Stretching device

Abstract

The present disclosure relates to a medical device for actively stretching a patient's stomach wall to induce satiety, the medical device being implantable and comprising a first member configured to be secured to a first portion of the stomach wall, a second member configured to be secured to a second portion of the stomach wall, and a manipulation device for manipulating the second member to displace the second member in a first direction relative to the first member to stretch the stomach wall between the first and second portions.

Description

[Technical Field]

[0001] This invention relates to a medical implant. More specifically, this invention relates to a medical implant for stretching the stomach wall of a patient to induce a feeling of fullness. [Background technology]

[0002] When a person eats or drinks, the ingested food fills the stomach, causing stretching of the stomach wall. This stretching activates stretch receptors, which are abundant in the fundus of the stomach. When these stretch receptors are activated, the patient feels full, and their desire to eat decreases. [Overview of the project]

[0003] According to one embodiment, a medical device is provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device is implantable and comprises a first member configured to be fixed to a first portion of the stomach wall and a second member configured to be fixed to a second portion of the stomach wall. The medical device further comprises an operating device for operating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions. At least one of the first and second members is flexible in a second direction substantially perpendicular to the first direction in order to conform the medical device to the curvature of the patient's stomach and / or to facilitate insertion of the medical device into the patient's body.

[0004] According to one embodiment, the operating device is further configured to operate the second member in a third direction relative to the first member in order to stretch the stomach wall between the first and second parts.

[0005] According to one embodiment, the medical device further comprises a third member configured to be fixed to a third portion of the stomach wall. The operating device may further be configured to operate the third member to displace the third member relative to at least one of the first and second members in order to stretch the stomach wall between the third portion and at least one of the first and second portions.

[0006] According to one embodiment, the medical device further comprises a fourth member configured to be fixed to a fourth portion of the stomach wall. The operating device may further be configured to operate the fourth member to displace the fourth member relative to at least one of the first, second, and third members in order to stretch the stomach wall between the fourth portion and at least one of the first, second, and third portions.

[0007] According to one embodiment, at least one of the first, second, third, and fourth members is fixed to the main part in an inoperable manner. According to one embodiment, at least two of the first, second, third, and fourth members are fixed to the main part in an inoperable manner. According to one embodiment, at least one of the first, second, third, and fourth members is fixed to the main part in an operable manner.

[0008] According to one embodiment, at least two of the first, second, third, and fourth members are movably fixed to the main part.

[0009] The main part can constitute at least a part of the operating device.

[0010] At least one of the first member, second member, third member, and fourth member can constitute at least a part of the operating device.

[0011] According to one embodiment, a member that is fixed to the main part in an inoperable manner can constitute at least a part of the operating device.

[0012] According to one embodiment, two members fixed to the main body in an inoperable manner each constitute at least a part of the operating device.

[0013] According to one embodiment, the first member is immovably fixed to the main body portion and constitutes the first part of the operating device, and the second member is immovably fixed to the main body portion and constitutes the second part of the operating device. The first part of the operating device may be configured to operate the third member, and the second part of the operating device may be configured to operate the fourth member.

[0014] According to one embodiment, the first member is immovably fixed to the main part and is composed of the first part of the operating device and the second part of the operating device. The first part of the operating device is configured to operate the third member, and the second part of the operating device is configured to operate the fourth member.

[0015] At least one of the first, second, third, and fourth members may be elongated.

[0016] At least one of the first, second, third, and fourth members can be fixed by a hinge to enable pivotal movement.

[0017] According to one embodiment, at least one of the first, second, third, and fourth members may be configured to be at least partially invaded by the tissue of the gastric wall.

[0018] According to one embodiment, at least one of the first, second, third, and fourth members includes at least one fixing portion configured to fix the member to the tissue of the gastric wall using at least one of a suture, a stapler, or a tissue growth promoting structure. The at least one fixing portion may be composed of at least one of a through hole and a recess for receiving at least one of a suture or a stapler.

[0019] In any embodiment, the operating device may be a mechanical operating device and / or a hydraulic operating device.

[0020] According to one embodiment, the operating device comprises at least one electric motor, and the operating device may further comprise a gear system configured to reduce the speed of motion and increase the force generated by the electric motor.

[0021] According to one embodiment, the operating device is configured to be powered remotely. The operating device may also be powered remotely using mechanical force. The medical device may further include a receiving part configured to receive mechanical force and a transmission part for converting the received mechanical force into a force to displace at least one of the gastric wall extension members.

[0022] According to one embodiment, the receiving portion may be configured to receive rotational mechanical force, and the transmission portion may be configured to convert the received rotational mechanical force into linear mechanical force.

[0023] According to one embodiment, the receiving portion is configured to receive linear mechanical forces.

[0024] In some embodiments, the operating device may be configured to be powered remotely by hydraulic pressure, and in such embodiments, the medical device may further include a receiving section configured to receive hydraulic pressure, and a transmission for converting the received hydraulic pressure into a force for displacing at least one of the members for stretching the stomach wall. The transmission unit may consist of at least one hydraulic cylinder.

[0025] The medical device may further include a housing configured to enclose at least a portion of the operating device, the housing may be flexible to allow displacement of at least one component. The housing may constitute the main part.

[0026] The medical device may further include a power storage device for supplying power directly or indirectly to the medical device, and a control device for controlling the operating device.

[0027] The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0028] The medical device may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor. The sensor may be configured to sense physical parameters of the medical device system.

[0029] According to one embodiment, the sensor is configured to sense at least one of the following: the temperature of the medical device system, parameters related to the power consumption of the medical device system, parameters related to the strain of the medical device system, parameters related to the state of the energy storage unit, parameters related to the wireless transfer of energy from an external energy source to the patient's body, and hydraulic pressure.

[0030] According to one embodiment, the sensor is configured to sense the patient's physiological parameters, and may be configured to sense at least one of the following: parameters related to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygen concentration, blood pressure, parameters related to ischemic markers, or pH.

[0031] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0032] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0033] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an external information source outside the patient's body.

[0034] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0035] In any embodiment of this specification, the medical device may further include a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0036] The implantable energy storage device may also be a solid-state battery.

[0037] The implantable energy storage device may also be a thionyl chloride cell.

[0038] Medical devices are designed to generate sensations detectable by the patient's senses. It can include even more containers.

[0039] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0040] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0041] The controller can be configured to receive signals from sensors located outside the patient's body.

[0042] In some embodiments, the medical device may further include an electrode arrangement configured to engage with and electrically stimulate the gastric muscle tissue in order to exercise the muscle tissue in order to improve the conditions for long-term implantation of the medical device.

[0043] Medical device systems are further provided. A medical device system comprises a medical device described in any embodiment herein and an implantable remote unit connected to the medical device.

[0044] The implantable remote unit may include an energy storage unit for directly or indirectly supplying power to a medical device. The implantable remote unit may also include an energy receiver for wirelessly receiving energy from an energy source located outside the patient's body.

[0045] According to any one embodiment of this specification, the medical device system may include a controller for controlling the medical device system. The controller may include a wireless transceiver for wireless communication with a source outside the patient's body. The implantable remote unit may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor.

[0046] The sensor may be configured to sense physical parameters of the medical device system. The sensor may be configured to sense at least one of the following: temperature of the medical device system, parameters related to the power consumption of the medical device system, parameters related to the strain of the medical device system, parameters related to the state of the energy storage unit, parameters related to the radio transmission of energy from an external source to the patient's body, and hydraulic pressure.

[0047] According to one embodiment, the sensor is configured to sense the physiological parameters of a patient, and may be configured to sense at least one of the following: parameters relating to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygen concentration, blood pressure, parameters relating to ischemic markers, or pH.

[0048] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0049] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0050] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an information source located outside the patient's body.

[0051] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0052] In any embodiment of this specification, the medical device may further include a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0053] The implantable energy storage device may also be a solid-state battery.

[0054] The implantable energy storage device may also be a thionyl chloride cell.

[0055] The medical device may further include a sensory generator adapted to produce a sensation detectable by the patient's senses.

[0056] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0057] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0058] The controller can be configured to receive signals from sensors located outside the patient's body.

[0059] According to one embodiment, a planted remote unit constitutes at least part of an operating device. Part of the operating device may include at least one electric motor and further include a gear system configured to reduce the speed and increase the force of the motion generated by the electric motor. In some embodiments, part of the operating device includes at least one hydraulic pump.

[0060] The medical device system may further comprise a force transmission element configured to mechanically transmit force from an implantable remote unit to the medical device. The force transmission element may be configured to transmit rotational mechanical force from the implantable remote unit to the medical device, and / or linear mechanical force from the implantable remote unit to the medical device.

[0061] According to one embodiment, the medical device system further comprises a force transmission element configured to hydraulically transmit force from an implantable remote unit to the medical device.

[0062] According to one embodiment, the medical device system further comprises at least one lead for transmitting electrical energy and / or information from an implantable remote unit to the medical device.

[0063] According to one embodiment, the medical device system further comprises at least one injection port for injecting fluid into the medical device system.

[0064] A method is further provided for implanting a medical device for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device comprises a first member configured to be fixed to a first portion of the stomach wall, a second member configured to be fixed to a second portion of the stomach wall, and an operating device for operating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions. At least one of the first member and the second member is characterized by having flexibility in a second direction substantially perpendicular to the first direction. The method includes making an incision in the patient's abdomen to access the stomach, making an incision in a portion of the stomach, inserting the medical device into the patient's abdomen, using the flexibility of at least one of the first and second members to adapt the medical device to the curvature of the patient's stomach, fixing the first member to a first portion of the stomach wall, and fixing the second member to a second portion of the stomach wall.

[0065] According to one embodiment, the medical device further comprises a third member configured to be fixed to a third portion of the stomach wall, and the method further comprises the step of fixing the third member to the third portion of the stomach wall.

[0066] According to one embodiment, the medical device further comprises a fourth member configured to be fixed to a fourth portion of the stomach wall, and the method comprises the step of fixing the fourth member to the fourth portion of the stomach wall.

[0067] According to one embodiment, at least one of the first, second, third, and fourth members is connected to a main portion, and the method includes using the flexibility of at least one of the first, second, third, and fourth members to adapt the medical device to the curvature of the patient's stomach by rotating at least one of the first, second, third, and fourth members relative to the main portion.

[0068] According to one embodiment, at least one of the steps of fixing the first member to a first portion of the stomach wall and fixing the second member to a second portion of the stomach wall comprises causing at least a portion of the first member and the second member to be penetrated by the tissue of the stomach wall.

[0069] According to one embodiment, at least one of the steps of fixing a first member to a first portion of the stomach wall and fixing a second member to a second portion of the stomach wall comprises fixing at least one of the first and second members to the stomach wall tissue using at least one of sutures, staplers, or tissue growth promoting structures.

[0070] This method may further include placing at least one sensor in the area of ​​the patient's esophagus to sense parameters related to the patient's swallowing.

[0071] The step of placing at least one sensor in the area of ​​the patient's esophagus to sense parameters related to the patient's swallowing may consist of placing at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0072] According to one embodiment, placing at least one sensor in the patient's stomach region comprises placing a sensor for sensing parameters related to the patient's diet.

[0073] According to one embodiment, the step of placing at least one sensor in the patient's stomach region to sense parameters related to the patient's diet comprises placing at least one of the following: a temperature sensor, a blood saturation or oxygenation sensor, a blood pressure sensor, a sensor configured to sense parameters related to ischemic markers, or a pH sensor. The step of sensing pH may comprise sensing the acidity within the stomach.

[0074] According to one embodiment, the method may further include arranging an electrode configuration configured to be positioned between a medical device and the stomach to engage with the gastric muscle tissue, electrically stimulate it to move the muscle tissue, and improve the conditions for long-term implantation of the medical device.

[0075] According to one embodiment, the method further includes placing an implantable remote unit connected to a medical device inside the patient's body, the step of placing an implantable remote unit connected to a medical device inside the patient's body may include placing an implantable remote unit that constitutes at least a part of an operating device.

[0076] According to one embodiment, the step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which includes an energy storage unit.

[0077] According to one embodiment, the step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which includes a wireless energy receiver.

[0078] According to one embodiment, the step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which includes a wireless transceiver for wireless communication.

[0079] A method is further provided for implanting a medical device for actively stretching the stomach wall of a patient to induce satiety. The medical device comprises a first member configured to be fixed to a first portion of the stomach wall, a second member configured to be fixed to a second portion of the stomach wall, and an operating device for operating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions, wherein at least one of the first and second members is flexible in a second direction substantially perpendicular to the first direction. A method is provided for accessing the stomach, comprising making an incision in the patient's abdomen, making an incision in a portion of the stomach, using the flexibility of at least one of the first and second members to facilitate insertion of a medical implant into the patient's body, and inserting the medical device into the patient's abdomen.

[0080] According to one embodiment, the step of using the flexibility of at least one of the first and second members to facilitate insertion of a medical device into a patient's body further includes using the flexibility of at least one of the first and second members to compress the medical device so that it can be inserted through an incision in the patient's skin.

[0081] According to one embodiment, the step of using the flexibility of at least one of the first and second members to facilitate the insertion of a medical device into the patient's body comprises using the flexibility of at least one of the first and second members to compress the medical device so that it can be inserted into the patient's body through the cannula of the trocar.

[0082] According to one embodiment, the procedure includes the step of using the flexibility of at least one of the first and second members to expand the medical device after it has been inserted into the patient's body.

[0083] According to one embodiment, this method further includes fixing a first member to a first portion of the stomach wall and fixing a second member to a second portion of the stomach wall.

[0084] According to one embodiment, the medical device further comprises a third member configured to be fixed to a third portion of the stomach wall, and the method further comprises the step of fixing the third member to the third portion of the stomach wall. Prepare for it.

[0085] According to one embodiment, the medical device further comprises a fourth member configured to be fixed to a fourth portion of the stomach wall, and the method comprises the step of fixing the fourth member to the fourth portion of the stomach wall.

[0086] According to one embodiment, at least one of the first, second, third, and fourth members is connected to the main part, and this method utilizes the flexibility of at least one of the first, second, third, and fourth members by pivoting at least one of the first, second, third, and fourth members relative to the main part.

[0087] According to one embodiment, at least one of the steps of fixing a first member to a first portion of the stomach wall and fixing a second member to a second portion of the stomach wall comprises at least partially invading at least one of the first and second members with the tissue of the stomach wall. At least one of the steps of fixing a first member to a first portion of the stomach wall and fixing a second member to a second portion of the stomach wall may comprise fixing at least one of the first and second members to the tissue of the stomach wall using at least one of sutures, staples, or tissue growth promoting structures.

[0088] The method may further include placing at least one sensor in the area of ​​the patient's esophagus to sense parameters related to the patient's swallowing. The step of placing at least one sensor in the area of ​​the patient's esophagus to sense parameters related to the patient's swallowing may consist of placing at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0089] According to one embodiment, the method further includes placing at least one sensor in the patient's stomach region to sense parameters related to the patient's diet.

[0090] The step of placing at least one sensor in the patient's stomach region to sense parameters related to the patient's diet may consist of placing at least one of the following: a temperature sensor, a blood saturation or oxygenation sensor, a blood pressure sensor, a sensor configured to sense parameters related to ischemic markers, or a pH sensor. The step of sensing pH consists of sensing the acidity in the stomach.

[0091] According to one embodiment, the method further includes arranging an electrode configuration configured to be placed between a medical device and the stomach to engage with and electrically stimulate the gastric muscle tissue, thereby exercising the muscle tissue and improving the long-term implantation conditions of the medical device.

[0092] According to one embodiment, the method further includes placing an implantable remote unit connected to a medical device inside the patient's body.

[0093] The step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which constitutes at least part of the operating device.

[0094] The step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which includes an energy storage unit.

[0095] The step of placing an implantable remote unit connected to a medical device inside the patient's body is This may involve deploying a plantable remote unit that includes a wireless energy receiver.

[0096] The step of placing an implantable remote unit connected to a medical device inside a patient's body may consist of placing the implantable remote unit, which includes a wireless communication unit.

[0097] A method for calibrating a medical device for actively stretching the stomach wall of a patient to induce satiety is further provided. The medical device comprises a first member configured to be fixed to a first portion of the stomach wall, a second member configured to be fixed to a second portion of the stomach wall, an operating device for manipulating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions, and a controller including a transceiver for wireless communication. The method includes the step of the controller receiving a first input signal, which includes at least one of a sensor input signal relating to the physical parameters of the medical device and an input signal from an external source of the patient's body. The method further includes the controller controlling the operating device to adjust the stretching of the stomach wall in response to the first input signal, the transceiver receiving a second input signal from an external source of the patient, and the controller controlling the operating device to further adjust the stretching of the stomach wall in response to the second input signal.

[0098] According to one embodiment, the sensor input signals related to the physical parameters of the medical device are sensor inputs related to at least one of the following: energy consumption, position of at least one of the first member, second member, and operating device, strain of at least one of the first member, second member, and operating device, and speed of the operating device.

[0099] According to one embodiment, the input signal from a source outside the patient's body is an input signal generated by the patient.

[0100] According to one embodiment, the input signals generated by the patient are input signals related to at least one of the following: satiety experienced by the patient, pain experienced by the patient, and the patient ingesting something.

[0101] According to one embodiment, the step of adjusting the stretching of the stomach wall consists of adjusting one of the following: the force with which the stomach wall is stretched, the rate at which the stomach wall is stretched, and the duration of the stretching of the stomach wall.

[0102] Further information is provided on a medical device for actively stretching the stomach wall of a patient to induce a feeling of fullness. This medical device is implantable and comprises a first member including a first gastric engagement portion configured to be fixed to a first portion of the stomach wall; a second member including a second gastric engagement portion configured to be fixed to a second portion of the stomach wall; an operating device for manipulating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions; and a main body. The first and second members are connected to a main body, and at least the second member is rotatably connected to the main body, so that the rotation of the second member relative to the main body can displace the second member in a first direction relative to the first member. The operating device includes at least one eccentrically rotatable engaging member configured such that the eccentric rotation of the engaging member causes the second member to swing relative to the main part in order to displace the second member relative to the first member in order to stretch the stomach wall between the first and second parts.

[0103] According to one embodiment, at least one eccentrically rotatable engaging member is configured to engage with the second member at a position away from the pivot point of the second member.

[0104] According to one embodiment, the eccentrically rotatable engaging member includes at least one of a recess or a projection, and the second member includes at least one of a recess or a projection. The engagement between the recess or projection of the engaging member and the recess or projection of the second member causes the second member to rotate relative to the main part in order to displace the second member in a first direction relative to the first member.

[0105] According to one embodiment, the first member is rotatably connected to the main portion, and by rotating the first member relative to the main portion, the first member can be displaced relative to at least one of the second member and the third member.

[0106] According to one embodiment, the operating device is configured to increase the distance between the first gastric engagement portion and the second gastric engagement portion by displacing the second member in the first direction and simultaneously displacing the first member in the second direction, thereby stretching the gastric wall between the first portion of the gastric wall and the second portion of the gastric wall.

[0107] According to one embodiment, the operating device includes a radial engagement surface configured to engage at least radially with the second member such that the second member swings relative to the main portion due to the eccentric rotation of the engaging member.

[0108] According to one embodiment, at least a second member is configured to be operated in a first direction by the eccentric rotation of an engaging member and operated in the opposite direction by an elastic element.

[0109] According to one embodiment, the eccentrically rotatable engaging member includes a groove surrounding the rotation center of the eccentrically rotatable engaging member. The groove may be configured to control the movement of at least the second member in a first direction and in the opposite direction. The groove may be configured to always control the movement of at least the second member.

[0110] According to one embodiment, the medical device is composed of a first member, a second member, a third member, and a fourth member, as follows: The first member, the second member, the third member, and the fourth member are all rotatably connected to the main member, and the groove is configured to control the movement of the first member, the second member, the third member, and the fourth member in a first direction and the opposite direction, and when the eccentrically rotatable engaging member constituting the groove rotates, the first member, the second member, the third member, and the fourth member are sequentially displaced in a first direction and the opposite direction relative to the main member, sequentially stretching the stomach wall portion between the members.

[0111] According to one embodiment, when the eccentrically rotatable engaging member constituting the groove rotates, the first member and the second member are displaced simultaneously, or the second member and the third member are displaced simultaneously, or the third member and the fourth member are displaced simultaneously.

[0112] According to one embodiment, at least one of the first, second, third, and fourth members is configured to be at least partially invaded by the tissue of the stomach wall.

[0113] According to one embodiment, at least one of the first, second, third, and fourth members includes at least one fixation portion configured to fix the member to the stomach wall tissue using at least one of a suture, a stapler, or a tissue growth promoting structure. The at least one fixation portion may consist of at least one through-hole and recess for receiving at least one of the suture or stapler.

[0114] The operating device in any embodiment of this specification may include at least one electric motor, which reduces the speed of motion generated by the electric motor. It may also be connected to a gear system configured to increase force.

