the patient. [000282] An implantable controller for an energized implant is further provided. The controller is configured to control an operation device configured to operate at least one implantable element configured to exert a force on a body portion of a patient. The implantable controller is further configured to receive a first input signal being at least one of a sensor input signal related to aphysiological parameter of the patient from an implantable sensor. The implantable controller is further configured to receive a control signal from an implanted or external source, and control the operation device to adjust the force exerted on the body portion of a patient, in response to the first input signal, and receive a second input signal from the implantable sensor related to the physiological parameter of the patient, and control the operation device to further adjust the force exerted on the body portion of a patient in response to the second input signal.[000283] According to one embodiment, the implantable element configured to exert a force on a body portion of a patient comprises an implantable constriction device for constricting the luminary organ of the patient.[000284] According to one embodiment, the implantable element configured to exert a force on a body portion of the patient comprises a hydraulically operable implantable element.[000285] According to one embodiment, the implantable element configured to exert a force on a body portion of the patient comprises a mechanically operable implantable element.[000286] According to one embodiment, the implantable element configured to exert a force on a body portion of the patient comprises an electrically operable implantable element, which may be an element configured to electrically or thermally stimulate a tissue portion of the patient.[000287] The physiological parameter may in any of the embodiments herein comprise a parameter related to an oxygenation of a tissue portion of the patient, related to a pulse of the patient, or related to a blood pressure of the patient.[000288] A method of calibrating an energized implant is further provided. The energized implant comprises at least one implantable element configured to exert a force on a body portion of a patient, an operation device for operating the implantable element and a controller for controlling the operation device. The method comprises receiving, at the controller, a first input signal comprising at least one of: a sensor input signal related to a physiological parameter of the patient from an implantable sensor, and a control signal from an implanted or external source. The method further comprises the step of controlling, by the controller, the operation device to adjust the force exerted on the body portion of a patient, in response to the first input signal, and receiving, at the controller, a second input signal from the implantable sensor related to the physiological parameter of the patient, and controlling, by the controller, the operation device to further adjust the force exerted on the body portion of a patient, in response to the second input signal.[000289] According to one embodiment, the implantable element configured to exert a force on a body portion of a patient comprises a constriction device for constricting a luminary organ of the patient, and wherein the step of controlling the operation device to adjust the force exerted on the body portion of a patient comprises adjusting the constriction of the luminary organ to adjust the restriction of a flow of fluid.[000290] According to one embodiment, the step of receiving, at the controller, a first input signal may comprise a signal related to an input from the patient or an input from a different unit in the controller or from another controller, e.g. a time signal. The step of receiving, at the controller, a first input signal may comprise a signal from another sensor, which may be a motion sensor in an external device.[000291] An implantable controller for controlling an operation device for operating an implantable element configured to exert a force on a body portion of a patient is further provided. The implantablecontroller comprises an electrical switch, and the electrical switch may be a switch being mechanically connected to the implantable element configured to exert a force on a body portion of a patient and being configured to be switched as a result of the force exerted on the body portion of a patient exceeding a threshold value. The switch may also be as switch being electrically connected to the operation device and being configured to be switched as a result of the current supplied to the operation device exceeding a threshold value.[000292] The operation device may comprise a hydraulic operation device, and the implantable element may be a hydraulically operable implantable element. The electrical switch may be connected to at least one of the hydraulic operation device and the hydraulically operable implantable element. According to one embodiment, the electrical switch may be configured to be switched as a result of the pressure in the hydraulically operable implantable element exceeding a threshold value.[000293] The operation device may in any of the embodiments herein comprise a motor, and the switch may be electrically connected to the motor and configured to be switched as a result of the current supplied to the motor exceeding a threshold value. The switch may be configured to cut the power to the operation device or may be configured to generate a control signal to a processor of the implantable controller.[000294] An implantable device for exerting a force on a body portion of the patient is further provided. The implantable device comprises an implantable operation device, an implantable element configured to exert a force on a body portion of the patient, and the implantable controller according to any one of the embodiments herein.[000295] The operation device may comprise a motor, and wherein the switch may be electrically connected to the motor and configured to be switched as a result of the current supplied to the motor exceeding a threshold value.[000296] The implantable device may further comprise a transmission coupled between the motor and the implantable element configured to exert a force on a body portion of the patient, the transmission may be configured to transfer a week force with a high velocity into a stronger force with lower velocity. The transmission may comprise a gear system.[000297] According to one embodiment, the operation device comprises a hydraulic pump for pumping hydraulic fluid from the operation device to the implantable element configured to exert a force on a body portion of the patient. The hydraulic pump may comprise a gear pump, a peristaltic pump, a pump comprising at least one compressible hydraulic reservoir or a gerotor pump.[000298] The implantable hydraulic constriction device may comprise an implantable hydraulic constriction device for constricting the luminary organ of the patient.[000299] Any embodiment, part of embodiment, method, or part of method may be combined in any applicable way.[000300] An implantable controller for controlling an operation device for operating an implantable element configured to exert a force on a body portion of a patient is further provided. The implantable controller comprises an electrical switch, and the electrical switch comprises at least one of: a switch being mechanically connected to the implantable element configured to exert a force on a body portion of a patient and being configured to be switched as a result of the force exerted on the body portion of a patient exceeding a threshold value, switch being electrically connected to the operation device andbeing configured to be switched as a result of the current supplied to the operation device exceeding a threshold value, and a switch being electrically connected to the operation device and being configured to be switched as a result of a temperature exceeding a threshold value.[000301] According to one embodiment, the operation device comprises a hydraulic operation device, and the implantable element is a hydraulically operable implantable element, and wherein the electrical switch is connected to at least one of the hydraulic operation device and the hydraulically operable implantable element.[000302] According to one embodiment, the electrical switch is configured to be switched as a result of the pressure in the hydraulically operable implantable element exceeding a threshold value.[000303] According to one embodiment, the operation device comprises a motor, and the switch is electrically connected to the motor and configured to be switched as a result of the current supplied to the motor exceeding a threshold value.[000304] According to one embodiment, the switch is configured to cut the power to the operation device.[000305] In one embodiment, the switch is configured to generate a control signal to a processor of the implantable controller.[000306] An implantable device for exerting a force on a body portion of the patient is further provided. The implantable operation device comprises an implantable element configured to exert a force on a body portion of the patient, and the implantable controller according to any one of the embodiments herein.[000307] In one embodiment, the operation device comprises a motor, and the switch is electrically connected to the motor and configured to be switched as a result of the current supplied to the motor exceeding a threshold value.[000308] The implantable device may further comprise a transmission coupled between the motor and the implantable element configured to exert a force on a body portion of the patient, the transmission is configured to transfer a week force with a high velocity into a stronger force with lower velocity. The transmission may comprise a gear system.[000309] The operation device may comprise a hydraulic pump for pumping hydraulic fluid from the operation device to the implantable element configured to exert a force on a body portion of the patient. The hydraulic pump may comprise a gear pump and / or a peristaltic pump and / or a pump comprising at least one compressible hydraulic reservoir and / or a gerotor pump.[000310] The implantable element configured to exert a force on a body portion of the patient may be an implantable hydraulic constriction device for constricting a luminary organ of the patient. The luminary organ may be the luminary organ of the patient, an intestine of the patient, a colon or rectum of the patient, the intestine at a region of a stoma of the patient, a vas deference of the patient or a blood vessel of the patient. The implantable hydraulic constriction device for constricting the blood vessel of the patient may be configured to constrict a venous blood flow leading from an erectile tissue for promoting engorgement of the erectile tissue.[000311] According to one embodiment, the implantable element configured to exert a force on a body portion of the patient may be an implantable element for actively emptying the urinary bladder of the patient. The implantable element for actively emptying the urinary bladder of the patient may beconfigured to empty the bladder of the patient by compressing the urinary bladder from the outside thereof.[000312] An implantable controller for an energized implant is further provided. The controller is configured to control an operation device configured to operate at least one implantable element configured to exert a force on a body portion of a patient. The implantable controller is further configured to receive a first input signal being related to a pressure in the implantable element configured to exert a force on a body portion of a patient, receive a second input signal being related to an atmospheric pressure, and control the operation device on the basis of the received first and second input signals.[000313] The implantable controller may be configured to receive the second input signal related to the atmospheric pressure from a signal transmitter configured to be located outside the body of the patient, or may be configured to receive the second input signal related to the atmospheric pressure from an implantable pressure sensor, and the implantable controller may be configured to control the force exerted on the body of the patient on the basis of the received first and second input signals.[000314] According to one embodiment, the implantable controller is configured to create an absolute pressure by subtracting the atmospheric pressure from the pressure in the implantable element, and the implantable controller may be configured to control the operation device on the basis of the absolute pressure.[000315] An energized implant is further provided. The energized implant comprises the implantable controller according to any one of the embodiment described herein, and at least one implantable element configured to exert a force on a body portion of a patient, and an operation device configured to operate the at least one implantable element.[000316] The energized implant may further comprise a pressure sensor configured to sense the pressure in the implantable element and the atmospheric pressure. In one embodiment, the energized implant further comprises a membrane, and the pressure sensor is configured to sense the pressure in the implantable element on a first side of the membrane and the atmospheric pressure on a second side of the membrane. A portion of a wall in fluid connection with the at least one implantable element configured to exert a force on a body portion of a patient may comprise the membrane.[000317] The sensor may be configured to derive an absolute pressure in the implantable element by comparing a pressure in the implantable element with the atmospheric pressure, in the alternative, the sensor may be configured to derive the pressure in the implantable element by comparing a pressure in the implantable element with vacuum.[000318] The pressure sensor may comprise at least one of: a strain gauge-based pressure sensor, a piezoresistive or piezoelectric pressure sensor, an optical pressure sensor, a capacitive pressure sensor, and an electromagnetic pressure sensor.[000319] In one embodiment, the energized implant further comprises a first pressure sensor configured to sense the pressure in the implantable element, and a second pressure sensor configured to sense the atmospheric pressure. The first pressure sensor may be connected to the at least one implantable element configured to exert a force on a body portion of a patient.[000320] The second pressure sensor may be an implantable sensor placed in or connected to the energized implant.[000321] The implantable element configured to exert a force on a body portion of a patient may comprise an implantable constriction device for constricting a luminary organ of the patient.[000322] The implantable constriction device for constricting a luminary organ of the patient may comprise a constriction device for constricting the luminary organ of the patient, or may comprises a constriction device for constricting an intestine of the patient, or may comprises a constriction device for constricting a colon or rectum of the patient, or may comprise a constriction device for constricting the intestine at a region of a stoma of the patient, or may comprises a constriction device for constricting a blood vessel of the patient, which may be a constriction device configured to constrict the venous blood flow leading from an erectile tissue for promoting engorgement of an erectile tissue.[000323] The implantable constriction device for constricting a luminary organ may comprise a constriction device for constricting a vas deference of the patient.[000324] In alternative embodiments, the implantable element configured to exert a force on a body portion of the patient may be an implantable element for actively emptying the urinary bladder of the patient which may be an implantable element for actively emptying the urinary bladder of the patient by compressing the urinary bladder from the outside thereof.[000325] The implantable element configured to exert a force on a body portion of the patient may in any of the embodiments herein comprise a hydraulically operable implantable element, which may comprise a hydraulic pump.[000326] A method in an implantable controller, for controlling an operation device of an energized implant is further provided. The operation device is configured to operate at least one implantable element for exerting force on a body portion of a patient. The method comprises receiving a first input signal, at the implantable controller, the first input signal being related to a pressure in the implantable element configured to exert a force on a body portion of a patient, receiving a second input signal, at the implantable controller, the second input signal being related to an atmospheric pressure, and controlling, by the controller, the operation device on the basis of the received first and second input signals.[000327] According to one embodiment, the step of receiving a second input signal comprises receiving the second input signal from a signal transmitter located outside the body of the patient. [000328] According to one embodiment, the step of receiving a second input signal from a signal transmitter located outside the body of the patient comprises receiving the second input signal in connection with the patient using, activating or controlling the energized implant.[000329] According to one embodiment, the step of receiving a second input signal from a signal transmitter located outside the body of the patient comprises receiving the second input signal wirelessly. [000330] The step of receiving a second input signal may comprise receiving the second input signal from an implantable pressure sensor.[000331] The step of controlling the operation device may comprise controlling the force exerted on the body of the patient by the implantable element on the basis of the received first and second input signals. [000332] The step of controlling the force exerted on the body of the patient may comprise controlling the constriction of the luminary organ.[000333] The method may further comprise the step of creating, in the controller, an absolute pressure by subtracting the atmospheric pressure from the pressure in the implantable element, and the step ofcontrolling the operation device may comprise controlling the operation device on the basis of the absolute pressure.[000334] In an example, the constriction device may be implemented as a urinary incontinence treatment apparatus. Thus, a method in an implantable controller for controlling an operation device of such an implantable constriction device to restrict the flow of urine therethrough may further be provided. The method comprising releasing the pressure in an implantable hydraulic constriction element such that substantially no pressure is exerted on the urethra, measuring the pressure in the implantable hydraulic constriction element, when substantially no pressure is exerted on the urethra, and increasing the pressure in the implantable hydraulic constriction element to a defined level, such that the urethra is constricted. It will however be appreciated that the inventive device and method may be implemented for restricting the flow in other luminary organs as well.[000335] According to one embodiment, the step of measuring the pressure in the implantable hydraulic constriction element when substantially no pressure is exerted on the urethra, further comprises comparing the measured pressure with the atmospheric pressure.[000336] According to one embodiment, the step of comparing the measured pressure with the atmospheric pressure comprises measuring the atmospheric pressure using a pressure sensor connected to a signal transmitter located outside the body of the patient.[000337] According to one embodiment, the step of increasing the pressure in the implantable hydraulic constriction element to a defined level, such that the urethra is constricted, comprises constricting the urethra to a defined cross-sectional distance.[000338] According to one embodiment, the method further comprises measuring the pressure in the implantable hydraulic constriction element when the pressure in the implantable hydraulic constriction element has been increased.[000339] According to one embodiment, the step of steps of: measuring the pressure in the implantable hydraulic constriction element, when substantially no pressure is exerted on the urethra, and measuring the pressure in the implantable hydraulic constriction element when the pressure in the implantable hydraulic constriction element has been increased, are performed using the same pressure sensor.[000340] According to one embodiment, the method further comprises the step of creating, in the controller, an absolute pressure by subtracting the pressure in the implantable hydraulic constriction element, when substantially no pressure is exerted on the urethra, from the pressure in the hydraulic constriction element, when the pressure in the implantable hydraulic constriction element has been increased, and wherein the step of controlling the operation device comprises controlling the operation device on the basis of the absolute pressure.[000341] A controller for controlling the pressure in an implantable constriction device for constricting the urethra is further provided, the controller comprises pressure sensor for measuring the pressure in the implantable hydraulic constriction element, and a computing unit. The computing unit is configured to create an absolute pressure by subtracting the pressure in the implantable hydraulic constriction element, when substantially no pressure is exerted on the urethra, from the pressure in the hydraulic constriction element, when the pressure in the implantable hydraulic constriction element has been increased.[000342] According to one embodiment, the computing unit is further configured to compare the measured pressure with the atmospheric pressure.[000343] According to one embodiment, the controller is further configured to receive a pressure signal from a pressure sensor located outside of the body of the patient and compare the measured pressure with a pressure received in the pressure signal.[000344] According to one embodiment, the controller is configured to increase the pressure in the implantable hydraulic constriction element on the basis of the measured pressure.[000345] According to one embodiment, the controller is configured to increase the pressure in the implantable hydraulic constriction element to a defined cross-sectional distance.[000346] In any of the embodiments, the pressure applied to the reservoir and / or hydraulic constriction element can be controlled either by controlling the actual pressure, or by controlling the volume of fluid pumped and / or by controlling the cross-sectional distance of the constricted urethra. I.e. if the pressure is continuously calibrated it can be established that a certain fluid level or distance leads to a specific pressure, which could make control of the device easier then control using constant pressure measurement. In embodiments in which the fluid level or cross-sectional distance of the urethra is used as control value, the pressure may be used as a back-up or safety system, e.g. the pressure sensor can be set to give an alarm signal or take a specific action if the pressure increases over a set value (threshold). [000347] Medical devices, designed to be implanted in a patient's body, are typically operated by means of electrical power. Such medical devices include electrical and mechanical stimulators, motors, pumps, etc, which are designed to support or stimulate various body functions. Electrical power can be supplied to such an implanted medical device from a likewise implanted battery or from an external energy source that can supply any needed amount of electrical power intermittently or continuously without requiring repeated surgical operations.[000348] An implanted energy receiver or other implanted devices required for the operation of an implanted medical device must in some way be located in the patient's body in a secure and convenient way. It is often the case that the implanted device must be located close to the patient's skin in order to keep the distance between an external device, such as an energy transmitter, and the implanted device to a minimum. In practice, this means subcutaneous placement of the implanted device.[000349] It is also often important that the implanted device is kept in a relatively fixed position so that for example energy transfer can be performed accurately.[000350] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by an remote unit configured to be held in position by a tissue portion of a patient, the remote unit comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and a fourth cross-sectional area in a fourth plane and a third surface configured to engage the firsttissue surface of the first side of the tissue portion, wherein the connecting portion is configured to connect the first portion to the second portion, wherein: the first, second, third and fourth planes are parallel to each other, the third cross-sectional area is smaller than the first, second and fourth cross- sectional areas, such that the first portion, second portion and connecting portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes, and the first portion is detachably connected to at least one of the connecting portion and the second portion.[000351] In some embodiments, the connecting portion comprises a flange comprising the fourth cross-sectional area, such that the flange is prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes.[000352] In some embodiments, the flange protrudes in a direction parallel to the first, second, third and fourth planes, and perpendicular to a central extension of the connecting portion.[000353] In some embodiments, the flange comprises the third surface configured to engage the first tissue surface of the first side of the tissue portion.[000354] In some embodiments, the connecting portion comprises at least one protruding element comprising the fourth cross-sectional area, such that the at least one protruding element is prevented from travelling through the hole in the tissue portion, such that the second portion and the connecting portion can be held in position by the tissue portion of the patient also when the first portion is disconnected from the connecting portion.[000355] In some embodiments, the at least one protruding element protrudes in a direction parallel to the first, second, third and fourth planes, and perpendicular to a central extension of the connecting portion.[000356] In some embodiments, the at least one protruding element comprises the third surface configured to engage the first tissue surface of the first side of the tissue portion.[000357] In some embodiments, the connecting portion comprises at least two protruding elements comprising the fourth cross-sectional area.[000358] In some embodiments, the at least two protruding elements are symmetrically arranged about a central axis of the connecting portion.[000359] In some embodiments, the at least two protruding elements are asymmetrically arranged about a central axis of the connecting portion.[000360] In some embodiments, at least one of the first, second and third surfaces comprises at least one of ribs, barbs, hooks, a friction enhancing surface treatment, and a friction enhancing material, to facilitate the remote unit being held in position by the tissue portion.[000361] In some embodiments, the connecting portion comprises a hollow portion.[000362] In some embodiments, the hollow portion provides a passage between the first and second portions.[000363] In some embodiments, the first portion is detachably connected to the connecting portion by at least one of a mechanical connection and a magnetic connection.[000364] In some embodiments, the first portion is detachably connected to the connecting portion by at least one of threads and corresponding grooves, a screw, a self-locking element, a twist and lock fitting, and a spring -loaded locking mechanism.[000365] In some embodiments, the at least one protruding element has a height in a direction perpendicular to the fourth plane being less than a height of the first portion in said direction.[000366] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than half of said height of the first portion in said direction. [000367] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than a quarter of said height of the first portion in said direction.[000368] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than a tenth of said height of the first portion in said direction.[000369] In some embodiments, the at least one protruding element has a diameter in the fourth plane being one of: less than a diameter of the first portion in the first plane, equal to a diameter of the first portion in the first plane, and larger than a diameter of the first portion in the first plane.[000370] In some embodiments, the at least one protruding element has a cross-sectional area in the fourth plane being one of: less than a cross-sectional area of the first portion in the first plane, equal to a cross-sectional area of the first portion in the first plane, and larger than a cross-sectional area of the first portion in the first plane.[000371] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than half of a height of the connecting portion in said direction.[000372] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than a quarter of said height of the connecting portion in said direction.[000373] In some embodiments, the at least one protruding element has a height in said direction perpendicular to the fourth plane being less than a tenth of said height of the connecting portion in said direction.[000374] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by an remote unit configured to be held in position by a tissue portion of a patient, the remote unit comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and being configured to connect the first portion to the second portion, wherein: the first, second, and third planes are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes,and a connecting interface between the connecting portion and the second portion is excentric with respect to the second portion.[000375] In some embodiments, the connecting interface between the connecting portion and the second portion is excentric, with respect to the second portion, in a first direction, but not in a second direction being perpendicular to the first direction.[000376] In some embodiments, the connecting interface between the connecting portion and the second portion is excentric, with respect to the second portion, in a first direction and in a second direction being perpendicular to the first direction.[000377] In some embodiments, the first direction and second direction are parallel to the second plane.[000378] In some embodiments, the second portion has a first end and a second end opposing the first end, wherein the second portion has a length between the first and second end.[000379] In some embodiments, the first end and second end are separated in a direction parallel to the second plane.[000380] In some embodiments, the second portion is curved along the length.[000381] In some embodiments, the second portion is curved in said first direction and said second direction being perpendicular to the first direction.[000382] In some embodiments, the first and second ends comprise an elliptical point respectively.[000383] In some embodiments, the first and second ends comprise a hemispherical end cap respectively.[000384] In some embodiments, the second portion has at least one circular cross-section along the length between the first and second end.[000385] In some embodiments, the second portion has at least one oval cross-section along the length between the first and second end.[000386] In some embodiments, the second portion has at least one elliptical cross-section along the length between the first and second end.[000387] In some embodiments, the second portion has said length in a direction being different to a central extension of the connecting portion.[000388] In some embodiments, the second portion has a proximal region, an intermediate region, and a distal region.[000389] In some embodiments, the proximal region extends from the first end to an interface between the connecting portion and the second portion, the intermediate region is defined by the connecting interface between the connecting portion and the second portion, and the distal region extends from the interface between the connecting portion and the second portion to the second end.[000390] In some embodiments, the proximal region is shorter than the distal region with respect to the length of the second portion.[000391] In some embodiments, the proximal region and the intermediate region together are shorter than the distal region with respect to the length of the second portion.[000392] In some embodiments, the proximal region and the distal region comprises the second surface configured to engage the second surface of the second side of the tissue portion.[000393] In some embodiments, the second portion has a length x and a width y along respective length and width directions being perpendicular to each other and substantially parallel to the second plane,wherein the connecting interface between the connecting portion and the second portion is contained within a region extending from x>0 to x<x / 2 and / or y>0 to y<y / 2, x and y and 0 being respective end points of the second portion along said length and width directions.[000394] In some embodiments, the second portion is tapered from the first end to the second end.[000395] In some embodiments, the second portion is tapered from each of the first end and second end towards the intermediate region of the second portion.[000396] In some embodiments, the first portion has a maximum dimension being in the range of 10 to 40 mm, such as in the range of 10 to 30 mm, such as in the range of 15 to 25 mm.[000397] In some embodiments, the first portion has a diameter being in the range of 10 to 40 mm, such as in the range of 10 to 30 mm, such as in the range of 15 to 25 mm.[000398] In some embodiments, the connecting portion has a maximum dimension in the third plane in the range of 2 to 20 mm, such as in the range of 2 to 15 mm, such as in the range of 5 to 10 mm.[000399] In some embodiments, the second portion has a maximum dimension being in the range of 30 to 90 mm, such as in the range of 30 to 70 mm, such as in the range of 35 to 60 mm.[000400] In some embodiments, the first portion has one or more of a spherical shape, an ellipsoidal shape, a polyhedral shape, an elongated shape, and a flat disk shape.[000401] In some embodiments, the connecting portion has one of an oval cross-section, an elongated cross-section, and a circular cross-section, in a plane parallel to the third plane.[000402] In some embodiments, the distal region is configured to be directed downwards in a standing patient.[000403] In some embodiments, the first portion comprises a proximal region extending from an first end to an interface between the connecting portion and the first portion, an intermediate region defined by an connecting interface between the connecting portion and the first portion, and a distal region extending from the interface between the connecting portion and the first portion to a second end of the first portion.[000404] In some embodiments, the first portion has a first height, and the second portion has a second height, both heights being in a direction perpendicular to the first and second planes, wherein the first height is smaller than the second height.[000405] In some embodiments, the first height is less than 2 / 3 of the second height, such as less than 1 / 2 of the second height, such as less than 1 / 3 of the second height.[000406] In some embodiments, the second end of the second portion comprises connections for connecting to an implant being located in a caudal direction from a location of the remote unit in the patient.[000407] In some embodiments, the first end of the second portion comprises connections for connecting to an implant being located in a cranial direction from a location of the remote unit in the patient.[000408] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by an remote unit configured to be held in position by a tissue portion of a patient, the remote unit comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configuredto be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion has a third cross-sectional area in a third plane and is configured to connect the first portion to the second portion, wherein: the first, second and third planes are parallel to each other, the third cross-sectional area is smaller than the first and second cross- sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes, the first cross- sectional area has a first cross-sectional distance and a second cross-sectional distance, the first and second cross-sectional distances being perpendicular to each other and the first cross-sectional distance being longer than the second cross-sectional distance, the second cross-sectional area has a first cross- sectional distance and a second cross-sectional distance, the first and second cross-sectional distances being perpendicular to each other and the first cross-sectional distance being longer than the second cross-sectional distance, the first cross-sectional distance of the first cross-sectional area and the first cross-sectional distance of the second cross-sectional area are rotationally displaced in relation to each other with an angle exceeding 45° to facilitate insertion of the second portion through the hole in the tissue portion.[000409] In some embodiments, the first cross-sectional distance of the first cross-sectional area and the first cross-sectional distance of the second cross-sectional area are rotationally displaced in relation to each other with an angle exceeding 60° to facilitate insertion of the second portion through the hole in the tissue portion.[000410] In some embodiments, the first cross-sectional distance of the first cross-sectional area and the first cross-sectional distance of the second cross-sectional area are substantially perpendicular to each other to facilitate insertion of the second portion through the hole in the tissue portion.[000411] In some embodiments, the first cross-sectional distance of the first cross-sectional area and the first cross-sectional distance of the second cross-sectional area are rotationally displaced in relation to each other with an angle exceeding 45° and being less than 135°.[000412] In some embodiments, the cross-sectional area of the first portion is elongated. [000413] In some embodiments, the cross-sectional area of the second portion is elongated. [000414] In some embodiments, the connecting portion is connected eccentrically to the second portion.[000415] In some embodiments, the first cross-sectional distance of the second portion is divided into a first, second and third equal length-portions, and wherein the connecting portion is connected to the second portion along the first length-portion of the first cross-sectional distance.[000416] In some embodiments, the first cross-sectional area of the first portion is elongated. [000417] In some embodiments, the second cross-sectional area of the second portion is elongated. [000418] In some embodiments, the first portion comprises a first wireless energy receiver configured to receive energy transmitted wirelessly from an external wireless energy transmitter.[000419] In some embodiments, the first portion comprises an internal wireless energy transmitter. [000420] In some embodiments, the second portion comprises a second wireless energy receiver.[000421] In some embodiments, the first portion comprises a first energy storage unit.[000422] In some embodiments, the second portion comprises a second energy storage unit.[000423] In some embodiments, at least one of the first and second energy storage unit is a solid-state battery.[000424] In some embodiments, the solid-state battery is a thionyl-chloride battery.[000425] In some embodiments, the first wireless energy receiver is configured to receive energy transmitted wirelessly by the external wireless energy transmitter, and store the received energy in the first energy storage unit, the internal wireless energy transmitter is configured to wirelessly transmit energy stored in the first energy storage unit to the second wireless energy receiver, and the second wireless energy receiver is configured to receive energy transmitted wirelessly by the internal wireless energy transmitter and store the received energy in the second energy storage unit.[000426] In some embodiments, the first portion comprises a first controller comprising at least one processing unit.[000427] In some embodiments, the second portion comprises a second controller comprising at least one processing unit.[000428] In some embodiments, at least one of the first and second controller is connected to a wireless transceiver for communicating wirelessly with an external device.[000429] In some embodiments, the first controller is connected to a first wireless communication receiver in the first portion for receiving wireless communication from an external device, and the first controller is connected to a first wireless communication transmitter in the first portion for transmitting wireless communication to a second wireless communication receiver in the second portion.[000430] In some embodiments, the second controller is connected to the second wireless communication receiver for receiving wireless communication from the first portion.[000431] In some embodiments, the first wireless energy receiver comprises a first coil and the internal wireless energy transmitter comprises a second coil.[000432] In some embodiments, the first portion comprises a combined coil, wherein the combined coil is configured to receive energy wirelessly from an external wireless energy transmitter, and transmit energy wirelessly to the second wireless receiver of the second portion.[000433] In some embodiments, at least one of the coils are embedded in a ceramic material.[000434] In some embodiments, the remote unit further comprises a housing configured to enclose at least the first portion, and wherein a first portion of the housing is made from titanium and a second portion of the housing is made from a ceramic material.[000435] In some embodiments, the portion of the housing made from a ceramic material comprises at least one coil embedded in the ceramic material.[000436] In some embodiments, the remote unit further comprises a housing configured to enclose at least the second portion, and wherein a first portion of the housing is made from titanium and a second portion of the housing is made from a ceramic material.[000437] In some embodiments, the portion of the housing made from a ceramic material comprises at least one coil embedded in the ceramic material.