[0115] According to one embodiment, the operating device is configured to be powered remotely. The operating device may also be configured to be powered remotely by mechanical force.

[0116] The medical device may further include a housing configured to enclose at least a portion of the operating device, the housing may be flexible to allow displacement of at least one component. The housing may constitute the main part.

[0117] The medical device may further include a power storage device for supplying power directly or indirectly to the medical device, and a control device for controlling the operating device.

[0118] The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0119] The medical device may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor. The sensor may be configured to sense physical parameters of the medical device system.

[0120] According to one embodiment, the sensor is configured to sense at least one of the following: temperature of the medical device system, parameters relating to the power consumption of the medical device system, parameters relating to the strain of the medical device system, parameters relating to the state of the energy storage unit, parameters relating to the wireless transfer of energy from an energy source outside the patient's body, and hydraulic pressure.

[0121] According to one embodiment, the sensor is configured to sense the patient's physiological parameters, and may be configured to sense at least one of the following: parameters related to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygen concentration, blood pressure, parameters related to ischemic markers, or pH.

[0122] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0123] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0124] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an external information source outside the patient's body.

[0125] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0126] In any embodiment of this specification, the medical device may further include a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0127] The implantable energy storage device may also be a solid-state battery.

[0128] The implantable energy storage device may also be a thionyl chloride cell.

[0129] The medical device may further include a sensory generator adapted to produce sensations detectable by the patient's senses.

[0130] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0131] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0132] The controller can be configured to receive signals from sensors located outside the patient's body.

[0133] In some embodiments, the medical device may further include an electrode arrangement configured to engage with and electrically stimulate the gastric muscle tissue in order to exercise the muscle tissue in order to improve the conditions for long-term implantation of the medical device.

[0134] Further medical devices are provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device comprises a first member including a first gastric engagement portion configured to be fixed to a first portion of the stomach wall and implantable, and a second member including a second gastric engagement portion configured to be fixed to a second portion of the stomach wall. The medical device further comprises a hydraulic operating device for operating the second member to displace the first member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions, and a main body. The first and second members are connected to a main member, and at least the second member is configured to bend or swing relative to the main member, so that the second member can be displaced in a first direction relative to the first member by bending or swinging the second member relative to the main member. At least the second member comprises a fluid chamber at least partially enclosed by a flexible wall portion, the flexible wall portion bending or oscillating the second member when a working fluid is moved into or out of the fluid chamber to stretch the stomach wall between the first and second portions.

[0135] According to one embodiment, the flexible wall portion consists of a raised portion and a lower portion. The lifting portion may be configured to allow the second member to bend or swing when the fibrous tissue covers the lifting portion.

[0136] The flexible wall portion consists of at least one pleated section, such as a bellows.

[0137] According to one embodiment, the second member consists of a rotating element rotatably fixed to the main portion, and the flexible wall portion rotates the rotating element when a hydraulic fluid is moved into or out of the hydraulic chamber to stretch the stomach wall between the first and second portions.

[0138] According to one embodiment, the second member consists of a second fluid chamber partially enclosed by a flexible wall, and bending or oscillating of the second member is caused by changing the relationship between the fluid levels of the first fluid chamber and the second fluid chamber.

[0139] According to one embodiment, the bending or oscillating of the second member is caused by at least one of the movement of fluid from the first fluid chamber and the movement of fluid to the second fluid chamber.

[0140] According to one embodiment, the second member is moved by the movement of fluid from the first fluid chamber. It is configured to be displaced in a first direction relative to the first member, and to be displaced in a second direction relative to the first member by the movement of fluid from the second fluid chamber.

[0141] According to one embodiment, the second member is configured to be displaced in a first direction relative to the first member by the movement of fluid into the first fluid chamber, and to be displaced in a second direction relative to the first member by the movement of fluid into the second fluid chamber.

[0142] The first member may include a fluid chamber at least partially enclosed by a flexible wall portion, the flexible wall portion being able to bend or swing the first member when a working fluid moves into or out of the fluid chamber.

[0143] According to one embodiment, the medical device comprises at least one of: a third member comprising a fluid chamber at least partially enclosed by a flexible wall portion, wherein the flexible wall portion bends or oscillates the third member when a working fluid is moved into or out of the fluid chamber; and a fourth member comprising a fluid chamber at least partially enclosed by a flexible wall portion; a fifth member comprising a fluid chamber at least partially enclosed by a flexible wall portion, wherein the flexible wall portion bends or oscillates the fourth member when a working fluid is moved into or out of the fluid chamber; and a fifth member comprising a fluid chamber at least partially enclosed by a flexible wall portion, wherein the flexible wall portion bends or oscillates the fifth member when a working fluid is moved into or out of the fluid chamber.

[0144] According to one embodiment, the medical device further comprises at least one operable valve configured to operate in at least one of the following ways: switching between distributing working fluid to or from the fluid chamber of a first member and distributing working fluid to or from the fluid chamber of a second member; distributing working fluid to or from the fluid chamber of a first member and distributing working fluid to or from the fluid chamber of a second member; and distributing working fluid to or from the fluid chamber of a third member. Switching between distribution, switching the distribution of working fluid to the fluid chamber of the first member, the fluid chamber of the second member, the fluid chamber of the third member, and the fluid chamber of the fourth member, switching the distribution of working fluid to the fluid chamber of the first member, the fluid chamber of the second member, the fluid chamber of the third member, the fluid chamber of the fourth member, and the fluid chamber of the fifth member, switching the distribution of working fluid to the fluid chamber of the first member, the fluid chamber of the second member, the fluid chamber of the third member, the fluid chamber of the fourth member, and the fluid chamber of the fifth member.

[0145] According to one embodiment, at least one operable valve is a rotatable operable valve.

[0146] According to one embodiment, the medical device further comprises an actuator for operating an operable valve, the actuator being at least one of an electric actuator and a hydraulic actuator.

[0147] According to one embodiment, the operable valve is configured to simultaneously distribute fluid to a first fluid chamber of a first member and a second fluid chamber of a second member, and to bend or pivot the first member and the second member away from each other in different directions in order to stretch the stomach wall between the first member and the second member.

[0148] According to one embodiment, the operable valve is configured to simultaneously distribute fluid to the first fluid chamber of the second member and the second fluid chamber of the third member, and the gas between the second member and the third member To stretch the wall, the second and third members are bent or pivoted in different directions, separating them from each other.

[0149] According to one embodiment, each of the first, second, third, fourth, and fifth members is provided with a gastric engagement portion. The gastric engagement portion may be configured to be penetrated by the stomach wall using stomach-to-stomach sutures or staples.

[0150] The gastric engagement portion may include a fixation portion configured to secure the gastric engagement portion to the tissue of the stomach wall using at least one of a suture and a stapler, and at least one of a tissue growth promoting structure that can fix the gastric engagement portion to the stomach wall through internal growth of fibrous tissue.

[0151] According to one embodiment, the main portion includes a fluid conduit for guiding a fluid to at least one of the first, second, third, fourth, and fifth members.

[0152] According to one embodiment, the medical device further comprises an implantable hydraulic pump for pressurizing fluid into a fluid conduit. The implantable pump may be configured to be positioned at a distance from the main part.

[0153] The medical device may further include an energy storage device for directly or indirectly supplying power to the medical device, and a control device for controlling at least one of a pump and an operable valve.

[0154] The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0155] The medical device may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor. The sensor may be configured to sense physical parameters of the medical device system.

[0156] According to one embodiment, the sensor is configured to sense at least one of the following: the temperature of the medical device system, parameters related to the power consumption of the medical device system, parameters related to the strain of the medical device system, parameters related to the state of the energy storage unit, parameters related to the wireless transfer of energy from an energy source outside the patient's body, and hydraulic pressure.

[0157] According to one embodiment, the sensor is configured to sense the physiological parameters of a patient, and may be configured to sense at least one of the following: parameters relating to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygenation, blood pressure, parameters relating to ischemic markers, or pH.

[0158] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0159] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0160] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an external information source outside the patient's body.

[0161] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0162] In any embodiment of this specification, the medical device may further include a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0163] The implantable energy storage device may also be a solid-state battery.

[0164] The implantable energy storage device may also be a thionyl chloride cell.

[0165] The medical device may further include a sensory generator adapted to produce a sensation detectable by the patient's senses.

[0166] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0167] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0168] The controller can be configured to receive signals from sensors located outside the patient's body.

[0169] In some embodiments, the medical device may further include an electrode arrangement configured to engage with and electrically stimulate the gastric muscle tissue in order to exercise the muscle tissue in order to improve the conditions for long-term implantation of the medical device.

[0170] Further medical devices are provided for actively stretching a patient's stomach wall to induce a feeling of fullness. These medical devices include a first member, which is implantable and includes a first gastric engagement, configured to be fixed to a first portion of the stomach wall; and a second member, which includes a second gastric engagement, configured to be fixed to a second portion of the stomach wall. The medical devices further include a main body and an operating device for manipulating the second member to displace it in a first direction in order to stretch the stomach wall between the first and second portions. The first and second members are connected to a main body, and at least the second member is configured to bend or swing relative to the main body, so that the second member is displaced away from the first member by bending or swinging relative to the main body. The operating device includes a first flexible cable for pulling the second member to displace it away from the first member, the first flexible cable being fixed to the second member at its distal half.

[0171] According to one embodiment, at least the second member comprises a flexible wall portion, and the first flexible cable is at least partially surrounded by the flexible wall portion. The flexible wall portion is composed of a raised portion and a lower portion, which may be configured to allow the second member to bend or swing when fibrous tissue covers the raised portion and the lower portion.

[0172] According to one embodiment, the flexible wall portion consists of at least one pleated portion, such as a bellows.

[0173] According to one embodiment, the second member consists of a pivot element rotatably fixed to the main part, and the first flexible cable rotates the pivot element when operated to stretch the stomach wall between the first and second parts.

[0174] According to one embodiment, the operating device includes a second flexible cable for pulling the second member in order to displace the second member toward the first member, and the second flexible cable is fixed to the second member at its distal half.

[0175] According to one embodiment, the first member is configured to bend or rotate relative to the main portion, and by bending or rotating the first member relative to the main portion, the first member can be displaced in a direction away from the second member.

[0176] According to one embodiment, the first flexible cable is further fixed to the first member, and by pulling the first flexible cable, the second member is displaced away from the first member, and the first member is displaced away from the second member, thereby stretching the stomach wall between the first and second parts.

[0177] According to one embodiment, the medical device comprises at least one of a third member configured to bend or rotate relative to a main portion, a fourth member configured to bend or rotate relative to a main portion, and a fifth member configured to bend or rotate relative to a main portion.

[0178] According to one embodiment, a second cable is connected to a second member and a third member at its distal half, and by pulling the cable, the second member is displaced away from the third member, and the third member is displaced away from the second member.

[0179] According to one embodiment, a third cable is connected to a third member and a fourth member at its distal half, and by pulling the cable, the third member is displaced away from the fourth member, and the fourth member is displaced away from the third member.

[0180] According to one embodiment, the fourth cable is connected to the fourth and fifth members at its distal half, and by pulling the cable, the fourth member is displaced away from the fifth member, and the fifth member is displaced away from the fourth member.

[0181] According to one embodiment, the fifth cable is connected to the fifth member and the first member at its distal half, and by pulling the cable, the fifth member is displaced away from the first member, and the first member is displaced away from the fifth member.

[0182] According to one embodiment, the medical device further comprises an operating device configured to pull at least one of a first cable, a second cable, a third cable, a fourth cable, and a fifth cable.

[0183] According to one embodiment, the operating device is configured to perform at least one of the following: switching between the pulling in of the first cable and the pulling in of the second cable; switching between the pulling in of the second cable and the pulling in of the third cable; switching between the pulling in of the third cable and the pulling in of the fourth cable; and switching between the pulling in of the fourth cable and the pulling in of the fifth cable.

[0184] The operating device may be a rotatable operating device.

[0185] The operating device may include at least one eccentrically rotatable engaging member configured to engage with at least one first flexible cable for pulling the first flexible wire.

[0186] The eccentrically rotatable engaging member may further be configured to engage with at least one of the second flexible cable, the third flexible cable, the fourth flexible cable, and the fifth flexible cable.

[0187] According to one embodiment, the eccentrically rotatable engaging member comprises at least one of a recess or a projection, at least a first flexible cable is fixed to at least one of the recess or projection, and the engagement between the recess or projection of the engaging member and the recess or projection of the second member causes the second member to swing relative to the main part in order to displace the second member in a first direction relative to the first member.

[0188] According to one embodiment, at least the second member is configured to be operated in a first direction by a first flexible cable and operated in the opposite direction by an elastic element.

[0189] According to one embodiment, the eccentrically rotatable engaging member is provided with a groove surrounding the center of rotation of the eccentrically rotatable engaging member.

[0190] According to one embodiment, the groove is configured to control the movement of at least the second member in a first direction and in the opposite direction.

[0191] In any embodiment of this specification, the gastric engagement portion may be configured to be penetrated by the gastric wall using a gastric suture or stapler.

[0192] The gastric engagement portion may include a fixation portion configured to secure the gastric engagement portion to the tissue of the stomach wall using at least one of a suture and a stapler, and at least one of a tissue growth promoting structure that can fix the gastric engagement portion to the stomach wall through internal growth of fibrous tissue.

[0193] In any embodiment of this specification, the operating device may include at least one electric motor, which may be connected to a gear system configured to reduce the speed and increase the force of the motion generated by the electric motor.

[0194] The operating device may be partially located in a position within the patient's body that is separate from the main part.

[0195] The medical device may further include an energy storage device for directly or indirectly supplying power to the medical device, and a control device for controlling at least one of a pump and an operable valve.

[0196] The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0197] The medical device may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor. The sensor may be configured to sense physical parameters of the medical device system.

[0198] According to one embodiment, the sensor is configured to sense at least one of the following: temperature of the medical device system, parameters relating to the power consumption of the medical device system, parameters relating to the strain of the medical device system, parameters relating to the state of the energy storage unit, parameters relating to the wireless transfer of energy from an energy source outside the patient's body, and hydraulic pressure.

[0199] According to one embodiment, the sensor is configured to sense the physiological parameters of a patient, and may be configured to sense at least one of the following: parameters relating to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygen concentration, blood pressure, parameters relating to ischemic markers, or pH.

[0200] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0201] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0202] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an external information source outside the patient's body.

[0203] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0204] In any embodiment of this specification, the medical device may further include a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0205] The implantable energy storage device may also be a solid-state battery.

[0206] The implantable energy storage device may also be a thionyl chloride cell.

[0207] The medical device may further include a sensory generator adapted to produce a sensation detectable by the patient's senses.

[0208] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0209] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0210] The controller can be configured to receive signals from sensors located outside the patient's body.

[0211] In some embodiments, the medical device may further include an electrode arrangement configured to engage with and electrically stimulate the gastric muscle tissue in order to exercise the muscle tissue in order to improve the conditions for long-term implantation of the medical device.

[0212] Further, a medical device is provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device is implantable and comprises a first member including a first gastric engagement portion configured to engage with a first portion of the stomach wall, a second member including a second gastric engagement portion configured to engage with a second portion of the stomach wall, and a main portion. The first member and the second member are connected to the main portion. The medical device further comprises an operating device for manipulating at least the second member to displace the second member away from the first member in order to stretch the stomach wall between the first and second portions, wherein a portion of the operating device is located in a remote unit configured to be located at a remote position within the patient's body, and a force transmission element configured to hydraulically or mechanically transmit force from the remote unit to the main portion for manipulating the second member.

[0213] According to one embodiment, the second member is configured to bend or rotate relative to the main portion so that the second member can be displaced in a direction away from the first member.

[0214] According to one embodiment, the first member is configured to bend or rotate relative to the main portion so that the first member can be displaced in a direction away from the second member.

[0215] According to one embodiment, the medical device further comprises a third member configured to engage with a third portion of the stomach wall.

[0216] According to one embodiment, the medical device further comprises a fourth member configured to engage with a fourth portion of the stomach wall.

[0217] According to one embodiment, the operating device is further configured to operate at least one of the first member, third member, and fourth member so as to displace it relative to the main body in order to stretch the stomach wall.

[0218] According to one embodiment, the main part constitutes at least a part of the operating device.

[0219] According to one embodiment, at least one of the first member, second member, third member, and fourth member constitutes at least a part of the operating device.

[0220] According to one embodiment, at least one of the first, second, third, and fourth members is elongated.

[0221] According to one embodiment, at least one of the first, second, third, and fourth members is fixed with a hinge to allow for pivoting motion.

[0222] According to one embodiment, at least one of the first, second, third, and fourth members is configured to be at least partially invaded by the tissue of the stomach wall.

[0223] According to one embodiment, the main portion is configured to be at least partially invaded by the tissue of the stomach wall.

[0224] According to one embodiment, at least one of the first, second, third, and fourth members includes at least one fixation portion configured to fix the member to the stomach wall tissue using at least one of sutures, staplers, or tissue growth promoting structures.

[0225] According to one embodiment, the portion of the operating device located in the remote unit is composed of at least one electric motor.

[0226] According to one embodiment, the portion of the operating device located in the remote unit further comprises a gear system configured to reduce the speed of motion and increase the force generated by the electric motor.

[0227] According to one embodiment, a part of the operating device is located in the main part, and the part of the operating device located in the main part comprises a receiving part configured to receive a mechanical force, and a transmission for converting the received mechanical force into a force to displace at least one of the gastric wall stretching members. The transmission may consist of a gear system configured to reduce the speed of the received mechanical force and increase the force.

[0228] According to one embodiment, the receiving part is configured to receive rotational mechanical force, and the transmission part is configured to convert the received rotational mechanical force into linear mechanical force.

[0229] According to one embodiment, the receiving portion is configured to receive linear mechanical forces.

[0230] According to one embodiment, a part of the operating device is located in the main part. The part of the operating device located in the main part includes a receiving part configured to receive liquid pressure and a transmission part for converting the received liquid pressure into a force to displace at least one of the gastric wall stretching members.

[0231] According to one embodiment, the transmission consists of at least one hydraulic cylinder.

[0232] According to one embodiment, the part of the operating device located in the main part comprises at least one operable valve.

[0233] The portion of the control device located in the remote control may consist of at least one operable valve.

[0234] According to one embodiment, the operable valve is configured to control the flow of hydraulic fluid from a first state in which the hydraulic fluid can operate a first member to a second state in which the hydraulic fluid can operate a second member. The portion of the operating device located in the remote unit may include at least one hydraulic pump. The remote unit may include a hydraulic fluid reservoir for holding the hydraulic fluid. The remote unit may include an injection port for at least one of injecting and removing the hydraulic fluid from the medical device.

[0235] According to one embodiment, the remote device further comprises an energy storage device for directly or indirectly supplying power to the medical device.

[0236] According to one embodiment, the remote device further comprises a controller for controlling the operating device. The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0237] According to one embodiment, the medical device may include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor.

[0238] According to one embodiment, the sensor is configured to sense the physical parameters of a medical device system.

[0239] According to one embodiment, the sensor is used to measure the temperature of the medical device system, parameters related to the power consumption of the medical device system, parameters related to the strain of the medical device system, and energy storage The sensor is configured to sense at least one of the following: parameters related to the state of the storage unit, parameters related to the wireless transfer of energy from an energy source outside the patient's body, and hydraulic pressure.

[0240] According to one embodiment, the sensor is configured to sense the patient's physiological parameters, and may be configured to sense at least one of the following: parameters related to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygen concentration, blood pressure, parameters related to ischemic markers, or pH.

[0241] According to one embodiment, the sensor is configured to sense parameters related to a patient's swallowing and comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0242] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0243] According to one embodiment, the controller is configured to transmit information based on sensor inputs to an external information source outside the patient's body.

[0244] According to one embodiment, the controller is configured to wirelessly transmit information based on sensor inputs to a source outside the patient's body.

[0245] In any embodiment of the foregoing, the remote unit may further comprise a capacitor connected to an implantable energy storage unit and an operating device, the capacitor being charged by the implantable energy storage unit and configured to supply power to the operating device.

[0246] The remote device may further include a sensory generator adapted to produce sensations detectable by the patient's senses.

[0247] The control device may be configured to receive control signals generated by the patient, and the control device may be configured to control the operating device based on the received control signals generated by the patient.

[0248] The controller may be configured to control the operating device based on signals relating to elapsed time or time.

[0249] The medical device may further include at least one lead wire for transmitting electrical energy and / or information from a remote unit to a main unit.

[0250] According to one embodiment, the medical device further comprises a housing configured to surround a remote unit. The first part of the housing may be made of titanium, and the second part of the housing may be made of a ceramic material.

[0251] According to one embodiment, the portion of the housing made from a ceramic material consists of at least one coil embedded in the ceramic material.

[0252] According to one embodiment, a portion of a housing made of a ceramic material includes at least one lead wire embedded in the ceramic material for transmitting electrical energy and / or information through the housing.

[0253] According to one embodiment, the remote unit is comprised of a magnetic coupling for mechanical transmission through the housing.

[0254] The remote unit may, in any embodiment of this specification, comprise a first portion configured to be positioned on the first side of a tissue portion, the first portion having a first cross-sectional area in a first plane and a first surface configured to engage with a first tissue surface of the tissue portion; a second portion configured to be positioned on the second side of the tissue portion, the second portion having a second cross-sectional area in a second plane and a second surface configured to engage with a second tissue surface of the tissue portion; and a connecting portion configured to be positioned through a hole in the tissue portion, the second portion having a second cross-sectional area in a second plane and a second surface configured to engage with a second tissue surface of the tissue portion; and a connecting portion configured to be positioned through a hole in the tissue portion, the connecting portion having a third cross-sectional area in a third plane and configured to connect the first portion to the second portion. The first, second, and third planes are parallel to each other, and the cross-sectional area of ​​the third plane is smaller than that of the first and second planes, preventing the first and second parts from moving through the holes in the tissue in directions perpendicular to the first, second, and third planes.

[0255] According to one embodiment, the first part comprises a first radio energy receiver for receiving energy radio-transmitted from an external radio energy transmitter and an internal radio energy transmitter configured to radio-transmit energy to the second part, the second part comprising a second radio energy receiver for radio-receiving energy from the first part.

[0256] According to one embodiment, the remote unit consists of a first energy storage unit connected to a first wireless energy receiver, and the second part consists of a second energy storage unit connected to a second wireless energy receiver.

[0257] According to one embodiment, a first wireless energy receiver is configured to receive energy from an external wireless energy transmitter and store the received energy in a first energy storage unit, a wireless energy transmitter is configured to transmit the energy stored in the first energy storage unit to a second wireless energy receiver, and a second wireless energy receiver is configured to receive energy from an internal wireless energy transmitter and store the received energy in a second energy storage unit.

[0258] According to one embodiment, the first part comprises a first wireless communication receiver for receiving wireless communication from an external device, and the first part comprises a first wireless communication transmitter for transmitting wireless communication to a second wireless communication receiver of the second part.

[0259] According to one embodiment, the first part is detachably connected to at least one of the second part and the connecting part.

[0260] According to one embodiment, the connecting portion includes a flange whose flange area is larger than that of the third cross-sectional area, preventing the flange from moving through the hole in the tissue portion, so that the second portion and the connecting portion can be held in place by the patient's tissue portion even when the first portion is detached from the connecting portion.

[0261] In any embodiment of this specification, the connecting portion can constitute a conduit for transferring fluid from the first portion to the second portion.

[0262] Further medical devices are provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device is implantable and comprises a first member consisting of a closed curve, the first member comprising a first part consisting of a first gastric engager configured to engage with a first portion of the stomach wall, and a second part consisting of a second gastric engager configured to engage with a second portion of the stomach wall, the first member being operable so that the first and second parts can move toward or away from each other in order to stretch the portion of the stomach wall.

[0263] According to one embodiment, the first member is configured to surround a portion of the patient's stomach wall.

[0264] According to one embodiment, the first member consists of a simple closed curve.

[0265] According to one embodiment, the first member is ring-shaped.

[0266] According to one embodiment, the first member is operable to take on an elliptical shape.

[0267] According to one embodiment, the first member is operable to take on an elliptical shape.

[0268] According to one embodiment, the separation of the first and second parts stretches a portion of the stomach wall between the first and second parts.

[0269] According to one embodiment, the first member further comprises a third portion consisting of a third gastric engager configured to engage with a third portion of the stomach wall, and a fourth portion consisting of a fourth gastric engager configured to engage with a fourth portion of the stomach wall, wherein the third and fourth portions move away from each other as the first and second portions move toward each other.

[0270] According to one embodiment, the separation of the third and fourth parts stretches a portion of the stomach wall between the third and fourth parts.

[0271] According to one embodiment, the first member is configured to be operated to stretch the stomach wall between the first member and a second member fixed to the stomach wall.

[0272] According to one embodiment, as the first and second parts move toward each other, stretching of the stomach wall occurs between at least one of the first and second parts and the second member.

[0273] According to one embodiment, the medical device further comprises a second member configured to act as a support that resists the force generated by the manipulation of the first member, so as to be able to stretch the stomach wall between the first member and the second member.

[0274] According to one embodiment, the support is configured to be fixed to the patient's stomach wall. The support can form a closed curve.

[0275] According to one embodiment, the first member is mechanically operable, in which case a mechanical operating device can be configured. The mechanical operating device may consist of at least one flexible element directly or indirectly fixed to the first and second portions of the first member. The flexible element is configured to operate the first member for at least one of moving the first portion toward the second portion and moving the first portion away from the second portion.

[0276] According to one embodiment, the mechanical operating device may include at least one second flexible element directly or indirectly fixed to the third and fourth portions of the first member. The flexible element may be configured to manipulate the first member for at least one of the following: moving the third portion toward the fourth portion, and moving the third portion away from the fourth portion.

[0277] According to one embodiment, the mechanical operating device comprises at least one third flexible element directly or indirectly fixed to the fifth and sixth portions of the first member. The flexible element may be configured to operate the first member for at least one of moving the fifth portion toward the sixth portion and moving the fifth portion away from the sixth portion.

[0278] According to one embodiment, the mechanical operating device comprises at least one fourth flexible element directly or indirectly fixed to the seventh and eighth portions of the first member. This flexible element may be configured to operate the first member for at least one of the following actions: moving the seventh portion toward the eighth portion, and moving the seventh portion away from the eighth portion.

[0279] According to one embodiment, at least one of the first and second members has at least one recess or channel, and at least one of the flexible elements moves at least partially within the recess or channel.

[0280] According to one embodiment, the first part of the flexible element is directly or indirectly fixed to the first part of the first member, the second part of the flexible element is directly or indirectly fixed to the second part of the first member, and the operation of the flexible element operates the first and second parts of the first member simultaneously.

[0281] The medical device may further include at least one sheath, and at least one flexible element may be configured to move through the sheath.

[0282] According to one embodiment, the sheath consists of raised and lowered portions so that the sheath can maintain its flexibility even when fibrous tissue covers it.

[0283] According to one embodiment, the first member is hydraulically operable, in which case the medical device may further include a hydraulic operating device.

[0284] According to one embodiment, the hydraulic operating device can include at least one hydraulic actuator directly or indirectly fixed to the first and second portions of the first member. The hydraulic actuator can be configured to operate the first member to move the first portion toward the second portion and / or to move the first portion away from the second portion.

[0285] According to one embodiment, the hydraulic operating device includes at least one second hydraulic actuator directly or indirectly fixed to the third and fourth portions of the first member, and the hydraulic actuator is configured to operate the first member to move the third portion toward the fourth portion and / or to move the third portion away from the fourth portion.

[0286] According to one embodiment, the hydraulic operating device includes at least one third hydraulic actuator directly or indirectly fixed to the fifth and sixth portions of the first member, and the hydraulic actuator is configured to operate the first member to move the fifth portion toward the sixth portion and / or to move the fifth portion away from the sixth portion.

[0287] According to one embodiment, the hydraulic operating device includes at least one fourth hydraulic actuator directly or indirectly fixed to the seventh and eighth portions of the first member. This hydraulic actuator is configured to operate the first member to move the seventh portion toward the eighth portion and / or to move the seventh portion away from the eighth portion. The hydraulic actuator is configured to operate the first member for at least one of moving the seventh portion toward the eighth portion and separating the seventh portion from the eighth portion.

[0288] In one embodiment, the medical device includes at least one hydraulic conduit for guiding hydraulic fluid to at least one of the hydraulic actuators.

[0289] According to one embodiment, at least one of the first and second members may be provided with at least one recess or channel, and the hydraulic pipeline may be configured to move at least partially within the recess or channel.

[0290] According to one embodiment, at least one of the first and second members is provided with at least one passage for conducting a working fluid. In one embodiment, the medical device may further include at least one sheath. At least one hydraulic actuator may be configured to move through the sheath.

[0291] According to one embodiment, the sheath consists of raised and lowered portions so that the sheath can maintain its flexibility even when fibrous tissue covers it.

[0292] According to one embodiment, the first member is flexible and / or elastic.

[0293] In one embodiment, the first member is more flexible than the second member.

[0294] In one embodiment, the first member is more elastic than the second member.

[0295] In one embodiment, the second member is substantially rigid. The main portion of the second member may be made from a material having an elastic modulus in the range of 0.2 GPa to 1000 GPa or 1 GPa to 400 GPa. The second member can have an elastic modulus in the range of 0.2 GPa to 1000 GPa or 1 GPa to 400 GPa.

[0296] At least one of the first and second members can be configured to be invaded by the stomach wall using stomach-to-stomach sutures or staples.

[0297] In one embodiment, at least one gastric engager comprises a fixation portion configured to fix the gastric engager to the tissue of the stomach wall using at least one suture and stapler, and at least one tissue growth promoting structure that allows the gastric engager to be fixed to the stomach wall by internal growth of fibrous tissue.

[0298] A portion of the mechanical or hydraulic operating device may be located in a remote unit configured to be positioned at a distance within the patient's body. The medical device may further include a force transmission element configured to transmit force hydraulically or mechanically from the remote unit to the first member in order to operate the first member.

[0299] The control unit located in the remote unit may consist of at least one electric motor.

[0300] The portion of the control device located in the remote unit may further include a gear system configured to reduce the speed of motion and increase the force generated by the electric motor.

[0301] In one embodiment, the portion of the operating device located in the remote unit comprises at least one pulley for propelling the flexible element.

[0302] In one embodiment, the portion of the operating device located in the remote unit may include at least one hydraulic pump.

[0303] The remote unit may include a hydraulic fluid reservoir for holding hydraulic fluid. The remote unit is provided with an injection port for at least one of injecting hydraulic fluid into a medical device and removing hydraulic fluid from a medical device.

[0304] The remote device may further include an energy storage device for directly or indirectly energizing the medical device. The remote unit may further include a controller for controlling the operating device. The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0305] In one embodiment, the medical device further includes at least one sensor configured to sense physical parameters of the medical device system.

[0306] In one embodiment, the sensor is a sensor configured to sense at least one of the temperature of the medical device system, a parameter related to the power consumption of the medical device system, a parameter related to the strain of at least one of the first and second members, a parameter related to the state of the energy storage unit, a parameter related to the wireless transfer of energy from a source outside the patient's body, and at least one of the hydraulic pressure of at least one of the hydraulic actuator, the hydraulic pump, the hydraulic reservoir, and the hydraulic conduit.

[0307] A medical device is provided for actively stretching the patient's gastric wall to produce a feeling of fullness. The medical device is implantable and includes a first member configured to be fixed to a first portion of the gastric wall, a second member configured to be fixed to a second portion of the gastric wall, and an operating device for operating to displace the second member relative to the first member in a first direction to stretch the gastric wall between the first portion and the second portion. The medical device further includes an acoustic sensor configured to sense at least one sound related to the patient's swallowing, and a control device configured to receive a signal from the acoustic sensor and control the operating device based on the signal received from the acoustic sensor.

[0308] According to one embodiment, the acoustic sensor is composed of at least one microphone.

[0309] According to one embodiment, the acoustic sensor consists of an implantable acoustic sensor.

[0310] According to one embodiment, the controller is configured to receive acoustic sensor signals from an acoustic sensor installed outside the patient's body.

[0311] The sensor may also be configured to sense at least one parameter relating to the functional state of the medical device, which may be at least one parameter relating to the operation of the operating device. In embodiments in which the operating device includes an electric motor, the sensor may be configured to sense at least one parameter relating to the operation of the electric motor.

[0312] A method for detecting when a patient is swallowing is further provided. This method includes receiving a wireless signal from an implanted acoustic sensor configured to detect at least one sound associated with a patient swallowing.

[0313] A method is further provided for implanting a medical device to actively stretch the stomach wall of a patient in order to induce a feeling of fullness. This method includes fixing the medical device to the stomach wall of the patient and implanting at least one acoustic sensor configured to detect at least one sound related to the patient's swallowing.

[0314] The controller may consist of at least one unit having a sleep mode and an active mode, the unit consuming less energy in sleep mode than in active mode. The unit is configured to switch from sleep mode to active mode based on at least one signal from an acoustic sensor. This unit is, for example, a DSP (Digital Signal Processor), another type of processor, or a wake-up circuit for the controller, which activates the controller's functions. The unit may be configured to switch from sleep mode to active mode based on a signal from an acoustic sensor related to the number of times the patient swallows, and / or based on a signal from an acoustic sensor related to the number of times the patient swallows during a period of time. The number and duration of swallows by the patient may be counted / measured and compared to a preset or moving threshold. The controller may further include at least one filtering unit configured to filter acoustic signals related to at least one of speech, saliva swallowing, and chewing. The filter is a digital filter implemented in the controller as hardware or software, and may have the filtering characteristics of a high-pass filter, a low-pass filter, or a band-pass filter.

[0315] A medical device is provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device is implantable and comprises a first member configured to be fixed to a first portion of the stomach wall, a second member configured to be fixed to a second portion of the stomach wall, and an operating device for manipulating the second member to displace the second member in a first direction relative to the first member in order to stretch the stomach wall between the first and second portions. The medical device further comprises a sensor configured to sense at least one parameter related to the patient's swallowing and fixed to a bony body structure. The medical device further comprises a controller configured to receive signals from the sensor and to control the operating device based on the signals received from the sensor.

[0316] According to one embodiment, the sensor comprises at least one acoustic sensor, which may include at least one microphone.

[0317] According to one embodiment, the sensor consists of at least one accelerometer.

[0318] According to one embodiment, the sensor comprises at least one piezoelectric sensor or piezoelectric resistance sensor.

[0319] According to one embodiment, the sensor consists of a strain gauge.

[0320] According to one embodiment, the sensor is configured to be fixed to at least one of the patient's sternum and at least one of the at least one rib.

[0321] A sensor configured to be fixed to the patient's sternum or at least one rib may be configured to be fixed to the anterior side of the patient's sternum or at least one rib.

[0322] A sensor configured to be fixed to the patient's sternum or at least one rib may be configured to be fixed to the posterior side of the patient's sternum or at least one rib.

[0323] The sensors may also consist of implantable sensors.

[0324] According to one embodiment, the sensor is configured to be fixed to a bony body structure on the outside of the patient's skin.

[0325] According to one embodiment, the controller is configured to receive sensor signals from a sensor placed outside the patient's body.

[0326] The sensor may be configured to sense at least one parameter related to the functional state of a medical device.

[0327] According to one embodiment, the sensor is configured to sense at least one parameter related to the operation of the operating device.

[0328] The controller may consist of at least one unit having a sleep mode and an active mode, the unit consuming less energy in sleep mode than in active mode. The unit is configured to switch from sleep mode to active mode based on at least one signal from a sensor. The unit could be, for example, a DSP (Digital Signal Processor), another type of processor, or a wake-up circuit for the controller, which activates the controller's functions. The unit can be configured to switch from sleep mode to active mode based on a signal from a sensor relating to the number of times the patient has swallowed, and / or based on a signal from a sensor relating to the number of times the patient has swallowed during a period of time. The number and time of the patient's swallows may be counted / measured and compared to a preset threshold or a moving threshold. The controller may further include at least one filtering unit configured to filter acoustic signals relating to at least one of speech, saliva swallowing, and chewing. A filter is a digital filter implemented in the controller as hardware or software, and may have the filtering characteristics of a high-pass filter, low-pass filter, or band-pass filter.

[0329] A method for detecting when a patient swallows is further provided. This method involves receiving a wireless signal from an implantable sensor that is fixed to a bony body structure and configured to detect at least one sound associated with the patient swallowing.

[0330] Further provided is a method for implanting a medical device to actively stretch the stomach wall of a patient in order to induce a feeling of fullness. This method includes fixing the medical device to the stomach wall of the patient and fixing at least one sensor configured to sense at least one parameter related to the patient's swallowing to a bony body structure.

[0331] A medical device is provided for actively stretching the stomach wall of a patient to induce a feeling of fullness. The medical device is implantable and comprises a first member including a first gastric engager configured to engage with a first portion of the stomach wall and a second gastric engager portion configured to engage with a second portion of the stomach wall. The medical device further comprises a first gastric engager configured to engage with a third portion of the stomach wall and a second gastric engager portion configured to engage with a fourth portion of the stomach wall. The medical device further comprises a main member, to which the first and second members are operably connected. The medical device further comprises an operating device equipped with an actuator, the operating device configured to displace the actuator, the actuator operating the first member to displace the first gastric engager portion of the first member relative to the second gastric engager portion of the first member in a first state to stretch the stomach wall, and in a second state to stretch the stomach wall To achieve this, the second member is configured to be operated so as to displace the first stomach engagement portion of the second member relative to the second stomach engagement portion of the second member.

[0332] According to one embodiment, the actuator is configured to, in a first state, operate the first member to displace the first gastric engagement portion of the first member away from the second gastric engagement portion of the first member, thereby stretching the gastric wall portion between the first and second gastric engagement portions, and in a second state, operate the second member to displace the first gastric engagement portion of the second member away from the second gastric engagement portion of the second member, thereby stretching the gastric wall portion between the first and second gastric engagement portions.

[0333] According to one embodiment, the actuator is configured to, in a first state, operate the first member to displace the first gastric engagement portion of the first member toward the second gastric engagement portion of the first member, thereby stretching at least the gastric wall portion between the first member and the second member, and in a second state, operate the second member to displace the first gastric engagement portion of the second member toward the second gastric engagement portion of the second member, thereby stretching at least the gastric wall portion between the first member and the second member.

[0334] The first and second gastric engagement portions may be fixed to the main body so as to be rotatable, and the first and second gastric engagement portions of the first member may be fixed to the main body so as to be rotatable at a common point of rotation.

[0335] According to one embodiment, the first member is scissor-shaped, and the first stomach engaging portion and the second stomach engaging portion of the first member are operable in a scissor-like manner so that they can be displaced toward each other or moved away from each other by operating the handle-shaped portion of the scissor-shaped first member.

[0336] According to one embodiment, the operating device is configured to displace the operating part by rotational motion.

[0337] According to one embodiment, the operating device is configured to displace the actuator by a combination of linear motion and rotational motion.

[0338] The actuator engages with the first member in the first state and with the second member in the second state.

[0339] According to one embodiment, the operating device is configured to detach the operating part from the first member by linear displacement of the operating part.

[0340] The medical device may further include a third member having a first gastric engagement portion configured to engage with a fifth portion of the stomach wall, and a second gastric engagement portion configured to engage with a sixth portion of the stomach wall. The operating device may be configured to displace an actuator, the actuator configured to operate the third member to displace the first gastric engagement portion of the third member relative to the second gastric engagement portion of the third member in order to stretch the stomach wall in the third state.

[0341] The medical device may further include a fourth member having a first gastric engagement portion configured to engage with a seventh portion of the stomach wall, and a second gastric engagement portion configured to engage with an eighth portion of the stomach wall. The operating device may be configured to displace the operating portion such that, in the fourth state, the operating portion operates the fourth member to displace the first gastric engagement portion of the fourth member relative to the second gastric engagement portion of the fourth member in order to stretch the stomach wall.

[0342] The operating device consists of a hydraulic operating device, the actuator consists of a hydraulic actuator, and the hydraulic actuator may consist of at least one hydraulic cylinder.

[0343] According to one embodiment, the hydraulic actuator consists of at least one flexible member that constitutes the lifting and lowering section.

[0344] According to one embodiment, the flexible member consists of at least one bellows.

[0345] According to one embodiment, the lifting section is configured such that the hydraulic actuator can be operated when fibrous tissue covers the lifting section.

[0346] According to one embodiment, the operating device includes an implantable pump configured to provide a working fluid for displacing an actuator by rotational motion, providing a working fluid for displacing an actuator by linear motion, and providing a working fluid for operating an actuator to displace a first gastric engager relative to a second gastric engager. The implantable pump may be configured to be positioned at a distance from the main part.

[0347] According to one embodiment, the operating device is operable in a first direction by a pressurized working fluid and operable in the opposite direction by an elastic element.

[0348] According to one embodiment, the actuator is actuated in a first direction by a pressurized working fluid and actuated in the opposite direction by an elastic element.

[0349] The operating device may further include a valve connected to the implantable pump. The valve is configured as follows: in a first state, it guides a working fluid to displace an actuator; and in a second state, it guides a working fluid to actuate an actuator to displace the first gastric engageor relative to a second gastric engageor.

[0350] According to one embodiment, the operating device consists of a mechanical operating device, and the actuator consists of a mechanical actuator. The mechanical actuator may consist of at least one electric motor or solenoid. At least one electric motor or solenoid may be configured to be positioned at a distance from the main part.

[0351] According to one embodiment, the mechanical actuator is composed of at least one flexible member including a lifting portion, and the lifting portion may be configured such that the mechanical actuator is operable when fibrous tissue covers the lifting portion.