[0062] According to one embodiment of the inventive concept, these and other objects are achievedin full, or at least in part, by an remote unit configured to be held in position by a tissue portion of a patient, the remote unit comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and being configured to connect the first portion to the second portion, wherein: the first, second, and third planes are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes, the first portion comprises a first wireless energy receiver for receiving energy transmitted wirelessly by an external wireless energy transmitter, and an internal wireless energy transmitter configured to transmit energy wirelessly to the second portion, and the second portion comprises a second wireless energy receiver configured to receive energy transmitted wirelessly by the internal wireless energy transmitter. [000438] In some embodiments, the remote unit further comprises at least one sensor for providing input to at least one of the first and second controller.[000439] In some embodiments, the sensor is a sensor configured to sense a physical parameter of the remote unit.[000440] In some embodiments, the sensor is a sensor configured to sense at least one of: a temperature of the remote unit or of a body engaging portion, a parameter related to the power consumption of the remote unit or of a body engaging portion, a parameter related to a status of at least one of the first and second energy storage unit, a parameter related to the wireless transfer of energy from a source external to the body of the patient, and a hydraulic pressure.[000441] In some embodiments, the sensor is a sensor configured to sense a physiological parameter of the patient.[000442] In some embodiments, the sensor is a sensor configured to sense at least one of: a parameter related to the patient swallowing, a local temperature, a systemic temperature, blood saturation, blood oxygenation, blood pressure, a parameter related to an ischemia marker, and pH.[000443] In some embodiments, the sensor configured to sense a parameter related to the patient swallowing comprises at least one of: a motility sensor, a sonic sensor, an optical sensor, and a strain sensor.[000444] In some embodiments, the sensor configured to sense pH is configured to sense the acidity in the stomach.[000445] In some embodiments, the controller is configured to transmit information based on sensor input to a device external to the body of the patient.[000446] In some embodiments, the second portion comprises at least a portion of an operation device for operating an implantable body engaging portion.[000447] In some embodiments, the second portion comprises at least one electrical motor.[000448] In some embodiments, the second portion comprises a transmission configured to reduce the velocity and increase the force of the movement generated by the electrical motor.[000449] In some embodiments, the transmission is configured to transfer a week force with a high velocity into a stronger force with lower velocity.[000450] In some embodiments, the transmission is configured to transfer a rotating force into a linear force.[000451] In some embodiments, the transmission comprises a gear system.[000452] In some embodiments, the second portion comprises a magnetic coupling for transferring mechanical work from the electrical motor through one of: a barrier separating a first chamber of the second portion from a second chamber of the second portion, a housing enclosing at least the second portion.[000453] In some embodiments, the second portion comprises at least one hydraulic pump.[000454] In some embodiments, the hydraulic pump comprises a pump comprising at least one compressible hydraulic reservoir.[000455] In some embodiments, the remote unit further comprises a capacitor connected to at least one of the first and second energy storage unit and connected to the electrical motor, wherein the capacitor is configured to: be charged by at least one of the first and second energy storage units, and provide the electrical motor with electrical power.[000456] In some embodiments, at least one of the first and second portion comprises a sensation generator adapted to generate a sensation detectable by a sense of the patient.[000457] In some embodiments, the second portion comprises a force transferring element configured to mechanically transfer force from the second portion to an implanted body engaging portion.[000458] In some embodiments, the second portion comprises a force transferring element configured to hydraulically transfer force from the second portion to an implanted body engaging portion.[000459] In some embodiments, the second portion comprises at least one lead for transferring electrical energy and / or information from the second portion to an implanted body engaging portion. [000460] In some embodiments, the first portion comprises an injection port for injecting fluid into the first portion.[000461] In some embodiments, the connecting portion comprises a conduit for transferring a fluid from the first portion to the second portion.[000462] In some embodiments, the conduit is arranged to extend through the hollow portion of the connecting portion.[000463] In some embodiments, the second portion comprises a first and a second chamber separated from each other, wherein the first chamber comprises a first liquid and the second chamber comprises a second liquid, and wherein the second liquid is a hydraulic liquid configured to transfer force to an implantable element configured to exert force on the body portion of the patient.[000464] In some embodiments, a wall portion of the first chamber is resilient to allow an expansion of the first chamber.[000465] In some embodiments, the second portion comprises a first hydraulic system in fluid connection with a first hydraulically operable implantable element configured to exert force on the body portion of the patient, and a second hydraulic system in fluid connection with a second hydraulicallyoperable implantable element configured to exert force on the body portion of the patient, wherein the first and second hydraulically operable implantable elements are adjustable independently from each other.[000466] In some embodiments, the first hydraulic system comprises a first hydraulic pump and the second hydraulic systems comprises a second hydraulic pump.[000467] In some embodiments, each of the first and second hydraulic systems comprises a reservoir for holding hydraulic fluid.[000468] In some embodiments, the implantable energized medical further comprises a first pressure sensor configured to sense a pressure in the first hydraulic system, and a second pressure sensor configured to sense a pressure in the second hydraulic system.[000469] In some embodiments, the first surface is configured to engage the first tissue surface of the first side of the tissue portion.[000470] In some embodiments, the first, second and third planes are parallel to a major extension plane of the tissue.[000471] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by an remote unit configured to be held in position by a tissue portion of a patient, the remote unit comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and being configured to connect the first portion to the second portion, wherein: the first, second, and third planes are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes, at least one of the first portion and the second portion comprises at least one coil embedded in a ceramic material, the at least one coil being configured for at least one of: receiving energy transmitted wirelessly, transmitting energy wirelessly, receiving wireless communication, and transmitting wireless communication.[000472] In some embodiments, the first portion comprises a first wireless energy receiver configured to receive energy transmitted wirelessly from an external wireless energy transmitter.[000473] In some embodiments, the first portion comprises a first wireless communication receiver. [000474] In some embodiments, the first portion comprises a coil embedded in a ceramic material, hereinafter referred to as a first coil.[000475] In some embodiments, the first wireless energy receiver comprises the first coil. [000476] In some embodiments, the first wireless communication receiver comprises the first coil. [000477] In some embodiments, the first portion comprises a distal end and a proximal end with respect to the connecting portion, along a direction perpendicular to the first plane.[000478] In some embodiments, the first coil is arranged at the distal end of the first portion.[000479] In some embodiments, the first portion comprises an internal wireless energy transmitter. [000480] In some embodiments, the first portion comprises a first wireless communication transmitter. [000481] In some embodiments, the first portion comprises a coil embedded in a ceramic material, hereinafter referred to as a second coil.[000482] In some embodiments, the internal wireless energy transmitter comprises the second coil. [000483] In some embodiments, the first wireless communication transmitter comprises the second coil.[000484] In some embodiments, the second coil is arranged at the proximal end of the first portion.[000485] In some embodiments, the first wireless energy receiver and the internal wireless energy transmitter comprises a single coil embedded in a ceramic material.[000486] In some embodiments, the first wireless communication receiver and the first wireless communication transmitter comprises a single coil embedded in a ceramic material.[000487] In some embodiments, the first wireless energy receiver, the internal wireless energy transmitter, the first wireless communication receiver, and the internal wireless communication transmitter comprises a single coil embedded in a ceramic material.[000488] In some embodiments, the second portion comprises a second wireless energy receiver.[000489] In some embodiments, the second portion comprises a coil embedded in a ceramic material, hereinafter referred to as a third coil, wherein the second wireless energy receiver comprises the third coil.[000490] In some embodiments, the second portion comprises a distal end and a proximal end with respect to the connecting portion, along a direction perpendicular to the first plane.[000491] In some embodiments, the third coil is arranged at the proximal end of the second portion.[000492] In some embodiments, the first portion comprises a first energy storage unit.[000493] In some embodiments, the second portion comprises a second energy storage unit.[000494] In some embodiments, the first wireless energy receiver is configured to receive energy transmitted wirelessly by the external wireless energy transmitter, and store the received energy in the first energy storage unit, the internal wireless energy transmitter is configured to wirelessly transmit energy stored in the first energy storage unit to the second wireless energy receiver, and the second wireless energy receiver is configured to receive energy transmitted wirelessly by the internal wireless energy transmitter and store the received energy in the second energy storage unit.[000495] In some embodiments, the first energy storage unit is configured to store less energy than the second energy storage unit, and configured to be charged faster than the second energy storage unit.[000496] In some embodiments, the first energy storage unit has lower energy density than the second energy storage unit.[000497] In some embodiments, the remote unit further comprises a housing configured to enclose at least the first portion, and wherein a first portion of the housing is made from titanium and a second portion of the housing is made from a ceramic material.[000498] In some embodiments, the housing made from a ceramic material comprises the at least one coil embedded in the ceramic material.[000499] In some embodiments, the remote unit further comprises a housing configured to enclose at least the second portion, and wherein a first portion of the housing is made from titanium and a second portion of the housing is made from a ceramic material.[000500] In some embodiments, the portion of the housing made from a ceramic material comprises the at least one coil embedded in the ceramic material.[000501] In some embodiments, the first, second and third planes are parallel to a major extension plane of the tissue.[000502] In some embodiments, the connecting portion further comprises a fourt cross-sectional area in a fourth plane, wherein the fourt plane is parallel to the first, second and third planes, and wherein the third cross-sectional area is smaller than the fourth cross-sectional area.[000503] In some embodiments, the connecting portion comprises a protruding element comprising the fourth cross-sectional area.[000504] In some embodiments, the fourth plane is parallel to a major extension plane of the tissue.[000505] In some embodiments, a connecting interface between the connecting portion and the second portion is excentric with respect to the second portion.[000506] According to an embodiment of the inventive concept, an implantable device for exerting a force on a body portion of a patient is provided, wherein the implantable device comprises: an remote unit and an implantable element configured to exert a force on a body portion of the patient.[000507] In some embodiments, the implantable element configured to exert a force on a body portion of the patient is an implantable hydraulic constriction device.[000508] In some embodiments, the implantable hydraulic constriction device is configured for constricting a luminary organ of the patient.[000509] In some embodiments, the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting an intestine of the patient.[000510] In some embodiments, the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a colon or rectum of the patient.[000511] In some embodiments, the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting the intestine at a region of a stoma of the patient.[000512] In some embodiments, the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a blood vessel of the patient.[000513] In some embodiments, the implantable hydraulic constriction device for constricting a blood vessel of the patient is configured to constrict the venous blood flow leading from an erectile tissue for promoting the engorgement of the erectile tissue.[000514] In some embodiments, the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a vas deference of the patient.[000515] In some embodiments, the implantable element configured to exert a force on a body portion of the patient is an implantable element for actively emptying the urinary bladder of the patient.[000516] In some embodiments, the implantable element for actively emptying the urinary bladder of the patient is configured to empty the bladder of the patient by compressing the urinary bladder from the outside thereof.[000517] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by a method of implanting an remote unit, the method comprising: placing a second portion of an remote unit between a peritoneum and a layer of muscular tissue of the abdominal wall, placing a first portion of the remote unit between the skin of the patient and a layer of muscular tissue of the abdominal wall, wherein the first and second portions are configured to be connected by a connecting portion extending through at least one layer of muscular tissue of the abdominal wall, placing a body engaging portion of the remote unit in connection with a tissue or an organ of the patient which is to be affected by the remote unit, and placing a transferring member, configured to transfer at least one of energy and force from the second portion to the body engaging portion, at least partially between a peritoneum and a layer of muscular tissue of the abdominal wall, such that at least 1 / 3 of the length of the transferring member is placed on the outside of the peritoneum.[000518] In some embodiments, the transferring member is configured to transfer mechanical force from the second portion to the body engaging portion.[000519] In some embodiments, the transferring member is configured to transfer hydraulic force from the second portion to the body engaging portion.[000520] In some embodiments, the transferring member is configured to transfer electrical energy force from the second portion to the body engaging portion.[000521] In some embodiments, the transferring member is configured to transfer data between the second portion and the body engaging portion.[000522] In some embodiments, the step of placing the transferring member comprises placing the transferring member at least partially between the peritoneum and the layer of muscular tissue of the abdominal wall, such that at least 1 / 2 of the length of the transferring member is placed on the outside of the peritoneum of the patient.[000523] In some embodiments, the step of placing the transferring member comprises placing the transferring member at least partially between the peritoneum and the layer of muscular tissue of the abdominal wall, such that at least 2 / 3 of the length of the transferring member is placed on the outside of the peritoneum of the patient.[000524] In some embodiments, the step of placing the transferring member comprises placing the transferring member entirely outside of the peritoneum of the patient.[000525] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to an area between the rib cage and the peritoneum of the patient, outside of the peritoneum.[000526] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to an area between the stomach and the thoracic diaphragm of the patient.[000527] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the stomach of the patient.[000528] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the esophagus of the patient.[000529] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the retroperitoneal space.[000530] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to an area of the kidneys.[000531] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the renal arteries.[000532] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the subperitoneal space, outside of the peritoneum.[000533] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the urinary bladder, outside of the peritoneum.[000534] In some embodiments, the step of placing the transferring member comprises placing the transferring member such that it extends from the second portion to the urethra, outside of the peritoneum.[000535] In some embodiments, the step of placing the second portion of the remote unit between the peritoneum and the layer of muscular tissue of the abdominal wall comprises placing the second portion between a first and second layer of muscular tissue of the abdominal wall.[000536] In some embodiments, the step of placing the second portion comprises placing a second portion comprising an electrical motor.[000537] In some embodiments, the step of placing the second portion comprises placing a second portion comprising a hydraulic pump.[000538] In some embodiments, the step of placing the second portion comprises placing a second portion comprising an energy storage unit.[000539] In some embodiments, the step of placing the second portion comprises placing a second portion comprising a receiver for receiving at least one of: energy and communication, wirelessly. [000540] In some embodiments, the step of placing the first portion comprises placing a first portion comprising a transmitter for transmitting at least one of: energy and communication, wirelessly.[000541] In some embodiments, the step of placing the second portion comprises placing a second portion comprising a controller involved in the control of the powered medical device.[000542] In some embodiments, the second portion is elongated and has a length axis extending substantially in the direction of the elongation of the second portion, and wherein the step of placing the second portion comprises placing the second portion such that the length axis is substantially parallel with the cranial -caudal axis of the patient.[000543] In some embodiments, the second portion is elongated and has a length axis extending substantially in the direction of the elongation of the second portion, and wherein the step of placing the second portion comprises placing the second portion such that the length axis is substantially perpendicular with the cranial -caudal axis of the patient.[000544] In some embodiments, the second portion is elongated and has a length axis extending substantially in the direction of the elongation of the second portion, and wherein the step of placing the second portion comprises entering a hole in a layer of muscular tissue of the stomach wall in the direction of the length axis of the second portion and pivoting or angling the second portion after the hole has been entered.[000545] In some embodiments, the step of placing the first portion of the remote unit between the skin of the patient and a layer of muscular tissue of the abdominal wall comprises placing the first portion in the subcutaneous tissue.[000546] In some embodiments, the step of placing the first portion of the remote unit between the skin of the patient and a layer of muscular tissue of the abdominal wall comprises placing the first portion between a first and second layer of muscular tissue of the abdominal wall.[000547] In some embodiments, the step of placing the first portion comprises placing a first portion comprising an energy storage unit.[000548] In some embodiments, the step of placing the first portion comprises placing a first portion comprising a receiver for receiving at least one of: energy and communication, wirelessly.[000549] In some embodiments, the step of placing the first portion comprises placing a first portion comprising a transmitter for transmitting at least one of: energy and communication, wirelessly.[000550] In some embodiments, the step of placing the first portion comprises placing a first portion comprising a controller involved in the control of the powered medical device.[000551] In some embodiments, the first portion is elongated and has a length axis extending substantially in the direction of the elongation of the first portion, and wherein the step of placing the first portion comprises placing the first portion such that the length axis is substantially parallel with the cranial -caudal axis of the patient.[000552] In some embodiments, the first portion is elongated and has a length axis extending substantially in the direction of the elongation of the first portion, and wherein the step of placing the first portion comprises placing the first portion such that the length axis is substantially perpendicular with the cranial -caudal axis of the patient.[000553] In some embodiments, the first portion is elongated and has a first portion length axis extending substantially in the direction of the elongation of the first portion, and the second portion is elongated and has a second portion length axis extending substantially in the direction of the elongation of the second portion, and wherein the step of placing the first and second portions comprises placing the first and second portions such that the first portion length axis and the second portion length axis are placed at an angle in relation to each other exceeding 30°.[000554] In some embodiments, the step of placing the first and second portions comprises placing the first and second portions such that the first portion length axis and the second portion length axis are placed at an angle in relation to each other exceeding 45°.[000555] In some embodiments, the method further comprises the step of placing the connecting portion through at least one layer of muscular tissue of the abdominal wall.[000556] In some embodiments, the first portion, the second portion and the connecting portion are portions of a single unit.[000557] In some embodiments, the method further comprises the step of connecting the first portion to the connecting portion, in situ.[000558] In some embodiments, the method further comprises the step of connecting the second portion to the connecting portion, in situ.[000559] In some embodiments, the method further comprises the step of connecting the transferring member to the first portion.[000560] In some embodiments, the method further comprises the step of connecting the transferring member to the body engaging portion.[000561] In some embodiments, the body engaging portion comprises a medical device for stretching the stomach wall such that a sensation of satiety is created.[000562] In some embodiments, the body engaging portion comprises a constriction device configured to constrict a luminary organ of a patient.[000563] In some embodiments, the body engaging portion comprises an implantable constriction device.[000564] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting a luminary organ of the patient.[000565] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting an intestine of the patient.[000566] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting a colon or rectum of the patient.[000567] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting the intestine at a region of a stoma of the patient.[000568] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting a blood vessel of the patient.[000569] In some embodiments, the implantable constriction device for constricting a blood vessel of the patient is configured to constrict the venous blood flow leading from an erectile tissue for promoting the engorgement of the erectile tissue.[000570] In some embodiments, the implantable constriction device for constricting a blood vessel of the patient is configured to constrict the blood flow in the renal artery to affect the patients systemic blood pressure.[000571] In some embodiments, the implantable constriction device comprises an implantable constriction device for constricting a vas deference of the patient.[000572] In some embodiments, the body engaging portion comprises an implantable element for actively emptying the urinary bladder of the patient.[000573] In some embodiments, the implantable element for actively emptying the urinary bladder of the patient is configured to empty the bladder of the patient by compressing the urinary bladder from the outside thereof.[000574] In some embodiments, the body engaging comprises an element for electrically stimulating a tissue portion of a patient.