[0352] According to one embodiment, an electric motor or solenoid is configured to perform at least one of the following: displacing an actuator by rotational motion, displacing an actuator by linear motion, and acting on an actuator to displace a first gastric engager relative to a second gastric engager.

[0353] The gastric engagement device can be configured to bite into the stomach wall using stomach-to-stomach sutures or staples.

[0354] According to one embodiment, the gastric engagement device comprises a fixation portion configured to fix the gastric engagement device to the tissue of the stomach wall using at least one of a suture and a stapler, and at least one of a tissue growth promoting structure that can fix the gastric engagement device to the stomach wall by internal growth of fibrous tissue.

[0355] The medical device may further include an energy storage device for directly or indirectly supplying power to the medical device, and / or a control device for controlling the operating device.

[0356] The controller may include a wireless transceiver for wireless communication with a source outside the patient's body.

[0357] According to one embodiment, the medical device may further include at least one sensor, and the controller may be configured to receive sensor input from at least one sensor.

[0358] According to one embodiment, the sensor is configured to sense the physical parameters of a medical device system.

[0359] According to one embodiment, the sensor is configured to sense at least one of the following: the temperature of the medical device system, parameters related to the power consumption of the medical device system, parameters related to the strain of the medical device system, parameters related to the state of the energy storage unit, or parameters related to the wireless transfer of energy from an energy source outside the patient's body.

[0360] According to one embodiment, the sensor may be configured to sense the physiological parameters of a patient.

[0361] According to one embodiment, the sensor is configured to sense at least one of the following: parameters related to a patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygenation, blood pressure, parameters related to ischemia markers, and pH.

[0362] According to one embodiment, a sensor configured to sense parameters related to a patient's swallowing comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, or a strain sensor.

[0363] According to one embodiment, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0364] The controller may be configured to transmit information based on sensor inputs to an external information source located outside the patient's body.

[0365] Further provided are implantable operating devices for operating a body-engaging portion of an implantable medical device according to any embodiment herein, which may be one of the components described herein. The implantable operating device comprises an electromechanism for converting electrical energy into mechanical force, a flexible shaft for transmitting the mechanical force to the body-engaging portion, and a pre-tension generator for generating pre-tension in the flexible shaft. The pre-tension eliminates slack at the end, for example, to ensure that the flexible shaft remains screwed into the pulley or spool / drum at all times.

[0366] The pretensioning device may consist of a flexible element, which may be composed of at least one of a spring and an elastic material.

[0367] A flexible shaft can be configured to transmit linear forces.

[0368] A Bowden cable can also be used for the flexible shaft.

[0369] According to one embodiment, the electromachine comprises an electric motor or a solenoid, and the implantable operating device may further include a transmission for converting the mechanical force produced by the electrical converter from a rotational mechanical force to a linear mechanical force. The transmission may be configured to convert the mechanical force produced by the electrical converter from a force having a first speed and a first strength to a force having a second lower speed and a second higher strength.

[0370] Further provided is an implantable operating device according to any one of the above embodiments, and an implantable system comprising a body engagement portion configured to exert force on a part of the patient's body, which can be a body engagement portion configured to engage with the patient's stomach wall in order to stretch the stomach wall to produce a feeling of fullness.

[0371] Further provided are implantable operating devices for operating a body-engaging portion of an implantable medical device described in any embodiment of this specification, which may be one of the components described herein. The implantable operating device comprises an electromechanism for converting electrical energy into mechanical force, and a transmission for converting the mechanical force generated by the electromechanism 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 first and second pulleys, and a flexible element configured to be positioned around the first and second pulleys, the flexible element being configured to be pulled by a force having a first velocity and a first strength, displacing the first and second pulleys relative to each other by a second lower velocity and a second higher strength, thereby generating a transmission.

[0372] According to one embodiment, the transmission is composed of a gun tackle.

[0373] According to one embodiment, the transmission consists of a rough or watch tackle.

[0374] According to one embodiment, the transmission is composed of a double-tackle system.

[0375] According to one embodiment, the transmission is composed of a jin-tackle.

[0376] The plantable operating device may further include a third pulley, which may be connected to an electromechanism, and the flexible element may be positioned around the third pulley such that the operation of the electromechanism pulls on the flexible element.

[0377] According to one embodiment, the flexible element is a flexible shaft for transmitting mechanical force to a body engagement part, or transitions into a flexible shaft.

[0378] The flexible shaft may be configured to transmit linear forces. The flexible shaft may also be a Bowden cable.

[0379] According to one embodiment, the implantable operating device further comprises a pre-tension generating device for generating pre-tension in a flexible element, and this pre-tension generating device may be a pre-tension generating device comprising a flexible element made of at least one of a spring and an elastic material.

[0380] According to one embodiment, the electric machine is comprised of an electric motor or a solenoid. The electric machine may be connected to a transmission for converting the mechanical force generated by an electric converter from rotational mechanical force to linear mechanical force.

[0381] According to one embodiment, the transmission can be configured to convert the mechanical force generated by an electromechanical device from a force having a first speed and a first intensity to a force having a second low speed and a second high intensity.

[0382] Further provided is an implantable system comprising an implantable operating device according to any one of the embodiments herein and an implantable element configured to exert force on a part of a patient's body.

[0383] Further provided are external devices configured to communicate with an implantable medical device according to any embodiment herein when implanted in a patient. The external device comprises at least one first radio transceiver configured to communicate with the implantable medical device using a first network protocol for determining the distance between the external device and the implantable medical device, and at least one second radio transceiver configured to communicate with the implantable medical device using a second network protocol for transferring data between the external device and the implantable medical device.

[0384] According to one embodiment, the first wireless transceiver is composed of a UWB transceiver.

[0385] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to an energy-consuming component of an implantable medical device and charging an implantable energy storage unit.

[0386] According to one embodiment, the second network protocol is a standard network protocol.

[0387] According to one embodiment, the second wireless transceiver is composed of a Bluetooth® transceiver.

[0388] According to one embodiment, the external device is further configured to communicate with a second external device using at least one wireless transceiver.

[0389] According to one embodiment, the external device is configured to determine the distance between the external device and the implantable medical device by determining the RSSI.

[0390] According to one embodiment, the standard network protocol is one or a combination thereof: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0391] According to one embodiment, the communication range of the first network protocol is smaller than the communication range of the second network protocol.

[0392] According to one embodiment, the frequency band of the first network protocol is different from the frequency band of the second network protocol.

[0393] According to one embodiment, the external device is configured to authenticate the implanted medical device when the determined distance between the external device and the implanted medical device is less than a predetermined threshold. After the implanted medical device has been authenticated, the external device may be configured to allow data transfer between the external device and the implanted medical device.

[0394] According to one embodiment, the external device is a wearable external device.

[0395] According to one embodiment, the external device is a handset.

[0396] Further provided is an implantable medical device configured to communicate with an external device according to one embodiment of the foregoing. The implantable medical device comprises at least one first radio transceiver configured to communicate with the external device using a first network protocol for determining the distance between the external device and the implantable medical device, and at least one second radio transceiver configured to communicate with the external device using a second network protocol for transferring data between the external device and the implantable medical device.

[0397] According to one embodiment, the first wireless transceiver is composed of a UWB transceiver.

[0398] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to an energy-consuming component of an implantable medical device and charging an implantable energy storage unit.

[0399] According to one embodiment, the second network protocol is a standard network protocol.

[0400] According to one embodiment, the second wireless transceiver is comprised of a Bluetooth transceiver.

[0401] According to one embodiment, the implantable medical device is further configured to communicate with a second external device using the at least one wireless transceiver.

[0402] According to one embodiment, the implantable medical device is configured to determine the distance between the external device and the implantable medical device by determining the RSSI.

[0403] According to one embodiment, the standard network protocol is one or a combination thereof: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0404] The communication range of the first network protocol may be narrower than that of the second network protocol.

[0405] The frequency band of the first network protocol may differ from the frequency band of the second network protocol.

[0406] According to one embodiment, the implantable medical device is configured to authenticate an external device when the determined distance between the external device and the implantable medical device is less than a predetermined threshold.

[0407] According to one embodiment, an implantable medical device can be configured to enable data transfer between the implantable medical device and the external device after the external device has been authenticated.

[0408] Further provided are external devices configured to communicate with an implantable medical device according to any one of the embodiments disclosed herein. These external devices are configured to wirelessly transmit control commands to the implantable medical device and to wirelessly communicate with a display device. The system comprises a wireless communication unit and a computing unit configured to run control software for creating control commands for the operation of an implantable medical device. The computing unit may be configured to transmit a control interface to a display device configured to display it to a user, receive user input from the display device, and convert the user input into control commands for wireless transmission to the implantable medical device.

[0409] In one embodiment, the wireless communication unit includes a wireless transceiver for wirelessly transmitting control commands to an implantable medical device and wirelessly transmitting a control interface to a display device.

[0410] According to one embodiment, the wireless communication unit includes a first wireless transceiver for wirelessly transmitting control commands to an implantable medical device and a second wireless transceiver for wirelessly transmitting a control interface to a display device.

[0411] In one embodiment, the wireless communication unit may be configured to communicate wirelessly with the display device using a standard network protocol.

[0412] In one embodiment, the wireless communication unit is configured to communicate wirelessly with an implantable medical device using a proprietary network protocol.

[0413] The wireless communication unit may consist of a Bluetooth transceiver, which may be configured as either a first or second wireless transceiver.

[0414] According to one embodiment, the wireless communication unit consists of a UWB transceiver, which may be configured as one of a first and a second wireless transceiver.

[0415] The wireless communication unit may include at least one first wireless transceiver configured to communicate with the implantable medical device using a first network protocol to determine the distance between the external device and the implantable medical device, and at least one second wireless transceiver configured to communicate with the implantable medical device using a second network protocol to transfer data between the external device and the implantable medical device.

[0416] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to an energy-consuming component of an implantable medical device and charging an implantable energy storage unit.

[0417] According to one embodiment, the standard network protocol is one or a combination thereof: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0418] The communication range of the first wire restaurant shiba may be smaller than that of the second wire restaurant shiba.

[0419] The frequency band of the first network protocol may differ from the frequency band of the second network protocol.

[0420] According to one embodiment, the external device is configured to authenticate the implantable medical device when the distance between the external device and the implantable medical device is less than a predetermined threshold.

[0421] According to one embodiment, the external device is configured to be authenticated by the implantable medical device when the distance between the external device and the implantable medical device is less than a predetermined threshold.

[0422] According to one embodiment, the external device is configured to authenticate the display device when the distance between the external device and the display device is less than a predetermined threshold.

[0423] According to one embodiment, the external device is configured to be authenticated by the implantable medical device when the distance between the external device and the display device is less than a predetermined threshold.

[0424] The external device may be configured, based on authentication, to enable data transfer between the external device and the implantable medical device, and / or between the external device and the display device.

[0425] According to one embodiment, the arithmetic unit is configured to encrypt at least one of the control interface and the control commands.

[0426] A display device for communicating with an external device for communicating with an implantable medical device is further provided. The display device comprises a wireless communication unit configured to wirelessly receive an implant control interface from the external device and to wirelessly transmit implant control user inputs to the external device. The display device further comprises a display for displaying the received implant control interface and an input device for receiving implant control inputs from the user.

[0427] According to one embodiment, the display device further comprises an auxiliary wireless communication unit configured to be disabled in order to enable at least one of receiving an implant control interface wirelessly from an external device and transmitting implant control user input wirelessly to an external device.

[0428] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external device using a standard network protocol.

[0429] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external device using its own network protocol.

[0430] According to one embodiment, the wireless communication unit consists of a Bluetooth transceiver.

[0431] According to one embodiment, the wireless communication unit is composed of a UWB transceiver.

[0432] According to one embodiment, the standard network protocol is one or a combination thereof: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0433] The communication range of the wireless communication unit of the display device may be smaller than the communication range of the auxiliary wireless communication unit.

[0434] According to one embodiment, the display device is configured to authenticate an external device when the distance between the display device and the external device is less than a predetermined threshold.

[0435] According to one embodiment, the display device is configured such that the distance between the display device and the external device is less than a predetermined threshold. In that case, it is configured to be authenticated by an external device.

[0436] According to one embodiment, the display device is configured to allow data transfer between the display device and an external device based on authentication.

[0437] The display device may be a wearable external device or a handset.

[0438] A communication system is further provided that enables communication between a display device and an implantable medical device. This communication system comprises a display device, a server, and an external device. The display device includes a wireless communication unit configured to wirelessly receive an implant control interface from the server, the implant control interface being provided by the external device, the wireless communication unit further configured to wirelessly transmit implant control user inputs destined for the external device to the server, a display for displaying the received implant control interface, and an input device for receiving implant control inputs from the user. The server of the communication system includes a wireless communication unit configured to wirelessly receive an implant control interface from the external device and wirelessly transmit the implant control interface to the display device, the wireless communication unit further configured to wirelessly receive implant control user inputs from the display device and wirelessly transmit the implant control user inputs to the external device. The external device of the communication system includes a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device and to wirelessly communicate with the server, and a computing unit configured as follows.

[0439] It sends commands for operating implantable medical devices to the server, sends control interfaces to the display device to the server, and receives implantable control user input generated by the server.

[0440] The system converts user input received from the server to the display device into control commands for wireless transmission to implantable medical devices.

[0441] According to one embodiment, the computing unit of the communication system is configured to encrypt at least one of the control interface and the control command.

[0442] According to one embodiment, the display device is configured to encrypt user input.

[0443] According to one embodiment, the server is configured to encrypt at least one of the user input received from the display device and the control interface received from the external device.

[0444] According to one embodiment, the computing device is configured to encrypt the control interface, and the display device is configured to decrypt the encrypted control interface.

[0445] According to one embodiment, the server functions as a router and is configured to transmit encrypted control interfaces from external devices to a display device without decryption.

[0446] A display device for communicating with an external device for communicating with an implantable medical device is further provided. This display device comprises a wireless communication unit, a display, and an input device for receiving implant control inputs from a user. The display device is configured to run a first application for wireless communication with a server and a second application for wireless communication with an external device for transmitting implant control inputs to the external device for communication with the implantable medical device, the second application running the first application It is configured to be accessed via a login. The display device may have a first login function and a second login function, the first login function allowing the user to access a first application, and a combination of the first and second login functions allowing the user to access a second application.

[0447] According to one embodiment, the initial login is a PIN-based login.

[0448] According to one embodiment, at least one of the first and second logins is a login based on biometric input or a hardware key.

[0449] According to one embodiment, the display device further comprises an auxiliary wireless communication unit, which is configured to be deactivated in order to enable wireless communication with an external device.

[0450] According to one embodiment, the display device is configured to wirelessly receive an implant control interface displayed on the display from an external device.

[0451] According to one embodiment of the display device, the wireless communication unit is configured to communicate wirelessly with an external device using a standard network protocol.

[0452] According to one embodiment of the display device, the wireless communication unit is configured to communicate wirelessly with an external device using a proprietary network protocol.

[0453] According to one embodiment of the display device, the wireless communication unit is configured to perform wireless communication with an external device using a first network protocol and with a server using a second network protocol.

[0454] According to one embodiment of the display device, the wireless communication unit is configured to perform wireless communication with an external device using a first frequency band and with a server using a second frequency band.

[0455] According to one embodiment of the display device, the wireless communication unit consists of a Bluetooth transceiver.

[0456] According to one embodiment of the display device, the wireless communication unit consists of a UWB transceiver.

[0457] According to one embodiment, the standard network protocol is one or a combination thereof: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0458] According to one embodiment, the communication range of the wireless communication unit is smaller than the communication range of the auxiliary wireless communication unit.

[0459] According to one embodiment, the wireless communication unit includes a first wireless transceiver for communicating with an external device and a second wireless transceiver for communicating with a server.

[0460] The second wireless transceiver may be configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[0461] According to one embodiment, the display device is configured to authenticate an external device when the distance between the display device and the external device is less than a predetermined threshold, and the display device is configured to be authenticated by the external device when the distance between the display device and the external device is less than a predetermined threshold.

[0462] According to one embodiment, the display device is configured to allow data transfer between the display device and an external device based on authentication.

[0463] The display device may be a wearable external device or a handset.

[0464] According to one embodiment of the display device, a second application may be configured to receive data relating to the parameters of an implanted medical device.

[0465] According to one embodiment, the second application is configured to receive data related to sensor values ​​received from an implanted medical device.

[0466] According to one embodiment, the second application is configured to receive data relating to at least one of the following parameters: battery status, temperature, time, and error.

[0467] According to one embodiment, the display device is configured to encrypt user input.

[0468] According to one embodiment, the display is configured to encrypt user input for decryption by an implantable medical device.

[0469] According to one embodiment, the display device is configured to decode a control interface received from an external device and display the control interface on the display.

[0470] According to one embodiment, at least one of the first and second applications is configured to receive data from an auxiliary external device and to present the received data to the user.

[0471] At least one of the first and second applications may be configured to receive data from an auxiliary external device, including a scale for measuring the user's weight.

[0472] According to one embodiment, at least one of the first and second applications may be configured to receive data relating to the user's weight from an auxiliary external device, which consists of a weighing scale.

[0473] According to one embodiment, the display device is configured to wirelessly transmit data related to the user's weight to an external device, or to wirelessly transmit instructions derived from data related to the user's weight, or to wirelessly transmit instructions derived from a combination of data related to the user's weight and implant control inputs received from the user.

[0474] A communication system is further provided that enables communication between a display device and an implantable medical device. The communication system comprises a display device, a server, and an external device. The display device includes a wireless communication unit configured to wirelessly receive an implant control interface from the external device, and the wireless communication unit is further configured to wirelessly transmit implant control user inputs to the external device. The display device further includes a display for displaying the received implant control interface and an input device for receiving implant control inputs from the user, and the display device is configured to run a first application for wireless communication with the server and an external device for communication with the implantable medical device. The system is configured to perform a second application for wireless communication with an external device in order to transmit implant control inputs to the device. The external device includes a wireless communication unit configured to wirelessly transmit control commands based on implant control inputs to the implantable medical device and to communicate wirelessly with a display device.

[0475] According to one embodiment, the display device includes a first login function and a second login function, the first login function allows the user to access a first application, and the combination of the first and second login functions allows the user to access a second application.

[0476] The second application may be configured to receive data relating to parameters of an implanted medical device, and the second application may be configured to receive data relating to sensor values ​​received from the implanted medical device.

[0477] According to one embodiment, the second application is configured to receive data relating to at least one of the following parameters: battery status, temperature, time, and error.

[0478] According to one embodiment, the display device is configured to encrypt user input.

[0479] According to one embodiment, the display is configured to encrypt user input for decryption by an implantable medical device.

[0480] According to one embodiment, the external device is configured to function as a router that transmits encrypted user input from the display device to the implantable medical device without decryption.

[0481] According to one embodiment, the external device is configured to encrypt at least one of the control interface and the control commands.

[0482] According to one embodiment, the external device is configured to encrypt the control interface, and the display device is configured to decrypt the encrypted control interface.

[0483] Further provided is a computer program product configured to run on a display device comprising a wireless communication unit, a display for displaying a received implant control interface, and an input device for receiving implant control input from a user. The computer program product includes a first application for communication with a server and a second application for communication with an external device for transmitting implant control input to an external device for communication with an implantable medical device, wherein the second application is configured to be accessed via the first application. The computer program product further includes a first login function and a second login function, wherein the first login function allows the user to access the first application, and a combination of the first and second login functions allows the user to access the second application.

[0484] According to one embodiment of the computer program product, a second application is configured to receive data relating to the parameters of an implanted medical device.

[0485] According to one embodiment of the computer program product, a second application is configured to receive data related to sensor values ​​received from an implanted medical device.

[0486] According to one embodiment of the computer program product, a second application is configured to receive data relating to a parameter relating to at least one of the following: battery status, temperature, time, or error.

[0487] A communication system is further provided that enables communication between a display device, an external device, a server, and an implantable medical device. The communication system comprises a server, a display device, an external device, and an implantable medical device. The display device comprises a wireless communication unit for wirelessly communicating with at least one of the external device and the server, a display, and an input device for receiving input from a user. The external device comprises a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device and to wirelessly communicate with at least one of the display device and the server. The server comprises a wireless communication unit configured to wirelessly communicate with at least one of the display device and the external device. The implantable medical device comprises a wireless communication unit configured to wirelessly communicate with the external device.The implantable medical device is equipped with an encryption unit, which encrypts data destined for a server and transmits the data to the server via an external device, which is configured to function as a router that transfers the data without full decryption, or the implantable medical device is equipped with an encryption unit and is configured as follows: it encrypts data destined for a display device and transmits the data to the display device via an external device, which is configured to function as a router that transfers the data without full decryption, or the server is equipped with an encryption unit and is configured as follows: it encrypts data destined for an implantable medical device and transmits the data to the implantable medical The encryption unit is configured as follows: it encrypts data for implantable medical devices and transmits the data to the implantable medical devices via a display device and an external device, and the display device and the external device function as routers that transfer the data without full decryption, or the display device includes an encryption unit and is configured as follows: it encrypts data for implantable medical devices and transmits the data to the implantable medical devices via an external device, and the external device function as routers that transfer the data without full decryption, or the display device includes an encryption unit and is configured to encrypt data for implantable medical devices and transmit the data to the implantable medical devices via a server and an external device, and the server and the external device function as routers that transfer the data without full decryption.