[000575] According to one embodiment of the inventive concept, these and other objects are achieved in full, or at least in part, by a kit for assembling an remote unit configured to be held in position by a tissue portion of a patient, the kit comprising: a group of one or more first portions, a group of one or more second portions, a group of one or more connecting portions, wherein at least one of said groups comprises at least two different types of said respective portions; wherein the remote unit is a modular device and, when assembled, comprises a selection, from said groups, of one first portion, one second portion, and one connecting portion, wherein: the first portion is configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a firstsurface configured to face a first tissue surface of the first side of the tissue portion, the second portion is configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, and the connecting portion is configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and being configured to connect the first portion to the second portion, wherein: the first, second, and third planes are parallel to each other, and the third cross-sectional area is smaller than the first and second cross-sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes. [000576] In general, any of the embodiments of the remote unit disclosed herein may form part of such kit, and any features of such embodiments may be combined to form part of such kit.[000577] In some embodiments, the group of one or more first portions comprises a first portion comprising a first energy storage unit.[000578] In some embodiments, the group of one or more first portions comprises a first portion comprising a first wireless energy receiver unit for receiving energy transmitted wirelessly by an external wireless energy transmitter.[000579] In some embodiments, the first energy storage unit is connected to the first wireless energy receiver, wherein the first wireless energy receiver is configured to receive energy transmitted wirelessly by the external wireless energy transmitter and store the received energy in the first energy storage unit. [000580] In some embodiments, the first wireless energy receiver is configured to be physically connected to a second energy storage unit in the second portion.[000581] In some embodiments, the group of one or more first portions comprises a first portion comprising an internal wireless energy transmitter.[000582] In some embodiments, the group of one or more second portions comprises a second portion comprising a second wireless energy receiver configured to receive energy transmitted wirelessly by the internal wireless energy transmitter.[000583] In some embodiments, the internal wireless energy transmitter is configured to transmit energy wirelessly to the second wireless energy receiver.[000584] In some embodiments, the group of one or more second portions comprises a second portion comprising a second energy storage unit connected to the second wireless energy receiver.[000585] In some embodiments, the second wireless energy receiver is configured to receive energy transmitted wirelessly by the internal wireless energy transmitter and store the received energy in the second energy storage unit.[000586] In some embodiments, the group of one or more first portions comprises a first portion being formed as one integral unit with a connecting portion.[000587] In some embodiments, the group of one or more second portions comprises a second portion being formed as one integral unit with a connecting portion.[000588] In some embodiments, one of the group of one or more first, second or connecting portions comprises a first portion, second portion and connecting portion being formed as one integral unit.[000589] In some embodiments, the group of one or more first portions comprises a first portion having a first height along a direction being perpendicular to the first plane, and a first portion having a second height along said direction being perpendicular to the first plane, wherein the second height is larger than the first height.[000590] In some embodiments, the group of one or more first portions comprises a first portion having a first width and / or length along a direction being parallel to the first plane, and a first portion having a second width and / or length along said direction being parallel to the first plane, wherein the second width and / or length is larger than the first width and / or length.[000591] In some embodiments, the group of one or more second portions comprises a second portion having a first height along a direction being perpendicular to the second plane, and a second portion having a second height along said direction being perpendicular to the second plane, wherein the second height is larger than the first height.[000592] In some embodiments, the group of one or more second portions comprises a second portion having a first width and / or length along a direction being parallel to the second plane, and a second portion having a second width and / or length along said direction being parallel to the second plane, wherein the second width and / or length is larger than the first width and / or length.[000593] In some embodiments, the group of one or more connecting portions comprises a connecting portion having a first height along a direction being perpendicular to the third plane, and a connecting portion having a second height along said direction being perpendicular to the third plane, wherein the second height is larger than the first height.[000594] In some embodiments, the group of one or more connecting portions comprises a connecting portion having a first width and / or length along a direction being parallel to the third plane, and a connecting portion having a second width and / or length along said direction being parallel to the third plane, wherein the second width and / or length is larger than the first width and / or length.[000595] In some embodiments, the group of one or more first portions comprises a first portion comprising an injection port for injecting fluid into the first portion.[000596] In some embodiments, the group of one or more connecting portions comprises a connecting portion comprising a hydraulic fluid conduit for hydraulically connecting the first portion to the second portion.[000597] In some embodiments, the group of one or more first portions comprises a first portion comprising a first controller comprising at least one processing unit.[000598] In some embodiments, the group of one or more second portions comprises a second portion comprising a second controller comprising at least one processing unit.[000599] In some embodiments, at least one of the first and second controller is connected to a wireless transceiver for communicating wirelessly with an external device.[000600] In some embodiments, the first controller is connected to a first wireless communication receiver in the first portion for receiving wireless communication from an external device, the first controller is connected to a first wireless communication transmitter in the first portion for transmitting wireless communication to a second wireless communication receiver in the second portion.[000601] In some embodiments, the second controller is connected to the second wireless communication receiver for receiving wireless communication from the first portion.[000602] In some embodiments, the first wireless energy receiver comprises a first coil and the internal wireless energy transmitter comprises a second coil.[000603] In some embodiments, the group of first portions comprises a first portion comprising a combined coil, wherein the combined coil is configured to receive wireless energy wirelessly from an external wireless energy transmitter, and transmit wireless energy wirelessly to the second wireless receiver of the second portion.[000604] In some embodiments, at least one of the coils are embedded in a ceramic material.[000605] In some embodiments, the group of one or more first portions comprises a first portion comprising a push button and / or a capacitive button for controlling a function of the remote unit. [000606] The term “body tissue” referred to in the present disclosure may be one or several body tissue groups or layers in a patient, such as muscle tissue, connective tissue, bone, etc.[000607] An implantable operation device for operating a constriction device engaging a body portion of the patient according to any of the embodiments herein is further provided, which may be one of the members described herein. The implantable operation device comprising an electrical machine for transforming electrical energy to mechanical force, a flexible shaft for transferring the mechanical force to a body engaging portion, and a pre-tensioning device for creating a pre-tension in the flexible shaft. The pre-tension eliminates slack end e.g. ensures that the flexible shaft remain threaded onto pulleys or the spools / drums at all time.[000608] The pre-tensioning device may comprise a flexible element, which may comprise at least one of a spring and an elastic material.[000609] The flexible shaft may be configured for transferring a linear force.[000610] The flexible shaft may be a Bowden cable.[000611] According to one embodiment, the electrical machine comprises an electrical motor or solenoid and the implantable operation device may further comprise a transmission for transforming the mechanical force created by electrical transforming device from a rotating mechanical force to a linear mechanical force. The transmission may be configured for transforming the mechanical force created by electrical transforming device from a force having a first velocity and a first strength to a force having a second lower velocity and a second higher strength.[000612] An implantable operation device for operating a constriction device engaging a body portion of the patient according to any of the embodiments herein is further provided, which may be one of the members described herein. The implantable operation device comprising an electrical machine for transforming electrical energy to mechanical force, a transmission for transforming a mechanical force created by electrical transforming device from a force having a first velocity and a first strength to a force having a second lower velocity and a second higher strength. The transmission comprises a first and second pulley, a flexible element configured to be placed around the first and second pulley, wherein the flexible element is configured to be pulled by the force having the first velocity and first strength, causing the first and second pulley to displace in relation to each other with the force having the second lower velocity and the second higher strength, thereby creating the transmission.[000613] According to one embodiment, the transmission comprises a gun tackle.[000614] According to one embodiment, the transmission comprises a luff or watch tackle.[000615] According to one embodiment, the transmission comprises a double tackle.[000616] According to one embodiment, the transmission comprises a gyn tackle.[000617] The implantable operation device may further comprise a third pulley, and the third pully may be connected to the electrical machine and the flexible element may be configured to be placed around the third pulley such that operation of the electrical machine pulls the flexible element.[000618] According to one embodiment, the flexible element is, or transitions into, a flexible shaft for transferring the mechanical force to a body engaging portion.[000619] The flexible shaft may be configured for transferring a linear force. The flexible shaft may be a Bowden cable.[000620] According to one embodiment, the implantable operation device further comprising a pretensioning device for creating a pre-tension in the flexible element, which may be a pre-tensioning device comprising a flexible element which may comprise at least one of a spring and an elastic material. [000621] According to one embodiment, the electrical machine comprises an electrical motor or solenoid. The electrical machine may be connected to a transmission for transforming the mechanical force created by electrical transforming device from a rotating mechanical force to a linear mechanical force.[000622] According to one embodiment, the transmission may be configured for transforming the mechanical force created by the electrical machine from a force having a first velocity and a first strength to a force having a second lower velocity and a second higher strength.[000623] An implantable system is further provided comprising the implantable operation device according to any one of the embodiments herein, and an implantable element configured to exert a force on a body portion of the patient.[000624] An external device configured for communication with an implantable medical device, when implanted in a patient, is provided. The external device comprises at least one first wireless transceiver configured for communication with the implantable medical device using a first network protocol, for determining a distance between the external device and the implantable medical device, and at least one second wireless transceiver configured for communication with the implantable medical device using a second network protocol, for transferring data between the external device and the implantable medical device.[000625] According to one embodiment, the first wireless transceiver comprises an UWB transceiver.[000626] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transfer for at least one of powering an energy consuming component of the implantable medical device and charging an implantable energy storage unit.[000627] According to one embodiment, the second network protocol is a standard network protocol. The standard network protocol may be one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[000628] According to one embodiment, the second wireless transceiver comprises a Bluetooth transceiver.[000629] According to one embodiment, the external device is further configured to communicate with a second external device using said at least one wireless transceiver.[000630] According to one embodiment, the external device is configured for determining a distance between the external device and the implantable medical device by determining the RSSI. [000631] According to one embodiment, a communication range of the first network protocol is less than a communication range of the second network protocol.[000632] According to one embodiment, a frequency band of the first network protocol differs from a frequency band of the second network protocol.[000633] According to one embodiment, the external device is configured to authenticate the implantable medical device if the determined distance between the external device and the implantable medical device is less than a predetermined threshold value.[000634] According to one embodiment, the external device is configured to allow the transfer of data between the external device and the implantable medical device after the implantable medical device has been authenticated.[000635] According to one embodiment, the external device is one from the list of: a wearable external device, and a handset.[000636] An implantable medical device configured for communication with an external device is provided. The implantable medical device comprises at least one first wireless transceiver configured for communication with the external device using a first network protocol, for determining a distance between the external device and the implantable medical device, and at least one second wireless transceiver configured for communication with the external device using a second network protocol, for transferring data between the external device and the implantable medical device.[000637] According to one embodiment, the first wireless transceiver comprises an UWB transceiver.[000638] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transfer for at least one of: powering an energy consuming component of the implantable medical device, and charging an implantable energy storage unit.[000639] According to one embodiment, the second network protocol is a standard network protocol, such as selected from the list of Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[000640] According to one embodiment, the second wireless transceiver comprises a Bluetooth transceiver.[000641] According to one embodiment, the implantable medical device is further configured to communicate with a second external device using said at least one wireless transceiver.[000642] According to one embodiment, the implantable medical device is configured for determining a distance between the external device and the implantable medical device by determining the RSSI.[000643] According to one embodiment, a communication range of the first network protocol is less than a communication range of the second network protocol.[000644] According to one embodiment, a frequency band of the first network protocol differs from a frequency band of the second network protocol.[000645] According to one embodiment, the implantable medical device is configured to authenticate the external device if the determined distance between the external device and the implantable medical device is less than a predetermined threshold value.[000646] According to one embodiment, the implantable medical device is configured to allow the transfer of data between the implantable medical device and the external device after the external device has been authenticated.[000647] According to one embodiment, the implantable medical device comprises at least one of: [000648] an external heart compression device,[000649] an apparatus assisting the pump function of a heart of the patient,[000650] an apparatus assisting the pump function comprising a turbine bump placed within a patient’s blood vessel for assisting the pump function of the heart,[000651] an operable artificial heart valve,[000652] an operable artificial heart valve for increasing the blood flow to the coronary arteries,[000653] an implantable drug delivery device,[000654] an implantable drug delivery device for injecting directly into a blood vessel and change the position of the injection site, all from within the patient’s body,[000655] an implantable drug delivery device for injecting potency enhancing drugs into an erectile tissue of the patient,[000656] a hydraulic, mechanic, and / or electric constriction implant,[000657] an operable volume filling device,[000658] an operable gastric band,[000659] an operable implant for stretching the stomach wall of the patient for creating satiety,[000660] an implant configured to sense the frequency of the patient ingesting food,[000661] an operable cosmetic implant,[000662] an operable cosmetic implant for adjust the shape and / or size in the breast region of a patient,[000663] an implant controlling medical device for the emptying of a urinary bladder,[000664] an implant hindering urinary leakage,[000665] an implant hindering anal incontinence,[000666] an implant controlling the emptying of fecal matter,[000667] an implant monitoring an aneurysm,[000668] an implant for hindering the expansion of an aneurysm,[000669] an implant lubricating a joint,[000670] an implant for affecting the blood flow to an erectile tissue of the patient,[000671] an implant for simulating the engorgement of an erectile tissue,[000672] an implant with a reservoir for holding bodily fluids,[000673] an implant storing and / or emptying a bodily reservoir or a surgically created[000674] reservoir,[000675] an implant communicating with a database outside the body,[000676] an implant able to be programmed from outside the body,[000677] an implant able to be programmed from outside the body with a wireless signal,[000678] an implant treating impotence,[000679] an implant controlling the flow of eggs in the uterine tube,[000680] an implant controlling the flow of sperms in the uterine tube,[000681] an implant controlling the flow of sperms in the vas deferens,[000682] an implant for hindering the transportation of the sperm in the vas deferens,[000683] an implant treating osteoarthritis,[000684] an implant performing a test of parameters inside the body,[000685] an implant controlling specific treatment parameters from inside the body,[000686] an implant controlling bodily parameters from inside the body,[000687] an implant controlling the blood pressure,[000688] an implant controlling the blood pressure by affecting the dilatation of the renal artery,[000689] an implant controlling a drug treatment parameter,[000690] an implant controlling a parameter in the blood,[000691] an implant for adjusting or replacing any bone part of a body of the patient,[000692] an implant replacing an organ of the patient or part of an organ of the patient or the function thereof,[000693] a vascular treatment device,[000694] an implant adapted to move fluid inside the body of the patient,[000695] an implant configured to sense a parameter related to the patient swallowing,[000696] an implant configured to exercise a muscle with electrical or mechanical stimulation,[000697] an implant configured for emptying an intestine portion on command,[000698] an operable implant configured to be invaginated in the stomach of the patient to reduce the volume of the stomach substantially more than the volume of the device,[000699] an implant configured for emptying the urinary bladder from within the patient’s body by compressing the bladder,[000700] an implant configured for draining fluid from within the patient’s body,[000701] an implant configured for the active lubrication of a joint with an added lubrication fluid,[000702] an implant configured for removing clots and particles from the patient’s blood stream,[000703] an implant configured for elongating or straightening a bone in the patient, to reduce scoliosis,[000704] a device to stimulate the brain for a several position to a focused point,[000705] an artificial stomach replacing the function of the natural stomach,[000706] an implant configured for adjusting the position of a female’s urinary tract or bladder neck,[000707] an implant configured for stimulating the ampulla vas deference and creating temporary constriction.[000708] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[000709] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[000710] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[000711] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[000712] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[000713] A patient external device configured for communication with an implantable medical device, when implanted in a patient, is provided. The patient external device comprises a wireless communication unit configured for wireless transmission of control commands to the implantable medical device and configured for wireless communication with a patient display device, and a computing unit configured for running a control software for creating the control commands for the operation of the implantable medical device. The computing unit is configured to transmit a control interface as a remote display portal to a patient display device configured to display the control interface to a user, receive user input from the patient display device, and transform the user input into the control commands for wireless transmission to the implantable medical device.[000714] According to one embodiment, the wireless communication unit comprises a wireless transceiver for wireless transmission of control commands to the implantable medical device, and wireless transmission of the control interface as the remote display portal to the patient display device.[000715] According to one embodiment, the wireless communication unit comprises a first wireless transceiver for wireless transmission of control commands to the implantable medical device, and a second wireless transceiver for wireless transmission of the control interface to the patient display device.[000716] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient display device using a standard network protocol.[000717] According to one embodiment, the wireless communication unit is configured for wireless communication with the implantable medical device using a proprietary network protocol.[000718] According to one embodiment, the wireless communication unit comprises a Bluetooth transceiver.[000719] According to one embodiment, at least one of the first and second wireless transceiver comprises a Bluetooth transceiver.[000720] According to one embodiment, the wireless communication unit comprises a UWB transceiver.[000721] According to one embodiment, at least one of the first and second wireless transceiver comprises a UWB transceiver.[000722] According to one embodiment, the wireless communication unit comprises at least one first wireless transceiver configured for communication with the implantable medical device using a firstnetwork protocol, for determining a distance between the patient external device and the implantable medical device, and at least one second wireless transceiver configured for communication with the implantable medical device using a second network protocol, for transferring data between the patient external device and the implantable medical device.[000723] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transfer for at least one of: powering an energy consuming component of the implantable medical device and charging an implantable energy storage unit.[000724] According to one embodiment, the standard network protocol is one from the list of:Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[000725] According to one embodiment, a communication range of the first wireless transceiver is less than a communication range of the second wireless transceiver.[000726] According to one embodiment, at least one of:[000727] the patient external device is configured to authenticate the implantable medical device if a distance between the patient external device and the implantable medical device is less than a predetermined threshold value,[000728] the patient external device is configured to be authenticated by the implantable medical device if a distance between the patient external device and the implantable medical device is less than a predetermined threshold value,[000729] the patient external device is configured to authenticate the patient display device if a distance between the patient external device and the patient display device is less than a predetermined threshold value, and[000730] the patient external device is configured to be authenticated by the implantable medical device if a distance between the patient external device and the patient display device is less than a predetermined threshold value.[000731] According to one embodiment, the patient external device is configured to allow the transfer of data between at least one of: the patient external device and the implantable medical device, and the patient external device and the patient display device, on the basis of the authentication.[000732] According to one embodiment, the computing unit is configured to encrypt at least one of the control interface and the control commands.[000733] According to one embodiment, the implantable medical device comprises at least one of: [000734] an external heart compression device,[000735] an apparatus assisting the pump function of a heart of the patient,[000736] an apparatus assisting the pump function comprising a turbine bump placed within a patient’s blood vessel for assisting the pump function of the heart, [000737] an operable artificial heart valve,[000738] an operable artificial heart valve for increasing the blood flow to the coronary arteries.[000739] an implantable drug delivery device,[000740] an implantable drug delivery device for injecting directly into a blood vessel and change the position of the injection site, all from within the patient’s body,[000741] an implantable drug delivery device for injecting potency enhancing drugs into an erectile tissue of the patient,[000742] a hydraulic, mechanic, and / or electric constriction implant,[000743] an operable volume filling device,[000744] an operable gastric band,[000745] an operable implant for stretching the stomach wall of the patient for creating satiety,[000746] an implant configured to sense the frequency of the patient ingesting food,[000747] an operable cosmetic implant,[000748] an operable cosmetic implant for adjust the shape and / or size in the breast region of a patient,[000749] an implant controlling medical device for the emptying of a urinary bladder,[000750] an implant hindering urinary leakage,[000751] an implant hindering anal incontinence,[000752] an implant controlling the emptying of fecal matter,[000753] an implant monitoring an aneurysm,[000754] an implant for hindering the expansion of an aneurysm,[000755] an implant lubricating a joint,[000756] an implant for affecting the blood flow to an erectile tissue of the patient,[000757] an implant for simulating the engorgement of an erectile tissue,[000758] an implant with a reservoir for holding bodily fluids,[000759] an implant storing and / or emptying a bodily reservoir or a surgically created[000760] reservoir,[000761] an implant communicating with a database outside the body,[000762] an implant able to be programmed from outside the body,[000763] an implant able to be programmed from outside the body with a wireless signal,[000764] an implant treating impotence,[000765] an implant controlling the flow of eggs in the uterine tube,[000766] an implant controlling the flow of sperms in the uterine tube,[000767] an implant controlling the flow of sperms in the vas deferens,[000768] an implant for hindering the transportation of the sperm in the vas deferens,[000769] an implant treating osteoarthritis,[000770] an implant performing a test of parameters inside the body,[000771] an implant controlling specific treatment parameters from inside the body,[000772] an implant controlling bodily parameters from inside the body,[000773] an implant controlling the blood pressure,[000774] an implant controlling the blood pressure by affecting the dilatation of the renal artery,[000775] an implant controlling a drug treatment parameter,[000776] an implant controlling a parameter in the blood,[000777] an implant for adjusting or replacing any bone part of a body of the patient,[000778] an implant replacing an organ of the patient or part of an organ of the patient or the function thereof,[000779] a vascular treatment device,[000780] an implant adapted to move fluid inside the body of the patient,[000781] an implant configured to sense a parameter related to the patient swallowing,[000782] an implant configured to exercise a muscle with electrical or mechanical stimulation,[000783] an implant configured for emptying an intestine portion on command,[000784] an operable implant configured to be invaginated in the stomach of the patient to reduce the volume of the stomach substantially more than the volume of the device,[000785] an implant configured for emptying the urinary bladder from within the patient’s body by compressing the bladder,[000786] an implant configured for draining fluid from within the patient’s body,[000787] an implant configured for the active lubrication of a joint with an added lubrication fluid,[000788] an implant configured for removing clots and particles from the patient’s blood stream,[000789] an implant configured for elongating or straightening a bone in the patient, to reduce scoliosis,[000790] a device to stimulate the brain for a several position to a focused point,[000791] an artificial stomach replacing the function of the natural stomach,[000792] an implant configured for adjusting the position of a female’s urinary tract or bladder neck,[000793] an implant configured for stimulating the ampulla vas deference and creating temporary constriction.[000794] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[000795] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[000796] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[000797] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[000798] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[000799] A patient display device for communication with a patient remote external device for communication with an implantable medical device is provided. The patient display device comprises a wireless communication unit configured for wirelessly receiving an implant control interface as a remote display portal from the patient remote external device and configured for wirelessly transmitting implant control user input to the patient remote external device, a display for displaying the received implant control interface, and an input device for receiving implant control input from the user.[000800] According to one embodiment, the patient display device further comprises an auxiliary wireless communication unit. The auxiliary wireless communication unit is configured to be disabled to enable at least one of: wirelessly receiving the implant control interface as the remote display portal from the patient remote external device, and wirelessly transmitting implant control user input to the patient remote external device.[000801] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient remote external device using a standard network protocol. The standard network protocol may be one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[000802] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient remote external device using a proprietary network protocol.[000803] According to one embodiment, the wireless communication unit comprises a Bluetooth transceiver.[000804] According to one embodiment, the wireless communication unit comprises a UWB transceiver.[000805] According to one embodiment, a communication range of the wireless communication unit is less than a communication range of the auxiliary wireless communication unit.[000806] According to one embodiment, the patient display device is configured to authenticate the patient remote external device if a distance between the patient display device and the patient remote external device is less than a predetermined threshold value, or to be authenticated by the patient remote external device if a distance between the patient display device and the patient remote external device is less than a predetermined threshold value.[000807] According to one embodiment, the patient display device is configured to allow the transfer of data between the patient display device and the patient remote external device on the basis of the authentication.[000808] According to one embodiment, the patient display device is a wearable external device or a handset.[000809] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[000810] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[000811] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[000812] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[000813] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said foodsensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[000814] A communication system for enabling communication between a patient display device and an implantable medical device, when implanted, is provided. The communication system comprises: a patient display device,[000815] a server, and a patient remote external device. The patient display device comprises a wireless communication unit configured for wirelessly receiving an implant control interface as a remote display portal being provided by the patient remote external device. The wireless communication unit is further configured for wirelessly transmitting implant control user input to the server, destined for the patient remote external device. The system further comprises a display for displaying the received remote display portal, and an input device for receiving implant control input from the user, wherein the patient remote external device comprises a wireless communication unit configured for wireless transmission of control commands to the implantable medical device, and a computing unit. The computing unit is configured for running a control software for creating the control commands for the operation of the implantable medical device, transmitting a control interface to the patient display device, receiving implant control user input generated at the patient display device, from the server, and transforming the user input into the control commands for wireless transmission to the implantable medical device.[000816] According to one embodiment, the computing unit is configured to encrypt at least one of the control interface and the control commands.[000817] According to one embodiment, the patient display device is configured to encrypt the user input.[000818] According to one embodiment, the server is configured to encrypt at least one of the user input received from the patient display device and the control interface received from the patient remote external device.[000819] According to one embodiment, the computing unit is configured to encrypt the control interface and the patient display device is configured to decrypt the encrypted control interface.[000820] According to one embodiment, the server is configured to act as a router, transferring the encrypted control interface from the patient remote external device to the patient display device without decryption.[000821] According to one embodiment of the communication system or patient display device the implantable medical device comprises at least one of: [000822] an external heart compression device,[000823] an apparatus assisting the pump function of a heart of the patient,[000824] an apparatus assisting the pump function comprising a turbine bump placed within a patient’s blood vessel for assisting the pump function of the heart, [000825] an operable artificial heart valve,[000826] an operable artificial heart valve for increasing the blood flow to the coronary arteries.[000827] an implantable drug delivery device,[000828] an implantable drug delivery device for injecting directly into a blood vessel and change the position of the injection site, all from within the patient’s body,[000829] an implantable drug delivery device for injecting potency enhancing drugs into an erectile tissue of the patient,[000830] a hydraulic, mechanic, and / or electric constriction implant,[000831] an operable volume filling device,[000832] an operable gastric band,[000833] an operable implant for stretching the stomach wall of the patient for creating satiety,[000834] an implant configured to sense the frequency of the patient ingesting food,[000835] an operable cosmetic implant,[000836] an operable cosmetic implant for adjust the shape and / or size in the breast region of a patient,[000837] an implant controlling medical device for the emptying of a urinary bladder,[000838] an implant hindering urinary leakage,[000839] an implant hindering anal incontinence,[000840] an implant controlling the emptying of fecal matter,[000841] an implant monitoring an aneurysm,[000842] an implant for hindering the expansion of an aneurysm,[000843] an implant lubricating a joint,[000844] an implant for affecting the blood flow to an erectile tissue of the patient,[000845] an implant for simulating the engorgement of an erectile tissue,[000846] an implant with a reservoir for holding bodily fluids,[000847] an implant storing and / or emptying a bodily reservoir or a surgically created[000848] reservoir,[000849] an implant communicating with a database outside the body,[000850] an implant able to be programmed from outside the body,[000851] an implant able to be programmed from outside the body with a wireless signal,[000852] an implant treating impotence,[000853] an implant controlling the flow of eggs in the uterine tube,[000854] an implant controlling the flow of sperms in the uterine tube,[000855] an implant controlling the flow of sperms in the vas deferens,[000856] an implant for hindering the transportation of the sperm in the vas deferens,[000857] an implant treating osteoarthritis,[000858] an implant performing a test of parameters inside the body,[000859] an implant controlling specific treatment parameters from inside the body,[000860] an implant controlling bodily parameters from inside the body,[000861] an implant controlling the blood pressure,[000862] an implant controlling the blood pressure by affecting the dilatation of the renal artery,[000863] an implant controlling a drug treatment parameter,[000864] an implant controlling a parameter in the blood,[000865] an implant for adjusting or replacing any bone part of a body of the patient,[000866] an implant replacing an organ of the patient or part of an organ of the patient or the function thereof,[000867] a vascular treatment device,[000868] an implant adapted to move fluid inside the body of the patient,[000869] an implant configured to sense a parameter related to the patient swallowing,[000870] an implant configured to exercise a muscle with electrical or mechanical stimulation,[000871] an implant configured for emptying an intestine portion on command,[000872] an operable implant configured to be invaginated in the stomach of the patient to reduce the volume of the stomach substantially more than the volume of the device,[000873] an implant configured for emptying the urinary bladder from within the patient’s body by compressing the bladder,[000874] an implant configured for draining fluid from within the patient’s body,[000875] an implant configured for the active lubrication of a joint with an added lubrication fluid,[000876] an implant configured for removing clots and particles from the patient’s blood stream,[000877] an implant configured for elongating or straightening a bone in the patient, to reduce scoliosis,[000878] a device to stimulate the brain for a several position to a focused point,[000879] an artificial stomach replacing the function of the natural stomach,[000880] an implant configured for adjusting the position of a female’s urinary tract or bladder neck,[000881] an implant configured for stimulating the ampulla vas deference and creating temporary constriction.[000882] According to one embodiment, the communication system further comprises a server. The server may comprise a wireless communication unit configured for wirelessly receiving an implant control interface received from the patient remote external device and wirelessly transmitting the implant control interface as a remote display portal to the patient display device. The wireless communication unit is further configured for wirelessly receiving implant control user input from a patient EID external device and wirelessly transmitting the implant control user input to the patient display device.[000883] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[000884] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[000885] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[000886] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[000887] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said foodsensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[000888] A patient display device for communication with a patient external device for communication with an implantable medical device, when implanted, is provided. The patient display device comprises a wireless communication unit, a display, and an input device for receiving implant control input from the user. The patient display device is configured to run a first application for wireless communication with a server and / or DDI, and run a second application for wireless communication with the patient external device for transmission of the implant control input to a remote display portal of the patient external device for the communication with the implantable medical device, wherein the second application is configured to be accessed through the first application. The patient display device comprises a first log-in function and a second log-in function, wherein the first log-in function gives the user access to the first application and wherein the first and second log-in function in combination gives the user access to the second application. The first log-in function may be configured to use at least one of a password, pin code, fingerprint, voice and face recognition. A second log-in function within the first application may be configured to use a private key from the user to authenticate, for a defined time period, a second hardware key of the patient external device.[000889] According to one embodiment, the first log-in is a PIN-based log-in.[000890] According to one embodiment, at least one of the first and second log-in is a log-in based on a biometric input or a hardware key.[000891] According to one embodiment, the patient display device further comprises an auxiliary wireless communication unit, and wherein the auxiliary wireless communication unit is configured to be disabled to enable wireless communication with the patient external device.[000892] According to one embodiment, the patient display device is configured to wirelessly receive an implant control interface as a remote display portal from the patient external device to be displayed on the display.[000893] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient external device using a standard network protocol.[000894] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient external device using a proprietary network protocol.[000895] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient external device using a first network protocol and with the server using a second network protocol.[000896] According to one embodiment, the wireless communication unit is configured for wireless communication with the patient external device using a first frequency band and with the server using a second frequency band.[000897] According to one embodiment, the wireless communication unit comprises a Bluetooth transceiver.[000898] According to one embodiment, the wireless communication unit comprises a UWB transceiver.[000899] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[000900] According to one embodiment, a communication range of the wireless communication unit is less than a communication range of the auxiliary wireless communication unit.[000901] According to one embodiment, the wireless communication unit comprises a first wireless transceiver for communication with the patient external device and a second wireless transceiver for communication with the server.[000902] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[000903] According to one embodiment, the patient display device is configured to authenticate the patient external device if a distance between the patient display device and the patient external device is less than a predetermined threshold value, or to be authenticated by the patient external device if a distance between the patient display device and the patient external device is less than a predetermined threshold value.[000904] According to one embodiment, the patient display device is configured to allow the transfer of data between the patient display device and the patient external device on the basis of the authentication.[000905] According to one embodiment, the patient display device is a wearable external device or a handset.[000906] According to one embodiment, the second application is configured to receive data related to a parameter of the implanted medical device.[000907] According to one embodiment, the second application is configured to receive data related to a sensor value received from the implanted medical device.[000908] According to one embodiment, the second application is configured to receive data related to a parameter related to at least one of: a battery status, a temperature, a time, and an error.[000909] According to one embodiment, the patient display device is configured to encrypt the user input.[000910] According to one embodiment, the display is configured to encrypt the user input for decryption by the implantable medical device.[000911] According to one embodiment, the patient display device is configured to decrypt the control interface received from the patient external device, for displaying the control interface on the display.[000912] According to one embodiment, at least one of the first and second application is configured to receive data from an auxiliary external device and present the received data to the user. [000913] According to one embodiment, at least one of the first and second application is configured to receive data from an auxiliary external device comprising a scale for determining the weight of the user.[000914] According to one embodiment, at least one of the first and second application is configured to receive data related to the weight of the user from an auxiliary external device comprising a scale.[000915] According to one embodiment, the patient display device is configured to: wirelessly transmit the data related to the weight of the user to the patient external device, or wirelessly transmit an instruction derived from the data related to the weight of the user, or wirelessly transmit an instruction derived from a combination of the data related to the weight of the user and the implant control input received from the user.[000916] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[000917] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[000918] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[000919] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[000920] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[000921] A communication system for enabling communication between a patient display device and an implantable medical device, when implanted, is provided. The communication system comprises a patient display device, [000922] a server or DDI, and a patient remote external device. The patient display device comprises a wireless communication unit configured for wirelessly receiving an implant control interface as a remote display portal from the patient remote external device, the wireless communication unit further being configured for wirelessly transmitting implant control user input to the patient remote external device, a display for displaying the received implant control interface as a remote display portal, and an input device for receiving implant control input from the user. The patient display device is configured to run a first application for wireless communication with the server, and to run a second application for wireless communication with the patient remote external device for transmission of the implant control input to the remote display portal of the patient remote external device for the communication with the implantable medical device. The patient remote external device comprises a wireless communication unit configured for wireless transmission of control commands based on the implant control input to the implantable medical device and configured for wireless communication with the patient display device.[000923] According to one embodiment, the patient display device comprises a first log-in function and a second log-in function, and wherein the first log-in function gives the user access to the first application and wherein the first and second log-in function in combination gives the user access to the second application.[000924] According to one embodiment, the second application is configured to receive data related to a parameter of the implanted medical device.[000925] According to one embodiment, the second application is configured to receive data related to a sensor value received from the implanted medical device.[000926] According to one embodiment, the second application is configured to receive data related to a parameter related to at least one of: a battery status,[000927] a temperature, a time, or an error.[000928] According to one embodiment, the patient display device is configured to encrypt the user input.[000929] According to one embodiment, the display is configured to encrypt the user input for decryption by the implantable medical device.[000930] According to one embodiment, the patient remote external device is configured to act as a router, transferring the encrypted user input from the patient display device to the implantable medical device without decryption.[000931] According to one embodiment, the patient remote external device is configured to encrypt at least one of the control interface and the control commands.[000932] According to one embodiment, the patient remote external device is configured to encrypt the control interface and wherein the patient display device is configured to decrypt the encrypted control interface.