[0488] According to one embodiment, the display device is configured to wirelessly receive an implant control interface displayed on the display from an external device.

[0489] According to one embodiment of the communication system, at least two of the following are configured for wireless communication using a standard network protocol: the server's wireless communication unit, the display device's wireless communication unit, the external device's wireless communication unit, and the implantable medical device's wireless communication unit.

[0490] According to one embodiment, at least two of the following—the server's wireless communication unit, the display device's wireless communication unit, the external device's wireless communication unit, and the implantable medical device's wireless communication unit—are configured for wireless communication using their own network protocols.

[0491] According to one embodiment, the wireless communication unit of the external device is configured to use a first network protocol for communication with the implantable medical device and a second network protocol for communication with the server, or to use a first network protocol for communication with the implantable medical device and a second network protocol for communication with the display device.

[0492] According to one embodiment, the wireless communication unit of the external device is configured to use a first frequency band for communication with the implantable medical device and a second frequency band for communication with the server, or to use a first frequency band for communication with the implantable medical device and a second frequency band for communication with the display device.

[0493] According to one embodiment, the wireless communication unit of the display device is configured to use a first network protocol for communication with an external device and a second network protocol for communication with a server.

[0494] According to one embodiment, the wireless communication unit of the display device is configured to use a first frequency band for communication with an external device and a second frequency band for communication with a server.

[0495] According to one embodiment, the server's wireless communication unit is configured to use a first network protocol for communication with an external device and a second network protocol for communication with a display device.

[0496] According to one embodiment, the server's wireless communication unit is configured to use a first frequency band for communication with an external device and a second frequency band for communication with a display device.

[0497] According to one embodiment, at least one wireless communication unit of a server, display device, external device, and implantable medical device includes a Bluetooth transceiver.

[0498] According to one embodiment, at least one wireless communication unit among a server, display device, external device, and implantable medical device comprises a UWB transceiver.

[0499] According to one embodiment, a standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0500] According to one embodiment, the wireless communication unit of the external device comprises a first wireless transceiver for wireless communication with an implantable medical device and a second wireless transceiver for wireless communication with a server, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0501] According to one embodiment, the wireless communication unit of the external device comprises a first wireless transceiver for wireless communication with an implantable medical device and a second wireless transceiver for wireless communication with a display device, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0502] According to one embodiment, the wireless communication unit of the display device comprises a first wireless transceiver for wireless communication with an external device and a second wireless transceiver for wireless communication with a server, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0503] According to one embodiment, the second wire transceiver has an effective range of any of the following: 2x, 4x, 8x, 20x, 50x, or 100x.

[0504] According to one embodiment, the second wireless transceiver is configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[0505] According to one embodiment, at least one of the communication systems is as follows: The display device is configured to authenticate the external device when the distance between the display device and the external device is less than a predetermined threshold. The display device is configured to be authenticated by the external device when the distance between the display device and the external device is less than a predetermined threshold. The display device is configured to authenticate the implanted medical device when the distance between the display device and the implanted medical device is less than a predetermined threshold. The display device is configured to be authenticated by the implanted medical device when the distance between the display device and the implanted medical device is less than a predetermined threshold. The external device is configured to authenticate the display device when the distance between the external device and the display device is less than a predetermined threshold. The external device is configured to be authenticated by the display device when the distance between the external device and the display device is less than a predetermined threshold. The external device is configured to authenticate the implantable medical device when the distance between the external device and the implantable medical device is less than a predetermined threshold, and If the distance between the external device and the implantable medical device is less than a predetermined threshold, the external device is configured to be authenticated by the implantable medical device.

[0506] According to one embodiment of the communication system, the display device can be configured to allow data transfer between the display device and an external device based on authentication.

[0507] According to one embodiment of the communication system, the external device is configured to allow data transfer between the display device and the external device based on authentication.

[0508] According to one embodiment of the communication system, the external device is configured to enable data transfer between the external device and the implantable medical device based on authentication.

[0509] According to one embodiment of the communication system, the display device is a wearable external device or a handset.

[0510] According to one embodiment of the communication system, the data encrypted by the implanted medical device relates to at least one of the following: battery status, temperature, time, or error.

[0511] The invention further comprises a server for use in a communication system according to any one of the above embodiments.

[0512] A display device for use in a communication system according to any one of the above embodiments is further provided.

[0513] Further external devices for use in a communication system according to any one of the above embodiments are provided.

[0514] Further provided are implantable medical devices for use in a communication system according to any one of the above embodiments.

[0515] Medical devices designed to be implanted in a patient's body are typically powered by electricity. Such devices include electrical and mechanical stimulators, motors, pumps, etc., designed to assist or stimulate various bodily functions. These implantable medical devices are powered by similarly implanted batteries, or by repeated surgical interventions. Power can be supplied from an external energy source that can provide any required amount of power intermittently or continuously without requiring any special techniques.

[0516] Implantable energy receivers or other implantable devices necessary for the operation of implantable medical devices must be placed in the patient's body in a safe and convenient manner. To minimize the distance between external devices such as energy transmitters and the implanted device, the implanted device must often be placed close to the patient's skin. In practice, this means subcutaneous placement of the implanted device.

[0517] Furthermore, for example, to ensure accurate energy transfer, it is often important that the implanted device is kept in a relatively fixed position.

[0518] According to one embodiment of the concept of the present invention, these and other objectives are achieved entirely or at least partially by a remote unit configured to be held in place by a patient's tissue portion, the remote unit comprising: a first portion configured to be positioned on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and a first surface configured to face a first tissue surface on the first side of the tissue portion; a second portion configured to be positioned on a second side of the tissue portion, the second side having a second cross-sectional area in a second plane and a second surface configured to engage with a second tissue surface on the second side of the tissue portion; and the first and second sides of the tissue portion. A connecting portion configured to be positioned through a hole in a tissue portion extending between a first and a second 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 comprising a third surface configured to engage with a first tissue surface on the first side of the tissue portion, wherein the connecting portion is configured to connect the first portion to the second portion, where 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, the first portion, the second portion and the connecting portion are prevented from moving 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.

[0519] In some embodiments, the connecting portion includes a flange constituting a fourth cross-sectional area, which is configured to prevent movement through the holes in the tissue portion in directions perpendicular to the first, second, and third planes.

[0520] In some embodiments, the flanges project in directions parallel to the first, second, third, and fourth planes and perpendicular to the central extension of the connecting portion.

[0521] In some embodiments, the flange comprises a third surface configured to engage with a first tissue surface on the first side of the tissue portion.

[0522] In some embodiments, the connecting portion comprises at least one protruding element constituting a fourth cross-sectional area, the at least one protruding element being configured to prevent movement through the hole in the tissue portion, thereby ensuring that the second portion and the connecting portion remain in place by the patient's tissue portion even when the first portion is detached from the connecting portion.

[0523] In some embodiments, at least one protruding element projects in a direction parallel to the first, second, third, and fourth planes and perpendicular to the central extension of the connecting portion.

[0524] In some embodiments, at least one protruding element is on the first side of the tissue portion. It comprises a third surface configured to engage with the tissue surface.

[0525] In some embodiments, the connecting portion consists of at least two protruding elements that constitute a fourth cross-sectional area.

[0526] In some embodiments, at least two protruding elements are arranged symmetrically with respect to the central axis of the connecting portion.

[0527] In some embodiments, at least two protruding elements are arranged asymmetrically with respect to the central axis of the connecting portion.

[0528] In some embodiments, at least one of the first, second, and third surfaces comprises at least one of ribs, barbs, hooks, friction-enhancing surface treatments, and friction-enhancing materials, facilitating the retention of the remote unit in place by the structured portion.

[0529] In some embodiments, the connecting portion consists of a hollow section.

[0530] In some embodiments, the hollow portion provides a passage between the first and second portions.

[0531] In some embodiments, the first part is detachably connected to the connecting part by at least one of a mechanical connection and a magnetic connection.

[0532] In some embodiments, the first part is removably connected to the connecting part by at least one of threads and corresponding grooves, screws, self-locking elements, twist-locking joints, and spring-loaded locking mechanisms.

[0533] In some embodiments, at least one protruding element has a height in a direction perpendicular to the fourth plane that is less than the height of the first portion in that direction.

[0534] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than half the height of the first portion in that direction.

[0535] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than one-quarter of the height of the first portion in that direction.

[0536] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than one-tenth of the height of the first portion in that direction.

[0537] In some embodiments, at least one protruding element has a diameter in the fourth plane that is smaller than the diameter of the first portion in the first plane, equal to the diameter of the first portion in the first plane, and larger than the diameter of the first portion in the first plane.

[0538] In some embodiments, at least one protruding element has a cross-sectional area in the fourth plane that is smaller than the cross-sectional area of ​​the first portion in the first plane, equal to the cross-sectional area of ​​the first portion in the first plane, and larger than the cross-sectional area of ​​the first portion in the first plane.

[0539] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than half the height of the connecting portion in that direction.

[0540] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than one-quarter of the height of the connecting portion in that direction.

[0541] In some embodiments, at least one protruding element has a height in the direction perpendicular to the fourth plane that is less than one-tenth of the height of the connecting portion in that direction.

[0542] According to one embodiment of the concept of the present invention, these and other objectives are achieved entirely or at least partially by a remote unit configured to be held in place by a patient's tissue portion, the remote unit comprising: a first portion configured to be positioned on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and a first surface configured to face a first tissue surface on the first side of the tissue portion; and a second portion configured to be positioned on a second side of the tissue portion, the second side facing the first side, the second portion having a second cross-sectional area in a second plane The tissue comprises a second surface having an area and configured to engage with a second tissue surface on the second side of the tissue portion, and a connecting portion configured to be positioned through a hole in the tissue portion extending between the first and second sides of the tissue portion, wherein 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, where 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, the first and second portions are prevented from moving through the hole in the tissue portion in directions perpendicular to the first, second and third planes, and the connecting interface between the connecting portion and the second portion is eccentric with respect to the second portion.

[0543] In some embodiments, the connecting interface between the connecting portion and the second portion is eccentric with respect to the second portion in the first direction, but not eccentric in the second direction perpendicular to the first direction.

[0544] In some embodiments, the connection interface between the connecting portion and the second portion is eccentric with respect to the second portion in a first direction and in a second direction perpendicular to the first direction.

[0545] In some embodiments, the first and second directions are parallel to the second plane.

[0546] In some embodiments, the second portion has a first end and a second end opposite to the first end, and the second portion has a length between the first end and the second end.

[0547] In some embodiments, the first end and the second end are separated in a direction parallel to the second plane.

[0548] In some embodiments, the second portion is curved along its length.

[0549] In some embodiments, the second portion is curved in the first direction, and the second direction is perpendicular to the first direction.

[0550] In some embodiments, the first and second ends are elliptical points, respectively.

[0551] In some embodiments, the first and second ends each consist of a hemispherical end cap.

[0552] In some embodiments, the second portion has at least one circular cross-section along the length between the first end and the second end.

[0553] In some embodiments, the second portion has at least one elliptical cross-section along the length between the first end and the second end.

[0554] In some embodiments, the second portion has at least one elliptical cross-section along the length between the first end and the second end.

[0555] In some embodiments, the second portion has the length in a direction different from the central extension of the connecting portion.

[0556] In some embodiments, the second portion has a proximal region, an intermediate region, and a distal region.

[0557] In some embodiments, the proximal region extends from the first end to the 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.

[0558] In some embodiments, the proximal region is shorter than the distal region with respect to the length of the second portion.

[0559] 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.

[0560] In some embodiments, the proximal region and the distal region comprise a second surface configured to engage a second surface of a second aspect of the tissue portion.

[0561] In some embodiments, the second portion is perpendicular to each other and has a length x and a width y along respective longitudinal and width directions that are substantially parallel to a second plane, and the connection interface between the connecting portion and the second portion is included within a region extending from x>0 to x<x / 2 and / or from y>0 to y<y / 2, where x and y and 0 are respective endpoints of the second portion along the longitudinal and width directions.

[0562] In some embodiments, the second portion is tapered from the first end towards the second end.

[0563] In some embodiments, the second portion is tapered from each of the first end and the second end towards an intermediate region of the second portion.

[0564] In some embodiments, the first portion has a maximum dimension 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.

[0565] In some embodiments, the first portion has a diameter in the range of 10 to 40 mm, for example, in the range of 10 to 30 mm, for example, in the range of 15 to 25 mm.

[0566] In some embodiments, the connecting portion has a maximum dimension in the third plane in the range of 2 to 20 mm, for example, in the range of 2 to 15 mm, for example, in the range of 5 to 10 mm.

[0567] In some embodiments, the second part has a maximum dimension in the range of 30 to 90 mm, for example, in the range of 30 to 70 mm, for example, in the range of 35 to 60 mm.

[0568] In some embodiments, the first part is spherical, ellipsoidal, polyhedral, or elongated. It has one or more of the following shapes: a solid shape and a flat disc shape.

[0569] In some embodiments, the connecting portion has one of the following cross-sections in a plane parallel to the third plane: an elliptical cross-section, an elongated cross-section, and a circular cross-section.

[0570] In some embodiments, the distal region is configured to face downwards towards a standing patient.

[0571] In some embodiments, the first portion comprises a proximal region extending from a first end to the interface between the connecting portion and the first portion, an intermediate region defined by the 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.

[0572] In some embodiments, the first portion has a first height and the second portion has a second height, both heights are perpendicular to the first and second planes, and the first height is smaller than the second height.

[0573] In some embodiments, the first height is less than two-thirds of the second height, for example, less than half of the second height, for example, less than one-third of the second height.

[0574] In some embodiments, the second end of the second portion includes a connector for connecting to an implant located caudally from the location of the remote unit within the patient.

[0575] In some embodiments, the first end of the second portion constitutes a connector for connecting to an implant located cranially from the position of a remote unit within the patient.

[0576] According to one embodiment of the concept of the present invention, these and other objectives are achieved entirely or at least partially by a remote unit configured to be held in place by a patient's tissue portion, the remote unit comprising: a first portion configured to be positioned on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and a first surface configured to face a first tissue surface on the first side of the tissue portion; a second portion configured to be positioned on a second side of the tissue portion, the second side facing the first side, the second portion having a second cross-sectional area in a second plane and a second surface configured to engage with a second tissue surface of a second aspect of the tissue portion; and a connecting portion configured to be positioned through a hole in the tissue portion extending between the first and second aspects of the tissue portion, the connecting portion in a third plane It has a third cross-sectional area, and is configured to connect the first part to the second part, where the first plane, the second plane and the third plane are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, and the first and second parts are prevented from moving through the holes in the tissue part in a direction perpendicular to the first plane, the second plane and the third plane, and the first cross-sectional area has a first cross-sectional distance and a second cross-sectional distance, and the first cross-sectional distance The first and second cross-sectional distances are perpendicular to each other, and the first cross-sectional distance is longer than the second cross-sectional distance. The second cross-sectional region has the first and second cross-sectional distances, and the first and second cross-sectional distances are perpendicular to each other, and the first cross-sectional distance is longer than the second cross-sectional distance. The first cross-sectional distance of the first cross-sectional region and the first cross-sectional distance of the second cross-sectional region are rotationally displaced relative to each other at an angle greater than 45° to facilitate insertion of the second portion through the hole in the tissue portion.

[0577] 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 relative to each other at an angle greater than 60° to facilitate insertion of the second portion through the hole in the tissue portion.

[0578] 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 in order to facilitate the insertion of the second portion through the hole in the tissue portion.

[0579] 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 relative to each other at an angle greater than 45° and less than 135°.

[0580] In some embodiments, the cross-sectional area of ​​the first portion is elongated.

[0581] In some embodiments, the cross-sectional area of ​​the second portion is elongated.

[0582] In some embodiments, the connecting portion is connected to the second portion eccentrically.

[0583] In some embodiments, the first cross-sectional distance of the second portion is divided into first, second, and third equal-length portions, and the connecting portion is connected to the second portion along the first length portion of the first cross-sectional distance.

[0584] In some embodiments, the first cross-sectional area of ​​the first portion is elongated.

[0585] In some embodiments, the second cross-sectional area of ​​the second portion is elongated.

[0586] In some embodiments, the first part comprises a first radio energy receiver configured to receive energy radio-transmitted from an external radio energy transmitter.

[0587] In some embodiments, the first part constitutes an internal radio energy transmitter.

[0588] In some embodiments, the second part comprises a second radio energy receiver.

[0589] In some embodiments, the first part comprises a first energy storage unit.

[0590] In some embodiments, the second part constitutes a second energy storage unit.

[0591] In some embodiments, at least one of the first and second energy storage units is a solid-state battery.

[0592] In some embodiments, the solid-state battery is a thionyl chloride battery.

[0593] In some embodiments, a first wireless energy receiver is configured to receive energy wirelessly transmitted by an external wireless energy transmitter and store the received energy in a first energy storage unit, an internal wireless energy transmitter is configured to wirelessly transmit the energy stored in the first energy storage unit to a second wireless energy receiver, and the second wireless energy receiver is configured to receive energy wirelessly transmitted by the internal wireless energy transmitter and store the received energy in a second energy storage unit.

[0594] In some embodiments, the first part comprises a first controller including at least one processing unit.

[0595] In some embodiments, the second part includes a second processing unit comprising at least one processing unit. It is equipped with a controller.

[0596] In some embodiments, at least one of the first and second controllers is connected to a wireless transceiver for wireless communication with an external device.

[0597] In some embodiments, the first controller is connected to a first wireless communication receiver in the first part to receive wireless communication from an external device, and the first controller is connected to a first wireless communication transmitter in the first part to transmit wireless communication to a second wireless communication receiver in the second part.

[0598] In some embodiments, the second controller is connected to a second wireless communication receiver for receiving wireless communication from the first unit.

[0599] In some embodiments, the first wireless energy receiver consists of a first coil, and the internal wireless energy transmitter consists of a second coil.

[0600] In some embodiments, the first part comprises a composite coil, which is configured to wirelessly receive energy from an external wireless energy transmitter and wirelessly transmit the energy to a second wireless receiver in the second part.

[0601] In some embodiments, at least one of the coils is embedded in a ceramic material.

[0602] In some embodiments, the remote unit further comprises a housing configured to enclose at least a first portion, the first portion of the housing being made of titanium, and the second portion of the housing being made of a ceramic material.

[0603] In some embodiments, a portion of the housing made from a ceramic material includes at least one coil embedded in the ceramic material.

[0604] In some embodiments, the remote unit further comprises a housing configured to enclose at least a second portion, the first portion of the housing being made of titanium and the second portion of the housing being made of a ceramic material.

[0605] In some embodiments, a portion of the housing made from a ceramic material includes at least one coil embedded in the ceramic material.

[0606] According to one embodiment of the concept of the present invention, these and other objectives are achieved, in whole or at least in part, by a remote unit configured to be held in place by a tissue portion of a patient, the remote unit comprising: a first portion configured to be positioned on a first side of the tissue portion, the first portion having a first cross-sectional area in a first plane and a first surface configured to face a first tissue surface on the first side of the tissue portion; and a second portion configured to be positioned on a second side of the tissue portion, the second side facing the first side A tissue comprising a first portion and a second portion, the second portion having a second cross-sectional area in a second plane and a second surface configured to engage with the second tissue surface of the second aspect of the tissue portion, and a connecting portion configured to be positioned through a hole in the tissue portion extending between the first aspect and the second aspect of the tissue portion, the connecting portion having a third cross-sectional area in a third plane and configured to connect the first portion to the second portion, where the first plane, the second plane and the third plane are parallel to each other, the third cross-sectional area is smaller than the first and second cross-sectional areas, and the first portion The first part comprises a first radio energy receiver for receiving energy radiotransmitted by an external radio energy transmitter and an internal radio energy transmitter configured to radiotransmit energy to the second part, wherein the second part comprises a second radio energy receiver configured to receive energy radiotransmitted by the internal radio energy transmitter.

[0607] In some embodiments, the remote unit further comprises at least one sensor for providing input to at least one of the first and second controllers.

[0608] In some embodiments, the sensor is configured to sense the physical parameters of a remote unit.

[0609] In some embodiments, the sensor is configured to sense at least one of the following: the temperature of the remote unit or body engagement part, parameters related to the power consumption of the remote unit or body engagement part, parameters related to the state of at least one of the first and second energy storage units, parameters related to the wireless transfer of energy from an energy source outside the patient's body, and hydraulic pressure.

[0610] In some embodiments, the sensor is configured to sense the physiological parameters of a patient.

[0611] In some embodiments, the sensor is configured to sense at least one of the following: parameters relating to the patient's swallowing, local temperature, whole-body temperature, blood saturation, blood oxygenation, blood pressure, parameters relating to ischemic markers, and pH.