[000933] A computer program product is provided, configured to run in a patient display device comprising a wireless communication unit, a display for displaying the received implant control interface as a remote display portal, and an input device for receiving implant control input from a user. The computer program product comprises:[000934] a first application for communication with a server or DDI,[000935] a second application for communication with an patient remote external device for transmission of the implant control input via the remote display portal of the patient remote external device for the communication with an implantable medical device, wherein the second application is configured to be accessed through the first application,[000936] a first log-in function using at least one of a password, pincode, fingerprint, or face recognition, and[000937] a second log-in function within the first application, using a private key from the user to authenticate for a defined time period a second hardware key of the patient remote external device. The first log-in function gives the user access to the first application and the first and second log-in function in combination gives the user access to the second application.[000938] According to one embodiment, the second application is configured to receive data related to a parameter of the implanted medical device.[000939] According to one embodiment, the second application is configured to receive data related to a sensor value received from the implanted medical device.[000940] According to one embodiment, the second application is configured to receive data related to a parameter related to at least one of: a battery status,[000941] a temperature, a time, or an error.[000942] According to one embodiment of the communication system, patient display device or computer program product, the implantable medical device comprises at least one of:[000943] an external heart compression device,[000944] an apparatus assisting the pump function of a heart of the patient,[000945] an apparatus assisting the pump function comprising a turbine bump placed within a patient’s blood vessel for assisting the pump function of the heart,[000946] an operable artificial heart valve,[000947] an operable artificial heart valve for increasing the blood flow to the coronary arteries.[000948] an implantable drug delivery device,[000949] an implantable drug delivery device for injecting directly into a blood vessel and change the position of the injection site, all from within the patient’s body,[000950] an implantable drug delivery device for injecting potency enhancing drugs into an erectile tissue of the patient,[000951] a hydraulic, mechanic, and / or electric constriction implant,[000952] an operable volume filling device,[000953] an operable gastric band,[000954] an operable implant for stretching the stomach wall of the patient for creating satiety,[000955] an implant configured to sense the frequency of the patient ingesting food,[000956] an operable cosmetic implant,[000957] an operable cosmetic implant for adjust the shape and / or size in the breast region of a patient,[000958] an implant controlling medical device for the emptying of a urinary bladder,[000959] an implant hindering urinary leakage,[000960] an implant hindering anal incontinence,[000961] an implant controlling the emptying of fecal matter,[000962] an implant monitoring an aneurysm,[000963] an implant for hindering the expansion of an aneurysm,[000964] an implant lubricating a joint,[000965] an implant for affecting the blood flow to an erectile tissue of the patient,[000966] an implant for simulating the engorgement of an erectile tissue,[000967] an implant with a reservoir for holding bodily fluids,[000968] an implant storing and / or emptying a bodily reservoir or a surgically created[000969] reservoir,[000970] an implant communicating with a database outside the body,[000971] an implant able to be programmed from outside the body,[000972] an implant able to be programmed from outside the body with a wireless signal,[000973] an implant treating impotence,[000974] an implant controlling the flow of eggs in the uterine tube,[000975] an implant controlling the flow of sperms in the uterine tube,[000976] an implant controlling the flow of sperms in the vas deferens,[000977] an implant for hindering the transportation of the sperm in the vas deferens,[000978] an implant treating osteoarthritis,[000979] an implant performing a test of parameters inside the body,[000980] an implant controlling specific treatment parameters from inside the body,[000981] an implant controlling bodily parameters from inside the body,[000982] an implant controlling the blood pressure,[000983] an implant controlling the blood pressure by affecting the dilatation of the renal artery,[000984] an implant controlling a drug treatment parameter,[000985] an implant controlling a parameter in the blood,[000986] an implant for adjusting or replacing any bone part of a body of the patient,[000987] an implant replacing an organ of the patient or part of an organ of the patient or the function thereof,[000988] a vascular treatment device,[000989] an implant adapted to move fluid inside the body of the patient,[000990] an implant configured to sense a parameter related to the patient swallowing,[000991] an implant configured to exercise a muscle with electrical or mechanical stimulation,[000992] an implant configured for emptying an intestine portion on command,[000993] an operable implant configured to be invaginated in the stomach of the patient to reduce the volume of the stomach substantially more than the volume of the device,[000994] an implant configured for emptying the urinary bladder from within the patient’s body by compressing the bladder,[000995] an implant configured for draining fluid from within the patient’s body,[000996] an implant configured for the active lubrication of a joint with an added lubrication fluid,[000997] an implant configured for removing clots and particles from the patient’s blood stream,[000998] an implant configured for elongating or straightening a bone in the patient, to reduce scoliosis,[000999] a device to stimulate the brain for a several position to a focused point,[0001000] an artificial stomach replacing the function of the natural stomach,[0001001] an implant configured for adjusting the position of a female’s urinary tract or bladder neck,[0001002] an implant configured for stimulating the ampulla vas deference and creating temporary constriction.[0001003] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001004] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001005] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001006] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001007] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001008] A communication system for enabling communication between a patient display device, a patient external device, a server and an implantable medical device, is provided. The communication system comprises a server,[0001009] a patient display device, a patient external device, and an implantable medical device. The patient display device comprises a wireless communication unit for wirelessly communicating with at least one of the patient external device and the server, a display, and an input device for receiving input from the user. The patient external device comprises a wireless communication unit configured for wireless transmission of control commands to the implantable medical device and configured for wireless communication with at least one of the patient display device and the server. Further, the server comprises a wireless communication unit configured for wireless communication with at least one of the patient display device and the patient external device, wherein the implantable medical device comprises a wireless communication unit configured for wireless communication with the patient external device. The implantable medical device further comprises an encryption unit and is configured to: encrypt data destined for the server, transmit the data to the server via the patient external device, wherein the patient external device acts as a router transferring the data without full decryption. In an example, the implantable medical device comprises an encryption unit and is configured to: encrypt data destined for the patient display device, transmit the data to the patient display device via the patient external device, wherein the patient external device acts as a router transferring the data without full decryption. In an example, the server comprises an encryption unit and is configured to: encrypt data destined for the implantable medical device, transmit the data to the implantable medical device via the patient external device, wherein the patient external device acts as a router transferring the data without full decryption, In an example, the server comprises an encryption unit and is configured to: encrypt data destined for the implantable medical device, transmit the data to the implantable medical device via the patient display device and the patient external device, wherein the patient display device and the patient external device acts as a router transferring the data without full decryption. In an example, the patient display device comprises an encryption unit and is configured to: encrypt data destined for the implantable medical device, transmit the data to the implantable medical device via the patient external device, wherein the patient external device acts as a router transferring the data without full decryption. In an example, the patient display device comprises an encryption unit and is configured to: encrypt data destined for the implantable medical device, transmit the data to the implantable medical device via the server and the patient external device, wherein the server and the patient external device acts as a router transferring the data without full decryption.[0001010] According to one embodiment, the patient display device is configured to wirelessly receive an implant control interface from the patient external device to be displayed on the display.[0001011] According to one embodiment, at least two of: the wireless communication unit of the server, the wireless communication unit of the patient display device, the wireless communication unit of the patient external device, and the wireless communication unit of the implantable medical device, are configured for wireless communication using a standard network protocol.[0001012] According to one embodiment, wherein at least two of: the wireless communication unit of the server, the wireless communication unit of the patient display device, the wireless communication unit of the patient external device, and the wireless communication unit of the implantable medical device, are configured for wireless communication using a proprietary network protocol.[0001013] According to one embodiment, the wireless communication unit of the patient external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the server, or use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the patient display device.[0001014] According to one embodiment, the wireless communication unit of the patient external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the server, or use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the patient display device.[0001015] According to one embodiment, the wireless communication unit of the patient display device is configured to use a first network protocol for communication with the patient external device and use a second network protocol for communication with the server.[0001016] According to one embodiment, the wireless communication unit of the patient display device is configured to use a first frequency band for communication with the patient external device and use a second frequency band for communication with the server.[0001017] According to one embodiment, the wireless communication unit of the server is configured to use a first network protocol for communication with the patient external device and use a second network protocol for communication with the patient display device.[0001018] According to one embodiment, the wireless communication unit of the server is configured to use a first frequency band for communication with the patient external device and use a second frequency band for communication with the patient display device.[0001019] According to one embodiment, the wireless communication unit of at least one of the server, the patient display device, the patient external device, and the implantable medical device comprises a Bluetooth transceiver.[0001020] According to one embodiment, the wireless communication unit of at least one of the server, the patient display device, the patient external device, and the implantable medical device comprises a UWB transceiver.[0001021] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[0001022] According to one embodiment, the wireless communication unit of the patient external device comprises a first wireless transceiver for wireless communication with the implantable medicaldevice, and a second wireless transceiver for wireless communication with the server, and wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.[0001023] According to one embodiment, the wireless communication unit of the patient external device comprises a first wireless transceiver for wireless communication with the implantable medical device, and a second wireless transceiver for wireless communication with the patient display device, and wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.[0001024] According to one embodiment, the wireless communication unit of the patient display device comprises a first wireless transceiver for wireless communication with the patient external device, and a second wireless transceiver for wireless communication with the server, and wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.[0001025] According to one embodiment, the second wireless transceiver has an effective range being one of: 2 times, 4 times, 8 times 20 times, 50 times or 100 times longer than the first wireless transceiver.[0001026] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[0001027] According to one embodiment, at least one of:[0001028] the patient display device is configured to authenticate the patient external device if a distance between the patient display device and the patient external device is less than a predetermined threshold value,[0001029] the patient display device is configured to be authenticated by the patient external device if a distance between the patient display device and the patient external device is less than a predetermined threshold value,[0001030] the patient display device is configured to authenticate the implantable medical device if a distance between the patient display device and the implantable medical device is less than a predetermined threshold value,[0001031] the patient display device is configured to be authenticated by the implantable medical device if a distance between the patient display device and the implantable medical device is less than a predetermined threshold value,[0001032] the patient external device is configured to authenticate the patient display device if a distance between the patient external device and the patient display device is less than a predetermined threshold value,[0001033] the patient external device is configured to be authenticated by the patient display device if a distance between the patient external device and the patient display device is less than a predetermined threshold value,[0001034] the patient external device is configured to authenticate the implantable medical device if a distance between the patient external device and the implantable medical device is less than a predetermined threshold value, and[0001035] the patient external device is configured to be authenticated by the implantable medical device if a distance between the patient external device and the implantable medical device is less than a predetermined threshold value.[0001036] According to one embodiment, the patient display device is configured to allow the transfer of data between the patient display device and the patient external device on the basis of the authentication.[0001037] According to one embodiment, the patient external device is configured to allow the transfer of data between the patient display device and the patient external device on the basis of the authentication.[0001038] According to one embodiment, the patient external device is configured to allow the transfer of data between the patient external device and the implantable medical device on the basis of the authentication.[0001039] According to one embodiment, the patient display device is a wearable patient external device or a handset.[0001040] According to one embodiment, the data encrypted by the implantable medical device is related to at least one of: a battery status, a temperature, a time, or an error.[0001041] A server for use in the communication system according to any one of the above embodiments is provided.[0001042] A patient display device for use in the communication system according to any one of the above embodiments is provided.[0001043] A patient external device for use in the communication system according to any one of the above embodiments is provided.[0001044] An implantable medical device for use in the communication system according to any one of the above embodiments is provided.[0001045] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001046] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001047] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001048] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001049] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001050] A system configured for changing pre-programmed treatment settings of an implantable medical device, when implanted in a patient, from a distant remote location in relation to the patient, is provided. The system comprises at least one health care provider, HCP, EID external device, and a HCP private key device. HCP EID external device is adapted to receive a command from the HCP to change said pre-programmed treatment settings of an implanted medical device, and further adapted to beactivated and authenticated and allowed to perform said command by the HCP providing the HCP private key device, wherein the HCP private key device is adapted to be provided to the HCP EID external device via at least one of: a reading slot or comparable for the HCP private key device, and a RFID communication or other close distance wireless activation communication. The HCP EID external device comprises at least one of: a reading slot or comparable for the HCP private key device, a RFID communication, and other close distance wireless activation communication or electrical direct contact. The HCP EID external device further comprises at least one wireless transceiver configured for communication with a data infrastructure server, DDI, through a first network protocol. Further, the system comprises a data infrastructure server, DDI, adapted to receive command from said HCP EID external device and to relay the received command without modifying said command to a patient EID external device, wherein the DDI comprises one wireless transceiver configured for communication with said patient external device, and a patient EID external device adapted to receive the command relayed by the DDI, further adapted to send this command to the implanted medical device, further adapted to receive a command from the HCP EID external device via the DDI to change said pre-programmed treatment settings of the implanted medical device, and further adapted to be activated and authenticated and allowed to perform said command by the patient providing a patient private key device adapted to be provided to the patient EID external device by the patient via at least one of: a reading slot or comparable for the patient private key device, a RFID communication or other close distance wireless activation communication or electrical direct contact. The patient EID external device comprises at least one of a reading slot or comparable for the HCP private key device, a RFID communication, and other close distance wireless activation communication or electrical direct contact. The patient EID external device further comprises at least one wireless transceiver configured for communication with the implanted medical device through a second network protocol. Further, the implanted medical device is configured to treat the patient or perform a bodily function.[0001051] According to one embodiment, at least one of the patient private key device or HCP private key device comprises a hardware key.[0001052] According to one embodiment, the private key device is at least one of, a smartcard, a key-ring device, a watch an arm or wrist band a neckless or any shaped device.[0001053] According to one embodiment of the system, at least two of: the HCP EID external device, the patient EID external device, the HCP private key device, the patient private key device, and the DDI are configured for wireless communication using a standard network protocol.[0001054] According to one embodiment, at least two of: the HCP EID external device, the patient EID external device, the HCP private key device, the patient private key device, and the DDI are configured for wireless communication using a proprietary network protocol.[0001055] According to one embodiment, the patient EID external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the DDI.[0001056] According to one embodiment, the patient EID external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the DDI.[0001057] According to one embodiment, the DDI is configured to use a first frequency band for communication with the patient EID external device and a second frequency band for communication with the patient private key device.[0001058] According to one embodiment, at least one of the HCP EID external device, the patient EID external device, the HCP private key device, the patient private key device and the DDI comprises a Bluetooth transceiver.[0001059] According to one embodiment, at least one of the HCP EID external device, the patient EID external device, the HCP private key device, the patient private key device and the DDI comprises a UWB transceiver.[0001060] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[0001061] According to one embodiment, the patient EID external device comprises a first wireless transceiver for wireless communication with the implantable medical device, and a second wireless transceiver for wireless communication with the DDI, and wherein the second wireless transceiver has longer effective range than the first wireless transceiver.[0001062] According to one embodiment, the patient private key device comprises a first wireless transceiver for wireless communication with the HCP EID external device, and a second wireless transceiver for wireless communication with the DDI, and wherein the second wireless transceiver has longer effective range than the first wireless transceiver.[0001063] According to one embodiment, the second wireless transceiver has an effective range being one of: 2 times, 4 times, 8 time, 20 times, 50 times or 100 times longer than the effective range of the first wireless transceiver.[0001064] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[0001065] According to one embodiment, the patient EID external device is configured to allow transfer of data between the EID external device and the implantable medical device on the basis of an authentication of the patient EID external device.[0001066] According to one embodiment, the patient EID external device is a wearable patient external device or a handset.[0001067] According to one embodiment, the data encrypted by the implantable medical device is related to at least one of: a battery status, a temperature, a time, or an error.[0001068] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001069] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001070] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001071] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001072] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001073] A system is provided, configured for changing pre-programmed treatment settings of an implantable medical device, when implanted in a patient, by a health care provider, HCP, in the physical presence of the patient. The system comprises at least one HCP EID external device adapted to receive a command from the HCP, directly or indirectly, to change said pre-programmed treatment settings in steps of an implantable medical device, when implanted, wherein the HCP EID external device is further adapted to be activated, authenticated, and allowed to perform said command by the HCP providing an HCP private key device comprising a HCP private key. The HCP private key device comprises at least one of: a smart card, a keyring device, a watch, a arm or wrist band, a necklace, and any shaped device. The HCP EID external device is adapted to be involved in at least one of: receiving information from the implant, receiving information from a patient remote external device, actuating the implanted medical device, changing pre-programmed settings, and updating software of the implantable medical device, when implanted. The HCP EID external device is further adapted to be activated, authenticated, and allowed to perform said command also by the patient. The system further comprises a patient private key device comprising a patient private key, wherein the patient private key device comprising at least one of: a smart card, a keyring device, a watch, a arm or wrist band, a necklace, and any shaped device. The HCP private key and the patient private key are required for performing said actions by the HCP EID external device to at least one of: receive information from the implant, to receive information from a patient remote external device, to actuate the implanted medical device, to change pre-programmed settings, and to update software of the implantable medical device, when the implantable medical device is implanted.[0001074] According to one embodiment, the HCP EID external device further comprises a wireless transceiver configured for communication with the implanted medical device through a second network protocol.[0001075] According to one embodiment, the HCP private key device is adapted to be provided to the at least one HCP external device via at least one of: a reading slot or comparable for the HCP private key device, a RFID communication, and a close distance wireless activation communication unit, or electrical direct contact.[0001076] According to one embodiment, the HCP EID external device comprises at least one of reading slot or comparable for the HCP private key device,[0001077] a RFID communication and a close distance wireless activation communication unit, or electrical direct contact.[0001078] According to one embodiment, the HCP EID external device is adapted to receive a command from a HCP dedicated device to change said pre-programmed treatment steps of theimplantable medical device, when implanted, wherein the HCP dedicated device is further adapted to be activated, authenticated, and allowed to perform said command by the HCP providing their private key. [0001079] According to one embodiment, at least two of: the HCP EID external device, the patient EID external device, the HCP private key device, and the patient private key device, are configured for wireless communication using a standard network protocol.[0001080] According to one embodiment, at least two of: the HCP EID external device, the patient EID external device, the HCP private key device, and the patient private key device, are configured for wireless communication using a proprietary network protocol.[0001081] According to one embodiment, the patient EID external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the patient private key device.[0001082] According to one embodiment, the patient EID external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the patient private key device.[0001083] According to one embodiment, at least one of the HCP EID external device, the patient EID external device, the HCP private key device, and the patient private key device comprises a Bluetooth transceiver.[0001084] According to one embodiment, at least one of the HCP EID external device, the patient EID external device, the HCP private key device, and the patient private key device comprises a UWB transceiver.[0001085] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[0001086] According to one embodiment, the patient EID external device comprises a first wireless transceiver for wireless communication with the implantable medical device, and a second wireless transceiver for wireless communication with the patient private key device, and wherein the second wireless transceiver has longer effective range than the first wireless transceiver.[0001087] According to one embodiment, the second wireless transceiver has an effective range being one of: 2 times, 4 times, 8 time, 20 times, 50 times or 100 times longer than the effective range of the first wireless transceiver.[0001088] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[0001089] According to one embodiment, the patient EID external device is configured to allow transfer of data between the EID external device and the implantable medical device on the basis of an authentication of the patient EID external device.[0001090] According to one embodiment, the patient EID external device is a wearable patient external device or a handset.[0001091] According to one embodiment, the data encrypted by the implantable medical device is related to at least one of: a battery status, a temperature, a time, or an error.[0001092] A system is provided, configured to change pre-programmed and pre-selected treatment actions of an implantable medical device, when implanted in a patient, by command from the patient.The system comprises an implantable medical device, a patient remote external device, a wireless transceiver configured for communication with the implantable medical device, when the medical device is implanted, through a second network protocol, and a remote display portal. The remote display portal is configured to receive content delivered from the patient remote external device to expose buttons to express the will to actuate the functions of the implanted medical device by the patient through the patient remote external device, and further configured to present the display portal remotely on a patient display device allowing the patient to actuate the functions of the implanted medical device through the display portal of the patient remote external device visualised on the patient display device.[0001093] According to one embodiment, the wireless transceiver, the remote display portal, and the remote display portal are comprised in the patient remote external device.[0001094] According to one embodiment, the system further comprises the patient display device, which may comprise a supporting application, a display which hosts the Remote Display Portal, and a patient display device private key.[0001095] According to one embodiment, the remote display portal is capable of generating a command to be signed by the patient display device private key.[0001096] According to one embodiment, the patient remote external device is adapted to accept input from the patient via said patient display device through its remote display portal. [0001097] According to one embodiment, the patient remote external device comprises a graphical user interface arranged on a touch-responsive display exposing buttons to express actuation functions of the implanted medical device.[0001098] According to one embodiment, the system is configured to allow the patient to actuate the implant at home through the patient remote external device by means of an authorization granted by a patient private key.[0001099] According to one embodiment, the patient private key comprises at least one of: a smart card, a keyring device, a watch, a arm or wrist band, a necklace, and any shaped device.[0001100] According to one embodiment, the system is configured to allow the patient to actuate the implantable medical device, when implanted, at home through the patient remote external device, using an authorization granted by the patient private key.[0001101] According to one embodiment, system further comprises a patient EID external device comprising at least one of: a reading slot or comparable for the patient private key device, a RFID communication, and a close distance wireless activation communication, or electrical direct contact. [0001102] According to one embodiment, the patient EID external device is adapted to be synchronised with the patient remote external device.[0001103] According to one embodiment, the patient EID external device further comprises at least one of: a wireless transceiver configured for communication with the patient, a remote external device, and a wired connector for communication with the patient remote external device.[0001104] According to one embodiment, the patient EID external device is adapted to generate an authorization to be signed by the patient private key to be installed into at least one of: the patient remote external device through the patient EID external device, and the implantable medical device.[0001105] According to one embodiment, the system comprises a patient display device comprising a supporting application capable of displaying the remote display portal with content delivered from the patient remote external device.[0001106] According to one embodiment, the remote display portal and patient remote external device are adapted to expose buttons to express the will to actuate the functions of the implanted medical device by the patient through the patient remote external device.[0001107] According to one embodiment, the patient display device comprises at least one of: a display which hosts the remote display portal, and a patient display device private key.[0001108] According to one embodiment, the remote display portal is capable of generating a command to be signed by the patient private key.[0001109] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001110] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001111] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001112] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001113] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001114] A system is provided, configured for providing information from an implantable medical device, when implanted in a patient, from a distant remote location in relation to the patient. The system comprises at least one patient EID external device adapted to receive information from the implant, adapted to send such information further on to a server or dedicated data infrastructure, DDI, further adapted to be activated and authenticated and allowed to receive said information by the implanted medical device by the patient providing a private key. Further, the system comprises a patient private key device comprising the private key adapted to be provided to the patient EID external device via at least one of: a reading slot or comparable for the patient private key device, a RFID communication or other close distance wireless activation communication or direct electrical connection. The patient EID external device comprises at least one of: a reading slot or comparable for the patient private key device, an RFID communication, and other close distance wireless activation communication or direct electrical contact. Further, the patient EID external device comprises at least one wireless transceiver configured for communication with the DDI, through a first network protocol.[0001115] According to one embodiment, the at least one patient EID external device is adapted to receive information from the implant, through a second network protocol.[0001116] According to one embodiment, the system comprises the DDI, wherein the DD1 is adapted to receive information from said patient EID external device, and wherein the DDI comprises a wireless transceiver configured for communication with said patient EID external device.[0001117] According to one embodiment, the patient EID external device is adapted to receive a command relayed by the DDI, to further send the command to the implanted medical device to change said pre-programmed treatment settings of the implanted medical device, and further adapted to be activated and authenticated and allowed to perform said command by the patient providing the patient private key.[0001118] According to one embodiment, the patient private key device is adapted to provide the patient private key to the patient EID external device by the patient via at least one of; a reading slot or comparable for the patient private key device, an RFID communication or other close distance wireless activation communication, or electrical direct contact.[0001119] According to one embodiment, the patient EID external device comprises at least one of: a reading slot or comparable for the HCP private key device, a RFID communication, and other close distance wireless activation communication, or direct electrical contact.[0001120] According to one embodiment, the patient EID external device further comprising at least one wireless transceiver configured for communication with the implanted medical device through a second network protocol.[0001121] According to one embodiment, the system comprises the implantable medical device, which may be adapted to, when implanted, treat the patient or perform a bodily function.[0001122] According to one embodiment, the patient private key comprises at least one of: a smart card, a keyring device, a watch, an arm band or wrist band, a necklace, and any shaped device.[0001123] According to one embodiment, at least two of: the patient EID external device, the IDD, and the patient private key device, are configured for wireless communication using a standard network protocol.[0001124] According to one embodiment, at least two of: the patient EID external device, the IDD, and the patient private key device, are configured for wireless communication using a proprietary network protocol.[0001125] According to one embodiment, the patient EID external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the patient private key device.[0001126] According to one embodiment, the patient EID external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the patient private key device.[0001127] According to one embodiment, at least one of the patient EID external device, the patient private key device and the IDD comprises a Bluetooth transceiver.[0001128] According to one embodiment,[0001129] at least one of the patient EID external device, the patient private key device and the IDD comprises a UWB transceiver.[0001130] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[0001131] According to one embodiment, the patient EID external device comprises a first wireless transceiver for wireless communication with the implantable medical device, and a second wireless transceiver for wireless communication with the patient private key device, and wherein the second wireless transceiver has longer effective range than the first wireless transceiver.[0001132] According to one embodiment, the second wireless transceiver has an effective range being one of: 2 times, 4 times, 8 time, 20 times, 50 times or 100 times longer than the effective range of the first wireless transceiver.[0001133] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[0001134] According to one embodiment, the patient EID external device is a wearable patient external device or a handset.[0001135] According to one embodiment, the data encrypted by the implantable medical device is related to at least one of: a battery status, a temperature, a time, or an error.[0001136] According to one embodiment, the system comprises a master private key device configured to allow issuance of a new private key device, wherein the HCP or HCP admin have such master private key device adapted to able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001137] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001138] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001139] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001140] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001141] A system is provided, comprising, an implantable medical device adapted to, when implanted in a patient, to communicate with an external device, the external device comprising at least one of a patient remote external device or a patient EID external device. The system further comprises the patient EID external device adapted to communicate with and send commands to the implantable medical device when implanted, to change pre-programmed settings, and a patient private key device comprising a patient private key, adapted to activate and authenticate and allow to perform said command by the patient EID external device, wherein said private key is adapted to be provided to the external device via at least one of: a reading slot or comparable for the HCP private key device, an RFID communication or other close distance wireless activation communication, or direct electrical contact. Further the system comprises a data infrastructure server, DDI, adapted to send commands to thepatient EID external device for further transport to the implanted medical device, to inactivate the authority and authenticating function of the patient private key.[0001142] According to one embodiment, the at least one patient remote external device comprises a patient remote external device private key, wherein the DDI via the patient EID external device is able to inactivate the authority and authenticating function of the patient remote external device, thereby inactivating the patient remote external device.[0001143] According to one embodiment, the patient EID external device comprises at least one wireless transceiver configured for communication with the DDI via a first network protocol.[0001144] According to one embodiment, the system comprises the DDI, wherein the DDI is adapted to receive command from a HCP EID external device, and to send the received command to the patient EID external device, wherein the DDI comprises a wireless transceiver configured for communication with said patient external device.[0001145] According to one embodiment, the patient EID external device is adapted to receive the command from the DDI, wherein the command originates from a health care provider, HCP, and wherein the patient EID is adapted to inactivate the patient private key and to send the command to the implanted medical device.[0001146] According to one embodiment, the patient EID external device is adapted to receive the command from the DDI, wherein the command originates from a health care provider, HCP, wherein the patient EID external device is adapted to receive the command from the HCP via the DDI to inactivate the patient remote external device comprising a patient remote external device private key, and wherein the patient EID external device is further adapted to send this command to the implanted medical device. [0001147] According to one embodiment, the patient EID external device further comprises at least one wireless transceiver configured for communication with the implanted medical device through a second network protocol.[0001148] According to one embodiment, at least one of the patient private key and a patient remote external device private key comprises a hardware key.[0001149] According to one embodiment, the private key device is at least one of, a smartcard, a key-ring device, a watch an arm or wrist band a neckless or any shaped device.[0001150] According to one embodiment, at least two of: the patient remote external device, the patient EID external device, the patient private key device, and the DDI, are configured for wireless communication using a standard network protocol.[0001151] According to one embodiment, wherein at least two of: the patient remote external device, the patient EID external device, the patient private key device, and the DDI, are configured for wireless communication using a proprietary network protocol.[0001152] According to one embodiment, the patient EID external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the patient private key device.[0001153] According to one embodiment, the patient EID external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the patient private key device.[0001154] According to one embodiment, at least one of the patient remote external device, the patient EID external device, the patient private key device, and the DDI, comprise a Bluetooth transceiver.[0001155] According to one embodiment, at least one of the patient remote external device, the patient EID external device, the patient private key device, and the DDI, comprise an UWB transceiver. [0001156] According to one embodiment, the standard network protocol is one from the list of: Radio Frequency type protocol, RFID type protocol, WLAN type protocol, Bluetooth type protocol, BLE type protocol, NFC type protocol, 3G / 4G / 5G type protocol, and GSM type protocol.[0001157] According to one embodiment, the patient EID external device comprises a first wireless transceiver for wireless communication with the implantable medical device, and a second wireless transceiver for wireless communication with the patient private key device, and wherein the second wireless transceiver has longer effective range than the first wireless transceiver.[0001158] According to one embodiment, the second wireless transceiver has an effective range being one of: 2 times, 4 times, 8 time, 20 times, 50 times or 100 times longer than the effective range of the first wireless transceiver.[0001159] According to one embodiment, the second wireless transceiver is configured to be disabled to enable wireless communication using the first wireless transceiver.[0001160] According to one embodiment, the patient EID external device is a wearable patient external device or a handset.[0001161] According to one embodiment, the data encrypted by the implantable medical device is related to at least one of: a battery status, a temperature, a time, or an error.[0001162] According to one embodiment, the system comprises a master private key device configured to allow issuance of new private key device, wherein the HCP or HCP admin have such master private key device adapted to be able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001163] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001164] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001165] According to one embodiment, the system comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001166] According to one embodiment, the system comprises a food sensor, adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001167] A system is provided, configured for changing pre-programmed treatment settings in steps of an implantable medical device, when implanted in a patient, by a health care provider, HCP, either in the physical presence of the patient or remotely with the patient on distance. The system comprises at least one HCP EID external device adapted to receive a command directly or indirectly from the HCP to change said pre-programmed treatment settings in steps of the implantable medicaldevice, when implanted. The HCP EID external device is further adapted to be activated, authenticated, and allowed to perform said command by the HCP providing a HCP private key device comprising a HCP private key. The HCP private key comprises at least one of: a smart card, a keyring device, a watch, an arm or wrist band, a necklace, and any shaped device. The system further comprises a patient private key device comprising a patient private key, comprising at least one of: a smart card, a keyring device, a watch, an arm or wrist band, a necklace, and any shaped device. Both the HCP and patient private key is required for performing said action by the HCP EID external device to change the pre-programmed settings in the implant and to update software of the implantable medical device, when the implantable medical device is implanted. The patient private key is adapted to activate, be authenticated, and allowed to perform said command provided by the HCP, either via the HCP EID external device or when the action is performed remotely via a patient EID external device.[0001168] According to one embodiment, the system comprises a master private key device that allow issuance of new private key device wherein the HCP or HCP admin have such master private key device adapted to be able to replace and pair a new patient private key device or HCP private key device into the system, through the HCP EID external device.[0001169] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.[0001170] According to one embodiment, the HCP dedicated device and the HCP EID external device are an integrated unit.[0001171] According to one embodiment, the system further comprises a measurement device or sensor adapted to deliver a measurement to at least one of the DDI, patent EID external device and a patient display device.[0001172] According to one embodiment, the system further comprises a food sensor adapted to measure at least if the patient swallows solid food or is drinking fluid, wherein said food sensor is configured to be connected to the control unit of a medical device to cause an action to stretch the stomach after a determined amount of food intake.[0001173] According to one embodiment, the HCP EID external device further comprises a wireless transceiver configured for communication with the implanted medical device through a second network protocol.[0001174] According to one embodiment, the HCP private key device is adapted to be provided to the at least one HCP external device via at least one of: a reading slot or comparable for the HCP private key device, a RFID communication, and a close distance wireless activation communication unit, or electrical direct contact.[0001175] According to one embodiment, the HCP EID external device comprises at least one of: reading slot or comparable for the HCP private key device, a RFID communication, and a close distance wireless activation communication unit, or electrical direct contact.[0001176] According to one embodiment, the HCP EID external device is adapted to receive a command from an HCP dedicated device to change said pre-programmed treatment steps of the implantable medical device, when implanted, wherein the HCP dedicated device is further adapted to be activated, authenticated, and allowed to perform said command by the HCP providing their private key.[0001177] According to one embodiment, the HCP EID external device and the HCP private key device are configured for wireless communication using a standard network protocol.[0001178] According to one embodiment, the HCP EID external device and the HCP private key device are configured for wireless communication using a proprietary network protocol. [0001179] According to one embodiment, the HCP EID external device is configured to use a first network protocol for communication with the implantable medical device and use a second network protocol for communication with the HCP private key device.[0001180] According to one embodiment, the HPC EID external device is configured to use a first frequency band for communication with the implantable medical device and use a second frequency band for communication with the HCP private key device.[0001181] According to one embodiment, at least one of the HCP EID external device and the HCP private key device comprises a Bluetooth transceiver.[0001182] According to one embodiment, at least one of the HCP EID external device and the HCP private key device comprises a UWB transceiver.[0001183] A system is provided, configured for changing pre-programmed treatment settings in steps of an implantable medical device, when implanted in a patient, by a health care provider, HCP, with the patient on remote on distance. The system comprises at least one HCP EID external device adapted to receive a command from the HCP direct or indirect, to change said pre-programmed treatment settings in steps of an implantable medical device, when implanted, wherein the HCP EID external device is further adapted to be activated, authenticated, and allowed to perform said command by the HCP. The action by the HCP EID external device to change pre-programmed settings in the implant and to update software of the implantable medical device, when the implantable medical device is implanted, is adapted to be authenticated by a HCP private key device and a patient private key device. [0001184] According to one embodiment, the HCP private key device comprising a HCP private key, comprising at least one of: a smart card, a keyring device, a watch, an arm or wrist band, a necklace, and any shaped device.[0001185] According to one embodiment, the patient private key device comprises a patient private key, comprising at least one of: a smart card, a keyring device, a watch, an arm or wrist band, a nec...