[0612] In some embodiments, a sensor configured to sense parameters related to a patient's swallowing comprises at least one of a motion sensor, an acoustic sensor, an optical sensor, and a strain sensor.

[0613] In some embodiments, a sensor configured to sense pH is configured to sense the acidity in the stomach.

[0614] In some embodiments, the controller is configured to transmit information based on sensor inputs to a device outside the patient's body.

[0615] In some embodiments, the second portion constitutes at least part of an operating device for operating an implantable body engagement portion.

[0616] In some embodiments, the second part consists of at least one electric motor.

[0617] In some embodiments, the second part consists of a transmission configured to reduce the speed of motion and increase the force generated by the electric motor.

[0618] In some embodiments, the transmission is configured to transmit a force at a high speed to a strong force at a low speed.

[0619] In some embodiments, the transmission is configured to convert rotational force into linear force.

[0620] In some embodiments, the transmission consists of a gear system.

[0621] In some embodiments, the second part includes a magnetic coupling for transmitting mechanical work from an electric motor through one of the following: a barrier separating the first chamber of the second part from the second chamber of the second part, or a housing enclosing at least the second part.

[0622] In some embodiments, the second part comprises at least one hydraulic pump.

[0623] In some embodiments, the hydraulic pump comprises a pump including at least one compressible hydraulic reservoir.

[0624] In some embodiments, the remote unit further comprises a capacitor connected to at least one of the first and second energy storage units and connected to an electric motor, the capacitor being charged by at least one of the first and second energy storage units and configured to supply power to the electric motor.

[0625] In some embodiments, at least one of the first and second parts comprises a sensation generator adapted to produce a sensation detectable by the patient's senses.

[0626] In some embodiments, the second portion includes a force transmission element configured to mechanically transmit force from the second portion to the implant engagement portion.

[0627] In some embodiments, the second portion includes a force transmission element configured to transmit force hydraulically from the second portion to the implant engagement portion.

[0628] In some embodiments, the second part comprises at least one lead for transmitting electrical energy and / or information from the second part to an implanted body engagement portion.

[0629] In some embodiments, the first part includes an injection port for injecting fluid into the first part.

[0630] In some embodiments, the connecting portion includes a conduit for transferring fluid from the first portion to the second portion.

[0631] In some embodiments, the conduit is positioned to extend through the hollow portion of the connection.

[0632] In some embodiments, the second part comprises a first chamber and a second chamber spaced apart from each other, the first chamber containing a first liquid and the second chamber containing a second liquid, the second liquid being a hydraulic fluid configured to transmit force to an implantable element configured to exert force on a part of the patient's body.

[0633] In some embodiments, the wall of the first chamber has elasticity that allows the first chamber to expand.

[0634] In some embodiments, the second part comprises a first hydraulic system in fluid communication with a first hydraulically actuated implant configured to exert force on a part of the patient's body, and a second hydraulic system in fluid communication with a second hydraulically actuated implant configured to exert force on a part of the patient's body, wherein the first and second hydraulically actuated implants are independently adjustable.

[0635] In some embodiments, the first hydraulic system consists of a first hydraulic pump, and the second hydraulic system consists of a second hydraulic pump.

[0636] In some embodiments, each of the first and second hydraulic systems includes a reservoir for holding the working fluid.

[0637] In some embodiments, the implantable electrotherapy device further comprises a first pressure sensor configured to sense pressure in a first hydraulic system and a second pressure sensor configured to sense pressure in a second hydraulic system.

[0638] In some embodiments, the first surface is configured to engage with the first tissue surface on the first side of the tissue portion.

[0639] In some embodiments, the first, second, and third planes are parallel to the primary elongation planes of the tissue.

[0640] According to one embodiment of the concept of the present invention, these and other objectives are achieved entirely or at least partially by a remote unit configured to be held in place by a patient's tissue portion, the remote unit comprising: a first portion configured to be positioned 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 on the first side of the tissue portion; and a second portion configured to be positioned on a second side of the tissue portion, the second portion having a second cross-sectional area in a second plane and comprising a second surface configured to engage with a second tissue surface on the second side of the tissue portion, the first side of the tissue portion and the The first part comprises a connecting part configured to be positioned through a hole in the tissue portion extending between it and a second side, the connecting part having a third cross-sectional area in a third plane and configured to connect the first part to the second part, where the first, second, and third planes are parallel to each other, the third cross-sectional area being smaller than the first and second cross-sectional areas, and preventing the first and second parts from moving through the hole in the tissue portion in directions perpendicular to the first, second, and third planes, and at least one of the first and second parts comprises at least one coil embedded in a ceramic material, the at least one coil configured for at least one of receiving energy transmitted wirelessly, transmitting energy wirelessly, receiving wireless communication, and transmitting wireless communication.

[0641] In some embodiments, the first part comprises a first radio energy receiver configured to receive energy radio-transmitted from an external radio energy transmitter.

[0642] In some embodiments, the first part comprises a first wireless communication receiver.

[0643] In some embodiments, the first part consists of a coil embedded in a ceramic material, and is hereinafter referred to as the first coil.

[0644] In some embodiments, the first wireless energy receiver consists of a first coil.

[0645] In some embodiments, the first wireless communication receiver constitutes the first coil.

[0646] In some embodiments, the first part is a connecting part along a direction perpendicular to the first plane. It has a distal end and a proximal end relative to the minute.

[0647] In some embodiments, the first coil is located at the distal end of the first portion.

[0648] In some embodiments, the first part constitutes an internal radio energy transmitter.

[0649] In some embodiments, the first part consists of a first wireless communication transmitter.

[0650] In some embodiments, the first part consists of a coil embedded in a ceramic material, and is hereafter referred to as the second coil.

[0651] In some embodiments, the internal radio energy transmitter constitutes a second coil.

[0652] In some embodiments, the first wireless communication transmitter constitutes the second coil.

[0653] In some embodiments, the second coil is located at the proximal end of the first portion.

[0654] In some embodiments, the first radio energy receiver and internal radio energy transmitter consist of a single coil embedded in a ceramic material.

[0655] In some embodiments, the first wireless communication receiver and the first wireless communication transmitter consist of a single coil embedded in a ceramic material.

[0656] In some embodiments, the first wireless energy receiver, internal wireless energy transmitter, first wireless communication receiver, and internal wireless communication transmitter consist of a single coil embedded in a ceramic material.

[0657] In some embodiments, the second part comprises a second wireless energy receiver.

[0658] In some embodiments, the second part includes a coil embedded in a ceramic material (hereinafter referred to as the third coil), and the second wireless energy receiver includes the third coil.

[0659] 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.

[0660] In some embodiments, the third coil is located at the proximal end of the second portion.

[0661] In some embodiments, the first part comprises a first energy storage unit.

[0662] In some embodiments, the second part constitutes a second energy storage unit.

[0663] In some embodiments, a first wireless energy receiver is configured to receive energy wirelessly transmitted by an external wireless energy transmitter and store the received energy in a first energy storage unit, an internal wireless energy transmitter is configured to wirelessly transmit the energy stored in the first energy storage unit to a second wireless energy receiver, and the second wireless energy receiver is configured to receive energy wirelessly transmitted by the internal wireless energy transmitter and store the received energy in a second energy storage unit.

[0664] In some embodiments, the first energy storage unit is configured to store less energy than the second energy storage unit and to charge faster than the second energy storage unit.

[0665] In some embodiments, the first energy storage unit has a lower energy density than the second energy storage unit.

[0666] In some embodiments, the remote unit further comprises a housing configured to enclose at least a first portion, the first portion of the housing being made of titanium, and the second portion of the housing being made of a ceramic material.

[0667] In some embodiments, the housing made from a ceramic material includes at least one coil embedded in the ceramic material.

[0668] In some embodiments, the remote unit further comprises a housing configured to enclose at least a second portion, the first portion of the housing being made of titanium and the second portion of the housing being made of a ceramic material.

[0669] In some embodiments, a portion of the housing made from a ceramic material constitutes at least one coil embedded in the ceramic material.

[0670] In some embodiments, the first, second, and third planes are parallel to the primary elongation planes of the tissue.

[0671] In some embodiments, the connecting portion further includes a fourth cross-sectional area in a fourth plane, the fourth plane being parallel to the first, second, and third planes, and the third cross-sectional area being smaller than the fourth cross-sectional area.

[0672] In some embodiments, the connecting portion consists of a protruding element that constitutes a fourth cross-sectional area.

[0673] In some embodiments, the fourth plane is parallel to the primary elongation plane of the tissue.

[0674] In some embodiments, the connecting interface between the connecting portion and the second portion is eccentric with respect to the second portion.

[0675] According to one embodiment of the concept of the present invention, an implantable device for exerting force on a part of a patient's body is provided, the implantable device comprising a remote unit and an implantable element configured to exert force on a part of the patient's body.

[0676] In some embodiments, an implantable element configured to exert force on a part of a patient's body is an implantable hydraulic stenosis device.

[0677] In some embodiments, the implantable hydraulic stenosis device is configured to narrow a patient's tubular organ.

[0678] In some embodiments, the implantable hydraulic stricture device comprises an implantable hydraulic stricture device for narrowing a patient's intestine.

[0679] In some embodiments, the implantable hydraulic stricture device comprises an implantable hydraulic stricture device for narrowing a patient's colon or rectum.

[0680] In some embodiments, the implantable hydraulic stenosis device comprises an implantable hydraulic stenosis device for narrowing the intestine in the area of ​​a patient's stoma.

[0681] In some embodiments, the implantable hydraulic stenosis device comprises an implantable hydraulic stenosis device for narrowing a patient's blood vessels.

[0682] In some embodiments, an implantable hydraulic stenosis device for narrowing a patient's blood vessels is configured to narrow venous blood flow from the erectile tissue in order to facilitate anchoring of the erectile tissue.

[0683] In some embodiments, the implantable hydraulic stenosis device comprises an implantable hydraulic stenosis device for narrowing a patient's blood vessels.

[0684] In some embodiments, an implantable element configured to exert force on a part of the patient's body is an implantable element for actively emptying the patient's bladder.

[0685] In some embodiments, an implantable element for actively emptying a patient's bladder is configured to empty the patient's bladder by compressing it from the outside.

[0686] In some embodiments, an implantable element configured to exert force on a part of the patient's body is an implantable element for actively stretching the patient's stomach wall to induce a feeling of fullness.

[0687] According to one embodiment, the electric motor is a piezoelectric motor. Piezoelectric motors are advantageous in that they offer high precision, low power consumption, miniaturization, and lightweight design, as well as high motion accuracy and relative resistance to interference such as electromagnetic interference. Furthermore, piezoelectric motors can be manufactured without using magnetic and / or metal components.

[0688] According to one embodiment, the piezoelectric motor is a piezoelectric inchworm motor.

[0689] According to one embodiment, the piezoelectric motor is a piezoelectric inertia motor.

[0690] According to one embodiment, the piezoelectric motor is a piezoelectric walk-drive motor.

[0691] According to one embodiment, the piezoelectric motor is a linear piezoelectric motor and can operate with at least one of a speed in the range of 1 mm / s to 10 mm / s, a stroke length in the range of 4 mm to 30 mm, and a force in the range of 2 N to 30 N.

[0692] According to one embodiment, the piezoelectric motor is a rotary piezoelectric motor that can operate with at least one of a rotational speed in the range of 1 mrad / s to 100 mrad / s and a torque in the range of 100 Nmm to 900 Nmm.

[0693] According to one embodiment, the piezoelectric motor is a piezoelectric ultrasonic motor, and may be a traveling wave ultrasonic motor or a standing wave ultrasonic motor.

[0694] The piezoelectric ultrasonic motor may be a rotary piezoelectric ultrasonic motor that operates with at least one of a rotational speed in the range of 10 mrad / s to 10,000 mrad / s and a torque in the range of 20 Nmm to 450 Nmm.

[0695] The piezoelectric ultrasonic motor may also be a linear piezoelectric ultrasonic motor, which has a range of 4 mm / s to 100 mm It operates with a velocity in the range of / s and at least one force in the range of 0.5N to 30N.

[0696] According to one embodiment, the piezoelectric motor comprises at least one bimorph piezoelectric actuator.

[0697] A piezoelectric motor according to any one embodiment may be substantially nonmagnetic.

[0698] The piezoelectric motor according to any one of the embodiments may be substantially nonmetallic.

[0699] A piezoelectric motor according to any one embodiment may be a reversible piezoelectric motor.

[0700] According to one embodiment, a piezoelectric pump is provided comprising a first wall, a first diaphragm, a first chamber, and a drive element. The first diaphragm and the first wall surround the first chamber. The first wall includes an inlet configured to connect the first chamber to a first inlet reservoir and an outlet configured to connect the first chamber to a first outlet reservoir. The first diaphragm is configured to bend in response to the operation of the drive element, which consists of a piezoelectric actuator or is configured to be operated by a piezoelectric motor. Piezoelectric pumps are advantageous in that they are miniaturized, energy-efficient, and implantable devices. Piezoelectric pumps can accurately deliver fluids at flow rates in the range of 0.01 ml / min to 35 ml / min and pressures in the range of 0.2 kPa to 36 kPa.

[0701] According to one embodiment, a piezoelectric pump is provided in which the inlet of a first wall portion constitutes an inlet valve and the outlet of a first wall portion constitutes an outlet valve. Either the inlet valve or the outlet valve of the first wall portion may be a check valve or an active valve. The check valve may be a ball valve. The inlet valve and the outlet valve are useful for stabilizing the flow rate in the first chamber.

[0702] According to one embodiment, the inlet of the first wall constitutes an inlet stationary element, and the outlet of the first wall constitutes an outlet stationary element, and either the inlet stationary element or the outlet stationary element is configured to function as a nozzle or a diffuser. Nozzles and diffusers are advantageous in that they are more resistant to wear and fatigue failure compared to check valves and activated valves.

[0703] According to one embodiment, the first diaphragm comprises a first movable wall portion. The first movable wall portion may consist of a lifting portion, which allows for at least one of compression and expansion to move the first movable wall portion. The first movable wall portion may consist of a substantially rigid portion. The first movable wall portion may consist of a bellows. The bellows may consist of metal. The bellows may consist of at least one of an elliptical cross section, an elliptical cross section, and a circular cross section. Metals are advantageous because they generally have a high density and fluid does not diffuse easily through them. This reduces the risk of fluid diffusing from or into the first chamber.

[0704] According to one embodiment, a piezoelectric pump is provided, further comprising an auxiliary wall and an auxiliary chamber sealed from the first chamber. The auxiliary wall and the first diaphragm surround the auxiliary chamber. The fact that the auxiliary chamber is sealed from the first chamber is advantageous in that components unsuitable for contact with the fluid in the first chamber can be housed in the auxiliary chamber. Such components may be drive elements.

[0705] According to one embodiment, a piezoelectric pump is provided, further comprising an auxiliary wall, an auxiliary chamber sealed from the first chamber, and an auxiliary diaphragm configured to bend in the same direction as the first diaphragm in response to the operation of a drive element. The auxiliary wall and the auxiliary diaphragm surround the auxiliary chamber.

[0706] According to one embodiment, the auxiliary chamber is configured to be connected to a pressure adapter that can change the pressure within the auxiliary chamber. The pressure adapter may consist of an elastic portion having a surface area, which may be configured to maintain substantially the same surface area while allowing for pressure fluctuations within the auxiliary chamber. This is advantageous in that a fibrous tissue covering at least partially the elastic portion can easily adapt to it.

[0707] According to one embodiment, a piezoelectric pump is provided further comprising a second wall, a second diaphragm, and a second chamber. The second diaphragm and the second wall surround the second chamber. The second wall includes an inlet configured to connect the second chamber to a second inlet reservoir and an outlet configured to connect the second chamber to a second outlet reservoir. The second diaphragm is configured to bend in the same direction as the first diaphragm in response to the operation of a drive element. This embodiment is advantageous in that the piezoelectric pump is configured to operate in double mode.

[0708] According to one embodiment, the inlet of the second wall consists of an inlet valve, and the outlet of the second wall consists of an outlet valve. Either the inlet valve or the outlet valve of the second wall may be a check valve or an activated valve. The check valve may be a ball valve. The inlet valve and the outlet valve are useful for stabilizing the flow rate in the second chamber.

[0709] According to one embodiment, the inlet of the second wall consists of an inlet stationary element, and the outlet of the second wall consists of an outlet stationary element, and either the inlet stationary element or the outlet stationary element is configured to function as a nozzle or a diffuser. Nozzles and diffusers are advantageous compared to check valves and activated valves in that they are more resistant to wear and fatigue failure.

[0710] According to one embodiment, the piezoelectric pump consists of at least two parts connected in series, each part being a piezoelectric pump. The series connection allows for higher pressure compared to a piezoelectric pump in which the fluid is transferred from an inlet to an outlet reservoir through a single chamber.

[0711] According to one embodiment, the piezoelectric pump comprises at least two parts connected in series, each part being a piezoelectric pump configured to operate in double mode. The series connection allows for greater pressure compared to a piezoelectric pump configured to operate in double mode, where a first fluid is transferred through a single first chamber from a first inlet reservoir to a first outlet reservoir, and a second fluid is transferred through a single second chamber from a second inlet reservoir to a second outlet reservoir.

[0712] According to one embodiment, the piezoelectric pump consists of at least two parts connected in parallel, each part being a piezoelectric pump. The parallel connection allows for higher flow rates compared to a piezoelectric pump configured such that the inlet reservoir is connected to a single inlet and the outlet reservoir is connected to a single outlet.

[0713] According to one embodiment, the piezoelectric pump comprises at least two parts connected in parallel, each part being a piezoelectric pump configured to operate in double mode. The parallel connection allows for higher flow rates compared to a piezoelectric pump configured to operate in double mode, where a first inlet reservoir and a second inlet reservoir are connected to a single first inlet and a single second inlet, respectively, and a first outlet reservoir and a second outlet reservoir are connected to a single first outlet and a single second outlet, respectively.

[0714] According to one embodiment, the medical device further comprises a controller configured to control a piezoelectric pump. According to one embodiment, the medical device further comprises a sensor configured to measure parameters of a piezoelectric pump and a feedback unit. The sensor is further configured to transmit the measured parameters to the feedback unit. The feedback unit is configured to transmit adjustment signals to a controller based on the measured parameters received from the sensor and based on the parameter setpoints. The controller is configured to adjust the control of the piezoelectric pump based on the conditioning signals received from the feedback unit so that the measured parameters achieve the setpoints.

[0715] According to one embodiment of the concept of the present invention, these and other objectives are achieved entirely or at least partially by a method for implanting a remote unit, the method comprising: positioning a second portion of the remote unit between the peritoneum and the layer of abdominal wall muscle tissue; positioning a first portion of the remote unit between the patient's skin and the layer of abdominal wall muscle tissue, wherein the first and second portions are configured to be connected by a connecting portion extending through at least one layer of abdominal wall muscle tissue; and positioning a body engagement portion of the remote unit in relation to the patient's tissue or organ affected by the remote unit, and positioning at least partially between the peritoneum and the layer of abdominal wall muscle tissue a transmission member configured to transmit at least one of energy and force from the second portion to the body engagement portion, such that at least one-third of the length of the transmission member is positioned outside the peritoneum.

[0716] In some embodiments, the transmission member is configured to transmit mechanical force from the second part to the body engagement part.

[0717] In some embodiments, the transmission member is configured to transmit fluid pressure from the second portion to the body engagement portion.

[0718] In some embodiments, the transmission member is configured to transmit electrical energy force from the second portion to the body engagement portion.

[0719] In some embodiments, the transfer member is configured to transfer data between the second portion and the body engagement portion.

[0720] In some embodiments, the step of positioning the transport member comprises positioning the transport member at least partially between the peritoneum and the layer of muscular tissue of the abdominal wall such that at least half of the length of the transport member is positioned outside the patient's peritoneum.

[0721] In some embodiments, the step of positioning the transport member comprises positioning the transport member at least partially between the peritoneum and the layer of abdominal wall muscle tissue such that at least two-thirds of the length of the transport member is positioned outside the patient's peritoneum.

[0722] In some embodiments, the step of positioning the transport member comprises positioning the transport member completely outside the patient's peritoneum.

[0723] In some embodiments, the step of positioning the transport member includes positioning the transport member so that it extends from a second portion to the region between the patient's thoracic cavity and peritoneum, outside the peritoneum.

[0724] In some embodiments, the step of positioning the transport member comprises positioning the transport member such that it extends from a second portion to the region between the patient's stomach and thoracic diaphragm.

[0725] In some embodiments, the step of positioning the transport member comprises positioning the transport member such that it extends from the second portion to the patient's stomach.

[0726] In some embodiments, the step of positioning the transport member comprises positioning the transport member such that it extends from the second portion to the patient's esophagus.

[0727] In some embodiments, the step of positioning the transport member comprises positioning the transport member so as to extend from the second portion to the retroperitoneal space.