Claims

319PC - CLAIMS1. An implantable hydraulic or pneumatic pump for pumping a fluid, the implantable hydraulic pump comprising: a reservoir configured to hold the fluid to be pumped, a sealed container comprising an actuator, a rigid outer wall, and an enclosed space, wherein: a first portion of the sealed container encloses a first container volume, and a second portion of the sealed container encloses a second container volume, wherein: the first portion of the sealed container comprises a connecting wall forming a portion of a wall enclosing the reservoir, wherein: the first portion of the sealed container comprises a first movable wall portion connected to the connecting wall, the second portion of the sealed container comprises a second movable wall portion, and wherein: the actuator is directly or indirectly connected to the first movable wall portion, for moving the movable wall portion, for altering a volume of the first portion of the sealed container and a volume of the reservoir, for pumping the fluid to or from the reservoir, and movement of the first movable wall portion causes movement of the second movable wall portion altering a volume of the second portion of the sealed container, such that the volume change of the sealed container is less than the volume change of the reservoir, when the volume of the reservoir is altered for pumping fluid to or from the reservoir, and wherein the rigid outer wall and the first and second movable wall portions encloses the enclosed space, and wherein the enclosed space is configured to hold a liquid for supporting at least a portion of the first movable wall portion and at least a portion of the second movable wall portion.

2. The implantable hydraulic or pneumatic pump according to claim 1, wherein: the first movable wall portion comprises a first movable sealing for sealing between the rigid outer wall and the first movable wall portion, the second movable wall portion comprises a second movable sealing for sealing between the rigid outer wall and the second movable wall portion.

3. The implantable hydraulic or pneumatic pump according to claim 2, wherein at least one of the first and second movable sealing comprises a resilient sealing.

4. The implantable hydraulic or pneumatic pump according to claim 3, wherein the resilient sealing is fixated to the rigid outer wall and to the first movable wall portion.

5. The implantable hydraulic or pneumatic pump according to claim 4, wherein the resilient sealing comprises a resilient polymer material.

6. The implantable hydraulic or pneumatic pump according to any one of claims 2 and 3, wherein at least one of the first and second movable sealing comprises a sliding sealing.

7. The implantable hydraulic or pneumatic pump according to claim 6, wherein the sliding sealing is configured to be fixated to the first or second movable wall portion and configured to sealingly slide against the rigid outer wall.

8. The implantable hydraulic or pneumatic pump according to claim 7, wherein the sliding sealing comprises a polymer material.

9. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 8, wherein the volume of the sealed container remains substantially the same when the volume of the reservoir is altered for pumping fluid to or from the reservoir.

10. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 9, wherein the volume of the enclosed space remains substantially the same when the volume of the reservoir is altered for pumping fluid to or from the reservoir.

11. The implantable hydraulic or pneumatic pump according to claim any one of claims 1 - 10, wherein the volume of the sealed container is altered less than 10% when the volume of the reservoir is altered for pumping fluid to or from the reservoir.

12. The implantable hydraulic or pneumatic pump according to claim 11, wherein the volume of the sealed container is altered less than 5% when the volume of the reservoir is altered for pumping fluid to or from the reservoir.

13. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 12, wherein at least a portion of the first movable wall portion being in contact with the fluid in the reservoir, comprises metal.

14. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 13, wherein at least a portion of the second movable wall portion comprises metal.

15. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 14, wherein at least 50% of the area of the wall enclosing the sealed container comprises metal.

16. The implantable hydraulic or pneumatic pump according to claim 15, wherein at least 80% of the area of the wall enclosing the sealed container comprises metal.

17. The implantable hydraulic or pneumatic pump according to claim 16, wherein at least 90% of the area of the wall enclosing the sealed container comprises metal.

18. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 17, wherein at least one of the first and second portion of the sealed container comprises elevated and lowered portions, and wherein the elevated and lowered portions enable at least one of compression and expansion of the sealed container.

19. The implantable hydraulic or pneumatic pump according to claim 18, wherein at least one of the first and second portion of the sealed container comprises a bellows.

20. The implantable hydraulic or pneumatic pump according to claim 19, wherein the bellows comprises metal.

21. The implantable hydraulic or pneumatic pump according to claim 20, wherein the bellows is a metallic bellows.

22. The implantable hydraulic or pneumatic pump according to any one of the preceding claims, wherein: the first portion of the sealed container comprises elevated and lowered portions, and the second portion of the sealed container comprises elevated and lowered portions, and wherein the elevated and lowered portions enable compression and expansion of the first and second portions of the sealed container.

23. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 22, further comprising a connecting element configured to connect the first movable wall portion to the second movable wall portion, such that movement of the first movable wall portion propagates to the second movable wall portion.

24. The implantable hydraulic or pneumatic pump according to claim 23, wherein the connecting element: is elongated, is positioned inside of the sealed container comprises a first portion being directly or indirectly fixated to the first movable wall portion, and comprises a second portion being directly or indirectly fixated to the second movable wall portion.

25. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 24, wherein the first portion of the sealed container can be altered such that the volume of the first portion of the sealed container is more than 20% of the volume of the sealed container.

26. The implantable hydraulic or pneumatic pump according to claim 25, wherein the first portion of the sealed container can be altered such that the volume of the first portion of the sealed container is more than 40% of the volume of the sealed container.

27. The implantable hydraulic or pneumatic pump according to claim 26, wherein the first portion of the sealed container can be altered such that the volume of the first portion of the sealed container is more than 60% of the volume of the maximum volume of the reservoir.

28. The implantable hydraulic or pneumatic pump according to any one of claim 1 - 27, wherein at least one of the first and second portion of the sealed container comprises at least one flexible portion, and wherein the flexible portion enable at least one of compression and expansion of the sealed container.

29. The implantable hydraulic or pneumatic pump according to claim 28, wherein at least one of the first and second portion of the sealed container comprises at least one elastic portion, and wherein the elastic portion enable at least one of compression and expansion of the sealed container.

30. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 29, wherein at least one of the first and second portion of the sealed container comprises an oval cross-section.

31. The implantable hydraulic or pneumatic pump according to claim 30, wherein at least one of the first and second portion of the sealed container comprises an elliptic cross-section.

32. The implantable hydraulic or pneumatic pump according to claim 31, wherein at least one of the first and second portion of the sealed container comprises a circular cross-section.

33. The implantable hydraulic or pneumatic pump according to any one of the claims 1 - 32, wherein the sealed container is configured to enclose a gas.

34. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 32, wherein the sealed container is configured to enclose a liquid.

35. The implantable hydraulic or pneumatic pump according to claim 34, wherein the implantable hydraulic or pneumatic pump further comprises a liquid configured to be enclosed in the sealed container.

36. The implantable hydraulic or pneumatic pump according to claim 35, wherein the liquid is a liquid selected from a list consisting of: dielectric silicone oil, synthetic single-phase liquid dielectric fluid, a 2-phase coolant,Fluorinert, andNovec.

37. The implantable hydraulic or pneumatic pump according to any one of claim 1 - 36, wherein the sealed container further comprises an implantable energy source for powering the actuator.

38. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 37, wherein the sealed container further comprises a controller for controlling the actuation of the actuator.

39. The implantable hydraulic or pneumatic pump according to any one of the preceding claims, wherein the sealed container further comprises at least one sensor or measuring device for measuring at least one of: a pressure in the sealed container, a pressure in the reservoir, a pressure in the body of the patient, a pressure difference between the pressure in the sealed container and the pressure in the reservoir, and a pressure difference between the pressure in the sealed container and the pressure in the body of the patient.

40. The implantable hydraulic or pneumatic pump according to claim 39, wherein the controller is configured to control the actuation of the actuator on the basis of input from the sensor or measuring device.

41. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 40, further comprising at least one conduit for connecting the reservoir to an active portion of an implant configured for receiving the fluid pumped by the implantable hydraulic pump.

42. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 41, wherein the reservoir comprises an oval cross-section.

43. The implantable hydraulic or pneumatic pump according to claim 42, wherein the reservoir comprises an elliptic cross-section.