[0728] In some embodiments, the step of positioning the transport member comprises positioning the transport member so as to extend from the second portion to the kidney region.

[0729] In some embodiments, the step of positioning the transport member comprises positioning the transport member so as to extend from the second portion to the renal artery.

[0730] In some embodiments, the step of positioning the transport member comprises positioning the transport member so that it extends from the second portion to the subperitoneal space outside the peritoneum.

[0731] In some embodiments, the step of positioning the transport member comprises positioning the transport member outside the peritoneum, extending from the second portion to the bladder.

[0732] In some embodiments, the step of positioning the transport member comprises positioning the transport member outside the peritoneum, extending from a second portion to the urethra.

[0733] In some embodiments, the step of positioning the second portion of the remote unit between the peritoneum and the layers of abdominal wall muscle tissue comprises positioning the second portion between the first and second layers of abdominal wall muscle tissue.

[0734] In some embodiments, the step of arranging the second part comprises arranging the second part which consists of an electric motor.

[0735] In some embodiments, the step of arranging the second part comprises arranging the second part, which consists of a hydraulic pump.

[0736] In some embodiments, the step of arranging the second part includes arranging the second part which includes an energy storage unit.

[0737] In some embodiments, the step of arranging the second part includes arranging the second part which includes a receiver for wirelessly receiving at least one of energy and communications.

[0738] In some embodiments, the step of arranging the first part includes arranging the first part which includes a transmitter for wirelessly transmitting at least one of energy and / or communications.

[0739] In some embodiments, the step of arranging the second part comprises arranging the second part which constitutes a controller involved in the control of a powered medical device.

[0740] In some embodiments, the second portion is elongated and has a length axis substantially extending in the elongated direction of the second portion, and the step of positioning the second portion is such that the length axis is aligned with the patient's craniococcal axis This includes positioning the second part so that it is substantially parallel.

[0741] In some embodiments, the second portion is elongated and has a length axis substantially extending in the elongated direction of the second portion, and the step of positioning the second portion includes positioning the second portion such that the length axis is substantially perpendicular to the patient's craniococcal axis.

[0742] In some embodiments, the second portion is elongated and has a length axis substantially extending in the elongated direction of the second portion, and the step of positioning the second portion includes making a hole in the layer of muscular tissue of the stomach wall in the direction of the length axis of the second portion, and then oscillating or angling the second portion after the hole has been made.

[0743] In some embodiments, the step of positioning the first portion of the remote unit between the patient's skin and the layer of muscle tissue of the abdominal wall comprises positioning the first portion in the subcutaneous tissue.

[0744] In some embodiments, the step of positioning a first portion of the remote unit between the patient's skin and the layers of abdominal wall muscle tissue comprises positioning the first portion between a first layer and a second layer of abdominal wall muscle tissue.

[0745] In some embodiments, the step of arranging the first part includes arranging the first part which includes an energy storage unit.

[0746] In some embodiments, the step of arranging the first part includes arranging the first part which includes a receiver for wirelessly receiving at least one of energy and communications.

[0747] In some embodiments, the step of arranging the first part includes arranging the first part which includes a transmitter for wirelessly transmitting at least one of energy and / or communications.

[0748] In some embodiments, the step of arranging the first part comprises arranging the first part which constitutes a controller involved in the control of a powered medical device.

[0749] In some embodiments, the first portion is elongated and has a length axis substantially extending in the elongated direction of the first portion, and the step of positioning the first portion includes positioning the first portion such that the length axis is substantially parallel to the patient's craniococcal axis.

[0750] In some embodiments, the first portion is elongated and has a length axis substantially extending in the elongated direction of the first portion, and the step of positioning the first portion includes positioning the first portion such that the length axis is substantially perpendicular to the patient's craniocranial axis.

[0751] In some embodiments, the first portion is elongated and has a first portion major axis substantially extending in the direction of elongation of the first portion, and the second portion is elongated and has a second portion major axis substantially extending in the direction of elongation of the second portion, and the step of arranging the first portion and the second portion includes arranging the first portion and the second portion such that the first portion major axis and the second portion major axis are arranged at an angle greater than 30° with respect to each other.

[0752] In some embodiments, the step of arranging the first and second parts includes arranging the first and second parts such that the major axes of the first and second parts are positioned at an angle greater than 45° with respect to each other.

[0753] In some embodiments, this method involves passing through at least one layer of abdominal wall muscle tissue. The process further includes the step of positioning the connecting parts.

[0754] In some embodiments, the first part, the second part, and the connecting part are parts of a single unit.

[0755] In some embodiments, the method further includes the step of connecting the first portion in place to the connecting portion.

[0756] In some embodiments, the method further includes the step of connecting the second portion in situ to the connecting portion.

[0757] In some embodiments, the method further includes the step of connecting the transfer member to the first portion.

[0758] In some embodiments, the method further includes the step of connecting the transport member to the body engagement portion.

[0759] In some embodiments, the body engagement portion consists of a medical device for stretching the stomach wall to induce a feeling of fullness.

[0760] In some embodiments, the body engagement portion includes a stenosis device configured to narrow the patient's tubular organ.

[0761] In some embodiments, the body engagement portion consists of an implantable constriction device.

[0762] In some embodiments, the implantable stenosis device comprises an implantable stenosis device for narrowing a patient's tubular organ.

[0763] In some embodiments, the implantable stricture device comprises an implantable stricture device for narrowing a patient's intestine.

[0764] In some embodiments, the implantable stricture device comprises an implantable stricture device for narrowing the patient's colon or rectum.

[0765] In some embodiments, the implantable stricture device comprises an implantable stricture device for narrowing the intestine in the area of ​​the patient's stoma.

[0766] In some embodiments, the implantable stenotic device comprises an implantable stenotic device for narrowing a patient's blood vessels.

[0767] In some embodiments, an implantable stenosis device for narrowing a patient's blood vessels is configured to narrow venous blood flow from the erectile tissue in order to facilitate anchoring of the erectile tissue.

[0768] In some embodiments, an implantable stenotic device for narrowing a patient's blood vessels is configured to constrict blood flow in the renal artery and affect the patient's systemic blood pressure.

[0769] In some embodiments, the implantable stenosis device comprises an implantable stenosis device for narrowing a patient's blood vessels.

[0770] In some embodiments, the body engagement portion includes an implantable element for actively emptying the patient's bladder.

[0771] In some embodiments, an implantable element for actively emptying a patient's bladder is configured to empty the patient's bladder by compressing it from the outside.

[0772] In some embodiments, the body engagement portion includes an element for electrically stimulating a portion of the patient's tissue.

[0773] According to one embodiment of the concept of the present invention, these and other objectives are achieved, in whole or in part, by a kit for assembling a remote unit configured to be held in place by a tissue portion of a patient, the kit comprising: a group of one or more first parts, a group of one or more second parts, a group of one or more connecting parts, wherein at least one of the groups comprises at least two different types of each of the parts; the remote unit is a modular device comprising, when assembled, selecting one first part, one second part, and one connecting part from the groups, wherein the first part is configured to be positioned on the first side of the tissue portion, the first part having a first cross-sectional area in a first plane, and on the first side of the tissue portion The first surface is configured to face the first tissue surface, the second portion is configured to be positioned on the second side of the tissue portion, the second side facing the first side, the second portion has a second cross-sectional area in the second plane and comprises a second surface configured to engage with the second tissue surface of the second aspect of the tissue portion, the connecting portion is configured to be positioned through a hole in the tissue portion extending between the first aspect and the second aspect of the tissue portion, the connecting portion has a third cross-sectional area in the third plane and comprises a connecting portion to connect the first portion to the second portion, where 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 and prevents the first and second portions from moving through the hole in the tissue portion in a direction perpendicular to the first, second and third planes.

[0774] In general, any of the embodiments of the remote unit disclosed herein can form part of such a kit, and features of such embodiments can be combined to form part of such a kit.

[0775] In some embodiments, one or more groups of first parts include a first part that contains a first energy storage unit.

[0776] In some embodiments, one or more groups of first parts include a first part that includes a first radio energy receiving unit for receiving energy radio-transmitted by an external radio energy transmitter.

[0777] In some embodiments, a first energy storage unit is connected to a first wireless energy receiver, which is configured to receive energy wirelessly transmitted by an external wireless energy transmitter and store the received energy in the first energy storage unit.

[0778] In some embodiments, the first wireless energy receiver is configured to be physically connected to the second energy storage unit of the second part.

[0779] In some embodiments, one or more groups of first parts include a first part that contains an internal radio energy transmitter.

[0780] In some embodiments, a group of one or more second parts includes a second part comprising a second radio energy receiver configured to receive energy radio-transmitted by an internal radio energy transmitter.

[0781] In some embodiments, the internal wireless energy transmitter is configured to wirelessly transmit energy to a second wireless energy receiver.

[0782] In some embodiments, a group of one or more second parts comprises a second part including a second energy storage unit connected to a second wireless energy receiver.

[0783] In some embodiments, a second wireless energy receiver is configured to receive energy wirelessly transmitted by an internal wireless energy transmitter and store the received energy in a second energy storage unit.

[0784] In some embodiments, one or more groups of first parts consist of first parts formed integrally with the connecting portion.

[0785] In some embodiments, one or more groups of second parts consist of second parts formed integrally with the connecting portion.

[0786] In some embodiments, one of a group of one or more first parts, second parts, or connecting parts comprises a first part, a second part, and a connecting part that are formed as a single integrated unit.

[0787] In some embodiments, a group of one or more first parts includes a first part having a first height along a direction perpendicular to a first plane and a first part having a second height along the same direction perpendicular to the first plane, wherein the second height is greater than the first height.

[0788] In some embodiments, one or more groups of first parts include a first part having a first width and / or length along a direction parallel to a first plane, and a first part having a second width and / or length along the direction parallel to the first plane, wherein the second width and / or length is greater than the first width and / or length.

[0789] In some embodiments, a group of one or more second parts includes a second part having a first height along a direction perpendicular to a second plane and a second part having a second height along the same direction perpendicular to the second plane, wherein the second height is greater than the first height.

[0790] In some embodiments, a group of one or more second parts includes a second part having a first width and / or length along a direction parallel to a second plane, and a second part having a second width and / or length along the direction parallel to the second plane, wherein the second width and / or length is greater than the first width and / or length.

[0791] In some embodiments, a group of one or more connecting portions comprises a connecting portion having a first height along a direction perpendicular to a third plane and a connecting portion having a second height along the same direction perpendicular to the third plane, wherein the second height is greater than the first height.

[0792] In some embodiments, a group of one or more connecting portions comprises a connecting portion having a first width and / or length along a direction parallel to a third plane, and a connecting portion having a second width and / or length along the direction parallel to the third plane, and The length is greater than the first width and / or length.

[0793] In some embodiments, a group of one or more first parts comprises a first part that includes an injection port for injecting fluid into the first part.

[0794] In some embodiments, a group of one or more connection portions comprises a connection portion that includes a hydraulic fluid conduit for hydraulically connecting a first portion to a second portion.

[0795] In some embodiments, a group of one or more first parts comprises a first part that includes a first controller, which includes at least one processing unit.

[0796] In some embodiments, a group of one or more second parts comprises a second part that includes a second controller comprising at least one processing unit.

[0797] In some embodiments, at least one of the first and second controllers is connected to a wireless transceiver for wireless communication with an external device.

[0798] In some embodiments, the first controller is connected to a first wireless communication receiver in the first part to receive wireless communication from an external device, and the first controller is connected to a first wireless communication transmitter in the first part to transmit wireless communication to a second wireless communication receiver in the second part.

[0799] In some embodiments, the second controller is connected to a second wireless communication receiver for receiving wireless communication from the first unit.

[0800] In some embodiments, the first wireless energy receiver consists of a first coil, and the internal wireless energy transmitter consists of a second coil.

[0801] In some embodiments, the first group of parts comprises a first part including a composite coil, which is configured to wirelessly receive radio energy from an external radio energy transmitter and wirelessly transmit the radio energy to a second radio receiver in the second part.

[0802] In some embodiments, at least one of the coils is embedded in a ceramic material.

[0803] In some embodiments, one or more groups of first parts comprise a first part consisting of push buttons and / or capacitive buttons for controlling the functions of a remote unit.

[0804] As used in this disclosure, the term “body tissue” may refer to one or more groups or layers of a patient’s body tissue, such as muscle tissue, connective tissue, or bone.

[0805] An external device is provided which is configured to communicate with an implantable medical device when implanted in a patient. The external device comprises at least one first radio transceiver configured to communicate with the implantable medical device using a first network protocol to determine the distance between the external device and the implantable medical device, and at least one second radio transceiver configured to communicate with the implantable medical device using a second network protocol to transfer data between the external device and the implantable medical device.

[0806] According to one embodiment, the first wireless transceiver is composed of a UWB transceiver.

[0807] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to the energy consumption components of an implantable medical device and charging an implantable energy storage unit.

[0808] According to one embodiment, the second network protocol is a standard network protocol. The standard network protocol may be one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0809] According to one embodiment, the second wireless transceiver is comprised of a Bluetooth transceiver.

[0810] According to one embodiment, the external device is further configured to communicate with the second external device using the at least one wireless transceiver.

[0811] According to one embodiment, the external device is configured to determine the distance between the external device and the implantable medical device by determining the RSSI.

[0812] According to one embodiment, the communication range of the first network protocol is smaller than the communication range of the second network protocol.

[0813] According to one embodiment, the frequency band of the first network protocol is different from the frequency band of the second network protocol.

[0814] According to one embodiment, the external device is configured to authenticate an implantable medical device when the determined distance between the external device and the implantable medical device is less than a predetermined threshold.

[0815] According to one embodiment, the external device is configured to enable data transfer between the external device and the implantable medical device after the implantable medical device has been authenticated.

[0816] According to one embodiment, the external device is one selected from a wearable external device and a handset.

[0817] An implantable medical device is provided which is configured to communicate with an external device. The implantable medical device comprises at least one first radio transceiver configured to communicate with the external device using a first network protocol to determine the distance between the external device and the implantable medical device, and at least one second radio transceiver configured to communicate with the external device using a second network protocol to transfer data between the external device and the implantable medical device.

[0818] According to one embodiment, the first wireless transceiver is composed of a UWB transceiver.

[0819] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to an energy-consuming component of an implantable medical device and charging an implantable energy storage unit.

[0820] According to one embodiment, the second network protocol is a standard network protocol selected from the list of radio frequency protocols, RFID protocols, WLAN protocols, Bluetooth protocols, BLE protocols, NFC protocols, 3G / 4G / 5G protocols, and GSM protocols.

[0821] According to one embodiment, the second wireless transceiver is comprised of a Bluetooth transceiver.

[0822] According to one embodiment, the implantable medical device is further configured to communicate with a second external device using the at least one wireless transceiver.

[0823] According to one embodiment, the implantable medical device is configured to determine the distance between the external device and the implantable medical device by determining the RSSI.

[0824] According to one embodiment, the communication range of the first network protocol is smaller than the communication range of the second network protocol.

[0825] According to one embodiment, the frequency band of the first network protocol is different from the frequency band of the second network protocol.

[0826] According to one embodiment, the implantable medical device is configured to authenticate an external device when the determined distance between the external device and the implantable medical device is less than a predetermined threshold.

[0827] According to one embodiment, the implantable medical device is configured to enable data transfer between the implantable medical device and the external device after the external device has been authenticated.

[0828] According to one embodiment, the implantable medical device comprises at least one of the following: External cardiac compression device, A device that assists the pumping function of the patient's heart. A pump function assist device consisting of a turbine bump placed inside a patient's blood vessels to assist the heart's pumping function. Operable artificial heart valve, An operable artificial heart valve to increase blood flow to the coronary arteries. Implantable drug delivery device, An implantable drug delivery device that can be injected directly into blood vessels and whose injection site can be changed. An implantable drug delivery device for injecting potency-enhancing drugs into a patient's erectile tissue. Hydraulic, mechanical, and / or electrical shrinkage implants, Operable volume filling device, Surgically treatable gastric band, A maneuverable implant for stretching the patient's stomach wall to induce a feeling of fullness. An implant configured to sense how often a patient eats food. Operable cosmetic implants, Operable cosmetic implants for adjusting the shape and / or size of a patient's breast region. An implantable medical device for emptying the bladder. An implant to prevent urinary incontinence. Implants to prevent anal incontinence An implant that controls the expulsion of feces. An implant to monitor aneurysms. Implants to prevent aneurysm expansion, Joint lubrication implants, Implants that affect blood flow to the patient's erectile tissue, An implant to simulate the expansion of erectile tissue. An implant equipped with a reservoir for storing bodily fluids. Implants for storing and / or emptying internal reservoirs or surgically fabricated reservoirs. An implant that communicates with an external database. Programmable implants from outside the body An implant that can be programmed wirelessly from outside the body. Implants to treat impotence, An implant that controls the flow of eggs within the uterine tract. An implant that controls the flow of sperm within the uterine tract. An implant that controls the flow of sperm in the vas deferens. An implant that inhibits sperm transport in the vas deferens. Implants for treating osteoarthritis, An implant that tests parameters inside the body. An implant that controls specific treatment parameters from within the body. An implant that controls bodily parameters from within the body. An implant to control blood pressure, An implant that controls blood pressure by affecting the dilation of the renal arteries. Implants that control drug therapy parameters An implant that controls parameters in the blood. Implants for adjusting or replacing bone portions of a patient's body. An implant that replaces a patient's organ, part of an organ, or its function. vascular treatment equipment, An implant that moves fluids within the patient's body. An implant configured to sense parameters related to a patient's swallowing, An implant configured to move muscles through electrical or mechanical stimulation. An implant configured to empty the intestinal tract in response to a command. A operable implant configured to be inserted into a patient's stomach to substantially reduce the volume of the stomach to a volume greater than that of the device, An implant configured to compress the bladder and empty it from the patient's body. An implant configured to drain bodily fluids from the patient's body, An implant configured to actively lubricate the joint by adding a lubricating fluid, An implant designed to remove blood clots and particles from the patient's bloodstream. Implants configured to lengthen or correct the patient's bones in order to alleviate scoliosis. A device that stimulates the brain. An artificial stomach that replaces the function of the natural stomach. An implant configured to adjust the position of the female urethra or bladder neck. An implant designed to stimulate the ampulla of a blood vessel, causing temporary constriction.

[0829] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0830] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0831] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0832] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0833] According to one embodiment, the system comprises a food sensor adapted to measure whether the patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0834] An external patient device is provided, configured to communicate with an implantable medical device when implanted in a patient. The external patient device comprises a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device and to wirelessly communicate with a patient display device, and a computing unit configured to run control software for creating control commands for the operation of the implantable medical device. The computing unit is configured to transmit the 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 convert the user input into control commands for wireless transmission to the implantable medical device.

[0835] According to one embodiment, the wireless communication unit includes a wireless transceiver for wirelessly transmitting control commands to an implantable medical device and for wirelessly transmitting a control interface as a remote display portal to a patient display device.

[0836] According to one embodiment, the wireless communication unit includes a first wireless transceiver for wirelessly transmitting control commands to an implantable medical device and a second wireless transceiver for wirelessly transmitting a control interface to a patient display device.

[0837] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with the patient display device using a standard network protocol.

[0838] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an implantable medical device using a proprietary network protocol.

[0839] According to one embodiment, the wireless communication unit consists of a Bluetooth transceiver.

[0840] According to one embodiment, at least one of the first and second wireless transceivers is comprised of a Bluetooth transceiver.

[0841] According to one embodiment, the wireless communication unit is composed of a UWB transceiver.

[0842] According to one embodiment, at least one of the first and second wireless transceivers is configured as a UWB transceiver.

[0843] According to one embodiment, the wireless communication unit comprises at least one first wireless transceiver configured to communicate with the implantable medical device using a first network protocol to determine the distance between the patient external device and the implantable medical device, and at least one second wireless transceiver configured to communicate with the implantable medical device using a second network protocol to transfer data between the patient external device and the implantable medical device.

[0844] According to one embodiment, the first wireless transceiver is configured for transcutaneous energy transmission for at least one of supplying power to energy-consuming components of an implantable medical device and charging an implantable energy storage unit.

[0845] According to one embodiment, the standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0846] According to one embodiment, the communication range of the first wireless transceiver is smaller than the communication range of the second wireless transceiver.

[0847] According to one embodiment, at least one of the following: The external patient device is configured to authenticate the implanted medical device when the distance between the external patient device and the implanted medical device is below a predetermined threshold. If the distance between the external patient device and the implantable medical device is less than a predetermined threshold, the external patient device is configured to be authenticated by the implantable medical device. The external patient device is configured to authenticate the patient display device when the distance between the external patient device and the patient display device is less than a predetermined threshold, and If the distance between the patient external device and the patient display device is less than a predetermined threshold, the patient external device is configured to be authenticated by the implantable medical device.

[0848] According to one embodiment, the patient external device is configured to enable data transfer between the patient external device and an implantable medical device, and between the patient external device and a patient display device, based on authentication.