44. The implantable hydraulic or pneumatic pump according to claim 43, wherein the reservoir comprises a circular cross-section.

45. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 44, wherein the actuator comprises at least one electrical motor.

46. The implantable hydraulic or pneumatic pump according to claim 45, wherein the electrical motor is positioned at least partially in the first portion.

47. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 46, wherein the actuator comprises at least one transmission, and wherein the transmission is configured to: receive mechanical force, and reduce the speed and increase the force of the received mechanical force.

48. The implantable hydraulic or pneumatic pump according to claim 47, wherein the transmission comprises a gear system configured to reduce the speed and increase the force of the received mechanical force.

49. The implantable hydraulic or pneumatic pump according to any one of claims 47 - 48, wherein the transmission is configured to receive a rotating mechanical force, and wherein the transmission is configured to transform the received rotating mechanical force into a liner mechanical force.

50. The implantable hydraulic or pneumatic pump according to any one of claims 47 - 49, wherein the transmission comprises a receiving portion connected to the electrical motor.

51. The implantable hydraulic or pneumatic pump according to any one of claims 47 - 50, wherein the transmission is positioned at least partially in the first portion of the sealed container.

52. The implantable hydraulic or pneumatic pump according to any one of claims 46 - 51, wherein at least one of the electrical motor and the transmission is fixedly fixated to a wall of the sealed container.

53. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 52, wherein the sealed container is hermetically enclosed by a metallic layer.

54. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 53, wherein a portion of a wall of the sealed container comprises at least one sealed entry for transferring electrical signals into the sealed container.

55. The implantable hydraulic or pneumatic pump according to claim 54, wherein the sealed entry comprises ceramic material.

56. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 55, further comprising a second reservoir configured to hold a fluid to be pumped, and wherein the secondportion of the sealed container is configured to protrude into the second reservoir, such that a wall of the second portion of the sealed container forms a portion of a wall enclosing the second reservoir, and wherein the actuator is directly or indirectly connected to the second movable wall portion, for moving the second movable wall portion, for altering a volume of the second portion of the sealed container and a volume of the second reservoir, for pumping the fluid to or from the second reservoir, and wherein volume change of the sealed container is less than the volume change of the second reservoir, when the volume of the second reservoir is altered for pumping fluid to or from the second reservoir.

57. The implantable hydraulic or pneumatic pump according to claim 56, further comprising at least one conduit for connecting the second reservoir to an active portion of an implant configured for receiving the fluid pumped by the implantable hydraulic pump.

58. The implantable hydraulic or pneumatic pump according to any one of claims 56 and 57, wherein: actuation of the actuator in a first direction: moves fluid from the first reservoir to an active portion of an implant, and moves fluid from an active portion of an implant to the second reservoir, and actuation of the actuator in a second direction: moves fluid from an active portion of an implant to the first reservoir, and moves fluid from the second reservoir to an active portion of an implant.

59. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 58, wherein at least one of the first and second reservoir is compressible and comprises a third movable wall portion, and wherein movement of: the first movable wall portion of the first portion of the sealed container, or the second movable wall portion of the second portion of the sealed container, moves the third movable wall portion which compresses the first or second reservoir and pumps hydraulic fluid from the first or second reservoir.

60. The implantable hydraulic or pneumatic pump according to claim 59, wherein: actuation of the actuator in a first direction: moves fluid from the first reservoir to an active portion of an implant, and moves fluid from the second reservoir to an active portion of an implant, and actuation of the actuator in a second direction: moves fluid from an active portion of an implant to the first reservoir, and moves fluid from an active portion of an implant to the second reservoir.

61. The implantable hydraulic or pneumatic pump according to any one of claims 59 and 60, wherein the third movable wall portion is mechanically connected to one of the first and second movable wall portions.

62. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 62, further comprising a pressure direction alteration device connected to at least one of the first and second reservoir for changing the direction of the flow of the hydraulic fluid.

63. The implantable hydraulic or pneumatic pump according to claim 62, wherein the second reservoir is connected to the pressure direction alteration device, such that: actuation of the actuator in a first direction: moves fluid from the first reservoir to an active portion of an implant, and moves fluid from the second reservoir to an active portion of an implant, and actuation of the actuator in a second direction: moves fluid from an active portion of an implant to the first reservoir, and moves fluid from an active portion of an implant to the second reservoir.

64. The implantable hydraulic or pneumatic pump according to any one of claims 62 and 63, wherein the pressure direction alteration device comprises at least one alteration reservoir configured to hold a hydraulic fluid, the alteration reservoir comprises a movable wall portion, wherein compression of at least one portion of the sealed container causes movement of the movable wall portion which causes compression of the alteration reservoir such that hydraulic fluid is pumped out of the alteration reservoir.

65. The implantable hydraulic or pneumatic pump according to claim 64, wherein the alteration reservoir is directly or indirectly connected to at least one of the first movable wall portion of the first portion of the sealed container and the second movable wall portion of the second portion of the sealed container.

66. The implantable hydraulic or pneumatic pump according to claim 65, wherein the alteration reservoir is fluidly connected to at least one of the first movable wall portion of the first portion of the sealed container and the second movable wall portion of the second portion of the sealed container.

67. The implantable hydraulic or pneumatic pump according to claim 66, further comprising a hydraulic actuator in fluid connection with at least one of the first movable wall portion of the first portion of the sealed container and the second movable wall portion of the second portion of the sealed container.

68. The implantable hydraulic or pneumatic pump according to claim 67, wherein the hydraulic actuator comprises one of: a hydraulic cylinder, and an operable actuation reservoir.

69. The implantable hydraulic or pneumatic pump according to claim 68, wherein the hydraulic actuator is mechanically connected to the alteration reservoir.

70. The implantable hydraulic or pneumatic pump according to any one of claims 67 - 69, further comprising fluid conduit for connecting the hydraulic actuator to at least one of the first reservoir and the second reservoir.

71. The implantable hydraulic or pneumatic pump according to any one of claims 64 - 70, wherein at least one of: the first reservoir, the second reservoir, the hydraulic actuator and the alteration reservoir comprises elevated and lowered portions enabling at least one of compression and expansion of at least one of the: the first reservoir, the second reservoir, the hydraulic actuator and the alteration reservoir.

72. The implantable hydraulic or pneumatic pump according to claim 71, wherein at least one of: the first reservoir, the second reservoir, the hydraulic actuator and the alteration reservoir comprises a bellows.

73. The implantable hydraulic or pneumatic pump according to any one of claims 62 - 72, further comprising a second pressure direction alteration device connected to at least one of the first and second reservoir, for changing the direction of the flow of the hydraulic fluid.

74. The implantable hydraulic or pneumatic pump according to claim 73, wherein the first and second pressure direction alteration device are both connected to one of the first and second reservoir, for changing the direction of the flow of the hydraulic fluid.

75. The implantable hydraulic or pneumatic pump according to any one of claims 62 - 74, wherein at least one of the first and second pressure direction alteration device comprises a first and second alteration reservoir for changing the direction of the flow of the hydraulic fluid.

76. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 75, wherein at least one of: the first reservoir comprises a first and second reservoir portion fluidly separated from each other, and the second reservoir comprises a third and fourth reservoir portion fluidly separated from each other.

77. The implantable hydraulic or pneumatic pump according to claim 76, wherein at least one of: compression of the first reservoir results in compression of the first and second reservoir portion of the first reservoir, and compression of the second reservoir results in compression of the third and fourth reservoir portion of the second reservoir.

78. The implantable hydraulic or pneumatic pump according to any one of claims 76 and 77, further comprising at least one of: a first conduit for connecting the first reservoir portion to an active portion of an implant and a second conduit for connecting the second reservoir portion to an active portion of an implant, anda third conduit for connecting the third reservoir portion to an active portion of an implant and a fourth conduit for connecting the fourth reservoir portion to an active portion of an implant.

79. The implantable hydraulic or pneumatic pump according to any one of claims 76 - 77, wherein at least one of the: the first reservoir portion, the second reservoir portion, the third reservoir portion and the fourth reservoir portion comprises elevated and lowered portions enabling at least one of compression and expansion of at least one of the first reservoir portion, the second reservoir portion, the third reservoir portion and the fourth reservoir portion.

80. The implantable hydraulic or pneumatic pump according to claim 79, wherein at least one of: the first reservoir portion, the second reservoir portion, the third reservoir portion and the fourth reservoir portion comprises a bellows.

81. The implantable hydraulic or pneumatic pump according to any one of the preceding claims, wherein at least a portion of a wall of at least one of: the sealed container, the first reservoir, the second reservoir, and the alteration reservoir comprises titanium.

82. The implantable hydraulic or pneumatic pump according to claim 81, wherein at least one of: the sealed container, the first reservoir, the second reservoir, and the alteration reservoir comprises a titanium bellows.

83. The implantable hydraulic or pneumatic pump according to any one of claims 1 - 82, wherein the actuator is a piezoelectric actuator.

84. The implantable hydraulic or pneumatic pump according to claim 83, wherein the piezoelectric actuator comprises a piezoelectric motor.

85. The implantable hydraulic or pneumatic pump according to claim 84, wherein the piezoelectric motor is a piezoelectric inchworm motor.

86. The implantable hydraulic or pneumatic pump according to claim 84, wherein the piezoelectric motor is a piezoelectric inertial motor.

87. The implantable hydraulic or pneumatic pump according to claim 84, wherein the piezoelectric motor is a piezoelectric walk-drive motor.

88. The implantable hydraulic or pneumatic pump according to any one of claims 83 - 87, wherein the piezoelectric actuator is a linear piezoelectric actuator.

89. The implantable hydraulic or pneumatic pump according to claim 88, wherein the linear piezoelectric actuator operates with at least one of: a speed in the range Imm / s to lOmm / s, a stroke length in the range 4mm - 30mm, and a force in the range 2N - 3 ON.

90. The implantable hydraulic or pneumatic pump according to any one of claims 84 - 87, wherein the piezoelectric motor is a rotational piezoelectric motor.

91. The implantable hydraulic or pneumatic pump according to claim 90, wherein the rotational piezoelectric motor is configured to operate with at least one of: a rotational speed in the range 1 mrad / s - 100 mrad / s, anda torque in the range lOONmm - 900Nmm.

92. The implantable hydraulic or pneumatic pump according to claim 84, wherein the piezoelectric motor is a piezoelectric ultrasonic motor.

93. The implantable hydraulic or pneumatic pump according to claim 92, wherein the piezoelectric ultrasonic motor is a traveling wave ultrasonic motor.

94. The implantable hydraulic or pneumatic pump according to claim 92, wherein the piezoelectric ultrasonic motor is a standing wave ultrasonic motor.

95. The implantable hydraulic or pneumatic pump according to any one of claims 92 - 94, wherein the piezoelectric ultrasonic motor is a rotational piezoelectric ultrasonic motor configured to operate with at least one of: a rotational speed in the range 10 mrad / s - 10000 mrad / s, and a torque in the range 20 Nmm - 450 Nmm.

96. The implantable hydraulic or pneumatic pump according to any one of claims 92 - 94, wherein the piezoelectric ultrasonic motor is a linear piezoelectric ultrasonic motor configured to operate with at least one of: a speed in the range 4mm / s - lOmm / s, and a force in the range 0,5N - 30N.

97. The implantable hydraulic or pneumatic pump according to any one of claims 83 - 96, wherein the piezoelectric actuator comprises at least one bimorph piezoelectric actuator.

98. The implantable hydraulic or pneumatic pump according to any one of claims 83 - 97, wherein the piezoelectric actuator is substantially non-magnetic.

99. The implantable hydraulic or pneumatic pump according to any one of claims 83 - 98, wherein the piezoelectric actuator is substantially non-metallic.

100. The medical device according to any one of claims 83 - 99, wherein the piezoelectric actuator is a reversable piezoelectric actuator.

101. An implantable device for exerting a force on a body portion of the patient comprising the implantable hydraulic or pneumatic pump according to any one of claims 1 - 100 and an active portion of an implant comprising an implantable element configured to exert a force on a body portion of the patient.

102. The implantable device according to claim 101, wherein the implantable element configured to exert a force on a body portion of the patient comprises an implantable hydraulic constriction device for constricting a luminary organ of the patient.

103. The implantable device according to claim 102, wherein the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting an intestine of the patient.

104. The implantable device according to claim 103, wherein the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a colon or rectum of the patient.

105. The implantable device according to claim 103, wherein the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting the intestine at a region of a stoma of the patient.

106. The implantable device according to claim 105, wherein the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a blood vessel of the patient.

107. The implantable device according to claim 106, wherein the implantable hydraulic constriction device for constricting a blood vessel of the patient is configured to constrict the venous blood flow leading from an erectile tissue for promoting the engorgement of the erectile tissue.

108. The implantable device according to claim 102, wherein the implantable hydraulic constriction device comprises an implantable hydraulic constriction device for constricting a vas deference of the patient.

109. The implantable device according to claim 101, wherein the implantable element configured to exert a force on a body portion of the patient is an implantable element for actively emptying the urinary bladder of the patient.

110. The implantable device according to claim 109, wherein the implantable element for actively emptying the urinary bladder of the patient is configured to empty the bladder of the patient by compressing the urinary bladder from the outside thereof.

111. An implantable energized medical device configured to be held in position by a tissue portion of a patient, the medical device comprising: a first portion configured to be placed on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and comprising a first surface configured to face a first tissue surface of the first side of the tissue portion, a second portion configured to be placed on a second side of the tissue portion, the second side opposing the first side, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage a second tissue surface of the second side of the tissue portion, a connecting portion configured to be placed through a hole in the tissue portion extending between the first and second sides of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and being configured to connect the first portion to the second portion, wherein: the first, second, and third planes are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, such that the first portion and second portion are prevented from travelling through the hole in the tissue portion in a direction perpendicular to the first, second and third planes, and wherein, the second portion comprises the implantable hydraulic or pneumatic pump according to any one of claims 1 -112. The implantable energized medical device according to claim 111, wherein the connecting portion comprises a flexible structure enabling the connecting portion to flex.

113. The implantable energized medical device according to any one of claims 111 - 112, further comprising a hermetic seal arrangement configured to enclose the connecting portion so as to prevent fluid from the patient from entering the connecting portion.

114. The implantable energized medical device according to any one of claims 112 - 113, wherein the flexible structure is configured to allow the connecting portion to flex in more than one direction.

115. The implantable energized medical device according to any one of claims 112 - 114, wherein the flexible structure is configured to allow the connecting portion to flex in all directions.

116. The implantable energized medical device according to any one of claims 112 - 115, wherein the flexible structure comprises a bellows.

117. The implantable energized medical device according to claim 116, wherein the bellows is a metallic bellows.

118. The implantable energized medical device according to claim 117, wherein the metallic bellows is welded.

119. The implantable energized medical device according to any one of claims 116 - 118, wherein the bellows is a titanium bellows.

120. The implantable energized medical device according to any one of claims 116 - 119, wherein the bellows form part of the hermetic seal arrangement.

121. The implantable energized medical device according to any one of claims 111 - 120, wherein the connecting portion and the second portion are configured to form a unit having a central axis extending from a first end of said unit to a second end of said unit, the first end being proximal to the first portion and the second end being distal to the first portion, wherein a physical footprint of said unit perpendicular to the central axis decreases continuously or stepwise from the first end to the second end of said unit.

122. The implantable energized medical device according to claim 121, wherein said physical footprint comprises a cross-sectional area perpendicular to the central axis.

123. The implantable energized medical device according to claim 121 or 122, wherein the connecting portion and the second portion are one of: configured to reversibly connect to each other to form said unit; or configured to irreversibly connect to each other to form said unit; or configured as a single body forming said unit.

124. The implantable energized medical device according to any one of the preceding claims, wherein said unit comprises an angled section forming a bend in said unit.

125. The implantable energized medical device according to claim 124, wherein the bend is between 15° and 165°, such as between 30° and 150°, such as between 45° and 135°, such as substantially 90°.

126. The implantable energized medical device according to any one of claims 111 - 125, wherein:the first portion comprises a first wireless energy receiver for receiving energy transmitted wirelessly by an external wireless energy transmitter, and an internal wireless energy transmitter configured to transmit energy wirelessly to the second portion, and the second portion comprises a second wireless energy receiver configured to receive energy transmitted wirelessly by the internal wireless energy transmitter.

127. The implantable energized medical device according to claim 126, wherein the first portion comprises a first energy storage unit connected to the first wireless energy receiver.

128. The implantable energized medical device according to any one of claims 126 and 127, wherein the second portion comprises a second energy storage unit connected to the second wireless energy receiver. the second portion is hermetically sealed by means of an outer wall of the second portion comprising titanium.

129. The implantable energized medical device according to any one of claims 111 - 129, wherein the first portion comprises an outer wall comprising a polymer material.

130. The implantable energized medical device according to claim 129, wherein the outer wall of the first portion consists of the polymer material.

131. The implantable energized medical device according to any one of claims 111 - 130, wherein the second portion is hermetically sealed with respect to the connecting portion and the first portion.

132. The implantable energized medical device according to any one of claims 111 - 131, wherein the outer wall of the second portion comprises a ceramic portion integrated in, or brazed to, a titanium portion.

133. The implantable energized medical device according to claim 132, wherein the ceramic portion of the second portion comprises at least one metallic lead travelling through the ceramic portion for transferring electrical energy or information from within the second portion to an outside of the second portion and / or from the outside of the second portion to an inside of the second portion.

134. The implantable energized medical device according to claim 132 or 133, wherein the at least one metallic lead is integrated in, or brazed to, the ceramic portion of the second portion, such that the at least one metallic lead can pass said ceramic portion without being further insulated.

135. The implantable energized medical device according to any one of claims 132 to 134, wherein the connecting portion comprises an outer wall comprising titanium.

136. The implantable energized medical device according to claim 135, wherein the outer wall of the connecting portion comprises a ceramic portion integrated in, or brazed to, the titanium.

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