[0849] According to one embodiment, the arithmetic unit is configured to encrypt at least one of the control interface and the control commands.

[0850] According to one embodiment, the implantable medical device comprises at least one of the following: External cardiac compression device, A device that assists the pumping function of the patient's heart. A pump function assist device consisting of turbine bumps placed inside a patient's blood vessels to assist the heart's pumping function. Operable artificial heart valve, An operable artificial heart valve designed to increase blood flow to the coronary arteries.

[0851] Implantable drug delivery device, An implantable drug delivery device that can be injected directly into a blood vessel and whose injection site can be changed. An implantable drug delivery device for injecting potency-enhancing drugs into a patient's erectile tissue. Hydraulic, mechanical, and / or electrical shrinkage implants, Operable volume filling device, Surgically treatable gastric band, A maneuverable implant for stretching the patient's stomach wall to induce a feeling of fullness. An implant configured to sense how often a patient eats food. Operable cosmetic implants, Operable cosmetic implants for adjusting the shape and / or size of a patient's breast region. An implantable medical device for emptying the bladder. An implant to prevent urinary incontinence. Implants to prevent anal incontinence An implant that controls the expulsion of feces. An implant to monitor aneurysms. Implants to prevent aneurysm expansion, Joint lubrication implants, Implants that affect blood flow to the patient's erectile tissue, An implant to simulate the expansion of erectile tissue. An implant equipped with a reservoir for storing bodily fluids. Implants for storing and / or emptying internal reservoirs or surgically fabricated reservoirs. An implant that communicates with an external database. Programmable implants from outside the body An implant that can be programmed wirelessly from outside the body. Implants to treat impotence, An implant that controls the flow of eggs within the uterine tract. An implant that controls the flow of sperm within the uterine tract. An implant that controls the flow of sperm in the vas deferens. An implant that inhibits sperm transport in the vas deferens. Implants for treating osteoarthritis, An implant that tests parameters inside the body. An implant that controls specific treatment parameters from within the body. An implant that controls bodily parameters from within the body. An implant to control blood pressure, An implant that controls blood pressure by affecting the dilation of the renal arteries. Implants that control drug therapy parameters An implant that controls parameters in the blood. Implants for adjusting or replacing bone portions of a patient's body. An implant that replaces a patient's organ, part of an organ, or its function. vascular treatment equipment, An implant that moves fluids within the patient's body. An implant configured to sense parameters related to a patient's swallowing, An implant configured to move muscles through electrical or mechanical stimulation. An implant configured to empty the intestinal tract in response to a command. A operable implant configured to be inserted into a patient's stomach to substantially reduce the volume of the stomach to a volume greater than that of the device, An implant configured to compress the bladder and empty it from the patient's body. An implant configured to drain bodily fluids from the patient's body, An implant configured to actively lubricate the joint by adding a lubricating fluid, An implant designed to remove blood clots and particles from the patient's bloodstream. Implants configured to lengthen or correct the patient's bones in order to alleviate scoliosis. A device that stimulates the brain. An artificial stomach that replaces the function of the natural stomach. An implant configured to adjust the position of the female urethra or bladder neck. An implant designed to stimulate the ampulla of a blood vessel, causing temporary constriction.

[0852] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and the HCP or HCP administrator can do so via an HCPEID external device. The system has a master private key device that has been adapted to allow replacement and pairing of a new patient private key device or HCP private key device.

[0853] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0854] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0855] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0856] According to one embodiment, the system comprises a food sensor adapted to measure whether at least a patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0857] A patient display device is provided for communicating with a patient remote external device for communicating with an implantable medical device. The patient display device comprises a wireless communication unit configured to wirelessly receive an implant control interface as a remote display portal from the patient remote external device and to wirelessly transmit implant control user inputs to the patient remote external device; a display for displaying the received implant control interface; and an input device for receiving implant control inputs from the user.

[0858] According to one embodiment, the patient display device further comprises an auxiliary wireless communication unit. The auxiliary wireless communication unit is configured to be deactivated in order to enable at least one of the following: wirelessly receiving an implant control interface as a remote display portal from a patient remote external device, and wirelessly transmitting implant control user inputs to the patient remote external device.

[0859] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with a patient remote external device using a standard network protocol. The standard network protocol may be one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0860] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with a patient remote external device using a proprietary network protocol.

[0861] According to one embodiment, the wireless communication unit consists of a Bluetooth transceiver.

[0862] According to one embodiment, the wireless communication unit is composed of a UWB transceiver.

[0863] According to one embodiment, the communication range of the wireless communication unit is smaller than the communication range of the auxiliary wireless communication unit.

[0864] According to one embodiment, the patient display device is configured to authenticate the patient remote external device when the distance between the patient display device and the patient remote external device is less than a predetermined threshold, or to be authenticated by the patient remote external device when the distance between the patient display device and the patient remote external device is less than a predetermined threshold.

[0865] According to one embodiment, the patient display device is configured to allow data transfer between the patient display device and the patient remote external device based on authentication.

[0866] According to one embodiment, the patient display device is an attachable external device or portable terminal.

[0867] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0868] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0869] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0870] According to one embodiment, the system includes a measuring device or sensor adapted to send measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0871] According to one embodiment, the system comprises a food sensor adapted to measure whether at least a patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0872] A communication system is provided that enables communication between a patient display device and an implantable medical device during transplantation. This communication system includes a patient display device. A server and a patient remote external device. The patient display device comprises a wireless communication unit configured to wirelessly receive an implant control interface as a remote display portal provided by the patient remote external device. The wireless communication unit is further configured to wirelessly transmit implant control user inputs for the patient remote external device to the server. The system further comprises a display for displaying the received remote display portal and an input device for receiving implant control inputs from the user. The patient remote external device comprises a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device and a computing unit. The computing unit is configured to run control software for creating control commands for the operation of the implantable medical device, transmit the control interface to the patient display device, receive implant control user inputs generated on the patient display device from the server, and convert the user inputs into control commands for wireless transmission to the implantable medical device.

[0873] According to one embodiment, the arithmetic unit is configured to encrypt at least one of the control interface and the control commands.

[0874] According to one embodiment, the patient display device is configured to encrypt user input.

[0875] 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.

[0876] According to one embodiment, the computing device is configured to encrypt the control interface, and the patient display device is configured to decrypt the encrypted control interface.

[0877] According to one embodiment, the server functions as a router and is configured to transfer an encrypted control interface from a patient remote external device to a patient display device without decryption.

[0878] According to one embodiment of a communication system or patient display device, the implantable medical device comprises at least one of the following: External cardiac compression device, A device that assists the pumping function of the patient's heart. A pump function assist device consisting of a turbine bump placed inside a patient's blood vessels to assist the heart's pumping function. Operable artificial heart valve, An operable artificial heart valve designed to increase blood flow to the coronary arteries.

[0879] Implantable drug delivery device, An implantable drug delivery device that can be injected directly into blood vessels and whose injection site can be changed. An implantable drug delivery device for injecting potency-enhancing drugs into a patient's erectile tissue. Hydraulic, mechanical, and / or electrical shrinkage implants, Operable volume filling device, Surgically treatable gastric band, A maneuverable implant for stretching the patient's stomach wall to induce a feeling of fullness. An implant configured to sense how often a patient eats food. Operable cosmetic implants, Operable cosmetic implants for adjusting the shape and / or size of a patient's breast region. An implantable medical device for emptying the bladder. An implant to prevent urinary incontinence. Implants to prevent anal incontinence An implant that controls the expulsion of feces. An implant to monitor aneurysms. Implants to prevent aneurysm expansion, Joint lubrication implants, Implants that affect blood flow to the patient's erectile tissue, An implant to simulate the expansion of erectile tissue. An implant equipped with a reservoir for storing bodily fluids. Implants for storing and / or emptying internal reservoirs or surgically fabricated reservoirs. An implant that communicates with an external database. Programmable implants from outside the body An implant that can be programmed wirelessly from outside the body. Implants to treat impotence, An implant that controls the flow of eggs within the uterine tract. An implant that controls the flow of sperm within the uterine tract. An implant that controls the flow of sperm in the vas deferens. An implant that inhibits sperm transport in the vas deferens. Implants for treating osteoarthritis, An implant that tests parameters inside the body. An implant that controls specific treatment parameters from within the body. An implant that controls bodily parameters from within the body. An implant to control blood pressure, An implant that controls blood pressure by affecting the dilation of the renal arteries. Implants that control drug therapy parameters An implant that controls parameters in the blood. Implants for adjusting or replacing bone portions of a patient's body. An implant that replaces a patient's organ, part of an organ, or its function. vascular treatment equipment, An implant that moves fluids within the patient's body. An implant configured to sense parameters related to a patient's swallowing, An implant configured to move muscles through electrical or mechanical stimulation. An implant configured to empty the intestinal tract in response to a command. A operable implant configured to be inserted into a patient's stomach to substantially reduce the volume of the stomach to a volume greater than that of the device, An implant configured to compress the bladder and empty it from the patient's body. An implant configured to drain bodily fluids from the patient's body, An implant configured to actively lubricate the joint by adding a lubricating fluid, An implant designed to remove blood clots and particles from the patient's bloodstream. Implants configured to lengthen or correct the patient's bones in order to alleviate scoliosis. A device that stimulates the brain. An artificial stomach that replaces the function of the natural stomach. An implant configured to adjust the position of the female urethra or bladder neck. An implant designed to stimulate the ampulla of a blood vessel, causing temporary constriction.

[0880] According to one embodiment, the communication system further comprises a server. The server may include a wireless communication unit configured to wirelessly receive an implant control interface from a patient remote external device and to wirelessly transmit the implant control interface to a patient display device as a remote display portal. The wireless communication unit is further configured to wirelessly receive implant control user input from a patient EID external device and to wirelessly transmit the implant control user input to a patient display device.

[0881] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0882] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0883] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0884] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0885] According to one embodiment, the system comprises a food sensor adapted to measure whether at least a patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0886] An external patient device for communicating with an implantable medical device and a patient display device for communication during implantation are 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 implements a first application for wireless communication with a server and / or DDI. The patient display device is configured to run a second application for wireless communication with the patient external device for transmitting implant control inputs to a remote display portal of the patient external device for communication with the implantable medical device, and the second application is configured to be accessed via the first application. The patient display device has a first login function and a second login function, the first login function allowing the user to access the first application, and a combination of the first and second login functions allowing the user to access the second application. The first login function can be configured to use at least one of a password, PIN code, fingerprint, voice, and facial recognition. The second login function within the first application is configured to authenticate a second hardware key of the patient external device for a defined period of time using a secret key from the user.

[0887] According to one embodiment, the initial login is a PIN-based login.

[0888] According to one embodiment, at least one of the first and second logins is a login based on biometric input or a hardware key.

[0889] According to one embodiment, the patient display device further comprises an auxiliary wireless communication unit, which is configured to be deactivated in order to enable wireless communication with an external patient device.

[0890] According to one embodiment, the patient display device is configured to wirelessly receive an implant control interface, which serves as a remote display portal displayed on the display, from an external patient device.

[0891] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external patient device using a standard network protocol.

[0892] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external patient device using a proprietary network protocol.

[0893] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external patient device using a first network protocol and with a server using a second network protocol.

[0894] According to one embodiment, the wireless communication unit is configured to communicate wirelessly with an external patient device using a first frequency band and with a server using a second frequency band.

[0895] According to one embodiment, the wireless communication unit consists of a Bluetooth transceiver.

[0896] According to one embodiment, the wireless communication unit is composed of a UWB transceiver.

[0897] According to one embodiment, the standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0898] According to one embodiment, the communication range of the wireless communication unit is the communication range of the auxiliary wireless communication unit. It is smaller than the enclosure.

[0899] According to one embodiment, the wireless communication unit includes a first wireless transceiver for communicating with an external patient device and a second wireless transceiver for communicating with a server.

[0900] According to one embodiment, the second wireless transceiver is configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[0901] According to one embodiment, the patient display device is configured to authenticate the patient external device when the distance between the patient display device and the patient external device is less than a predetermined threshold, or to be authenticated by the patient external device when the distance between the patient display device and the patient external device is less than a predetermined threshold.

[0902] According to one embodiment, the patient display device is configured to allow data transfer between the patient display device and an external patient device based on authentication.

[0903] According to one embodiment, the patient display device is an attachable external device or portable terminal.

[0904] According to one embodiment, the second application is configured to receive data related to the parameters of an implanted medical device.

[0905] According to one embodiment, the second application is configured to receive data related to sensor values ​​received from an implanted medical device.

[0906] According to one embodiment, the second application is configured to receive data relating to at least one of the following parameters: battery status, temperature, time, and error.

[0907] According to one embodiment, the patient display device is configured to encrypt user input.

[0908] According to one embodiment, the display is configured to encrypt user input for decryption by an implantable medical device.

[0909] According to one embodiment, the patient display device is configured to decode a control interface received from an external patient device and display the control interface on the display.

[0910] According to one embodiment, at least one of the first and second applications is configured to receive data from an auxiliary external device and to present the received data to the user.

[0911] According to one embodiment, at least one of the first and second applications is configured to receive data from an auxiliary external device, including a scale for measuring the user's weight.

[0912] According to one embodiment, at least one of the first and second applications is configured to receive data about the user's weight from an auxiliary external device consisting of a weighing scale.

[0913] According to one embodiment, the patient display device wirelessly transmits data relating to the user's weight to an external patient device, or wirelessly transmits instructions derived from the data relating to the user's weight. Alternatively, it is configured to wirelessly transmit instructions derived from a combination of user weight data and implant control inputs received from the user.

[0914] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0915] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0916] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0917] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0918] According to one embodiment, the system comprises a food sensor adapted to measure whether the patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0919] A communication system is provided that enables communication between the patient display device and the implanted medical device when implanted. The communication system consists of the patient display device. A server or DDI, and a patient remote external device. The patient display device comprises a wireless communication unit configured to wirelessly receive an implant control interface as a remote display portal from the patient remote external device, the wireless communication unit further comprises 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, configured to wirelessly transmit implant control user input to the patient remote external device. The patient display device is configured to run a first application for wireless communication with the server and a second application for wireless communication with the patient remote external device for transmitting implant control input to the remote display portal of the patient remote external device for communication with the implantable medical device. The patient remote external device comprises a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device based on implant control input and to wirelessly communicate with the patient display device.

[0920] According to one embodiment, the patient display device includes a first login function and a second login function, wherein the first login function allows the user to access a first application, and a combination of the first and second login functions allows the user to access a second application.

[0921] According to one embodiment, the second application is configured to receive data related to the parameters of an implanted medical device.

[0922] According to one embodiment, the second application is configured to receive data related to sensor values ​​received from an implanted medical device.

[0923] According to one embodiment, the second application is configured to receive data relating to a parameter relating to at least one of the following: Temperature, time, error.

[0924] According to one embodiment, the patient display device is configured to encrypt user input.

[0925] According to one embodiment, the display is configured to encrypt user input for decryption by an implantable medical device.

[0926] According to one embodiment, the patient remote external device is configured to function as a router that transmits encrypted user input from the patient display device to the implantable medical device without decryption.

[0927] According to one embodiment, the patient remote external device is configured to encrypt at least one of the control interface and the control commands.

[0928] According to one embodiment, the patient remote external device is configured to encrypt the control interface, and the patient display device is configured to decrypt the encrypted control interface.

[0929] A computer program product is provided, configured to run on a patient display device comprising a wireless communication unit, a display for displaying received implant control interfaces as a remote display portal, and an input device for receiving implant control inputs from the user. The computer program product comprises the following: A first application for communicating with a server or DDI, A second application for communication with an implantable medical device, wherein the second application is configured to be accessed via the first application, to transmit implant control inputs via a remote display portal of the patient remote external device for communication with the implantable medical device, the second application being configured to be accessed via the first application, A first login feature that uses at least one of the following: password, PIN code, fingerprint, or facial recognition. A second login function within the first application authenticates a second hardware key for a patient's remote external device for a defined period of time using a private key from the user. The first login function allows the user to access the first application, and a combination of the first and second login functions allows the user to access the second application.

[0930] According to one embodiment, the second application is configured to receive data related to the parameters of an implanted medical device.

[0931] According to one embodiment, the second application is configured to receive data related to sensor values ​​received from an implanted medical device.

[0932] According to one embodiment, the second application is configured to receive data relating to a parameter relating to at least one of the following: Temperature, time, error.

[0933] According to one embodiment of a communication system, patient display device, or computer program product, the implantable medical device comprises at least one of the following: External cardiac compression device, A device that assists the pumping function of the patient's heart. A pump function assist device consisting of a turbine bump placed inside a patient's blood vessels to assist the heart's pumping function. Operable artificial heart valve, An operable artificial heart valve designed to increase blood flow to the coronary arteries.

[0934] Implantable drug delivery device, An implantable drug delivery device that can be injected directly into a blood vessel and whose injection site can be changed. An implantable drug delivery device for injecting potency-enhancing drugs into a patient's erectile tissue. Hydraulic, mechanical, and / or electrical shrinkage implants, Operable volume filling device, Surgically treatable gastric band, A maneuverable implant for stretching the patient's stomach wall to induce a feeling of fullness. An implant configured to sense how often a patient eats food. Operable cosmetic implants, Operable cosmetic implants for adjusting the shape and / or size of a patient's breast region. An implantable medical device for emptying the bladder. An implant to prevent urinary incontinence. Implants to prevent anal incontinence An implant that controls the expulsion of feces. An implant to monitor aneurysms. Implants to prevent aneurysm expansion, Joint lubrication implants, Implants that affect blood flow to the patient's erectile tissue, An implant to simulate the expansion of erectile tissue. An implant equipped with a reservoir for storing bodily fluids. Implants for storing and / or emptying internal reservoirs or surgically fabricated reservoirs. An implant that communicates with an external database. Programmable implants from outside the body An implant that can be programmed wirelessly from outside the body. Implants to treat impotence, An implant that controls the flow of eggs within the uterine tract. An implant that controls the flow of sperm within the uterine tract. An implant that controls the flow of sperm in the vas deferens. An implant that inhibits sperm transport in the vas deferens. Implants for treating osteoarthritis, An implant that tests parameters inside the body. An implant that controls specific treatment parameters from within the body. An implant that controls bodily parameters from within the body. An implant to control blood pressure, An implant that controls blood pressure by affecting the dilation of the renal arteries. Implants that control drug therapy parameters An implant that controls parameters in the blood. Implants for adjusting or replacing bone portions of a patient's body. An implant that replaces a patient's organ, part of an organ, or its function. vascular treatment equipment, An implant that moves fluids within the patient's body. An implant configured to sense parameters related to a patient's swallowing, An implant configured to move muscles through electrical or mechanical stimulation. An implant configured to empty the intestinal tract in response to a command. A operable implant configured to be inserted into a patient's stomach to substantially reduce the volume of the stomach to a volume greater than that of the device, An implant configured to compress the bladder and empty it from the patient's body. An implant configured to drain bodily fluids from the patient's body, An implant configured to actively lubricate the joint by adding a lubricating fluid, An implant designed to remove blood clots and particles from the patient's bloodstream. Implants configured to lengthen or correct the patient's bones in order to alleviate scoliosis. A device that stimulates the brain. An artificial stomach that replaces the function of the natural stomach. An implant configured to adjust the position of the female urethra or bladder neck. An implant designed to stimulate the ampulla of a blood vessel, causing temporary constriction.

[0935] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0936] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0937] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0938] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0939] According to one embodiment, the system comprises a food sensor adapted to measure whether the patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0940] A communication system is provided that enables communication between a patient display device, an external patient device, a server, and an implantable medical device. The communication system consists of a server. 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 a server, a display, and an input device for receiving input from a user. The patient external device comprises a wireless communication unit configured to wirelessly transmit control commands to the implantable medical device and to wirelessly communicate with at least one of the patient display device and the server. Furthermore, the server comprises a wireless communication unit configured to wirelessly communicate with at least one of the patient display device and the patient external device, and the implantable medical device comprises a wireless communication unit configured to wirelessly communicate with the patient external device. The implantable medical device further comprises an encryption unit configured to: encrypt data destined for the server, transmit the data to the server via the patient external device, and the patient external device acts as a router for transferring the data without full decryption. In one embodiment, the implantable medical device comprises an encryption unit configured to encrypt data destined for the patient display device, transmit the data to the patient display device via the patient external device, and the patient external device acts as a router for transferring the data without full decryption. In one embodiment, the server includes an encryption unit and is configured as follows: it encrypts data destined for an implantable medical device, transmits the data to the implantable medical device via an external patient device, and the external patient device functions as a router that transfers the data without full decryption; it encrypts data destined for an implantable medical device, transmits the data to the implantable medical device via a patient display device and an external patient device, and the external patient device and The patient external device functions as a router that transfers data without complete decryption. In one embodiment, the patient display device includes an encryption unit that encrypts data destined for the implanted medical device and transmits the data to the implanted medical device via the patient external device, and the patient external device is configured to function as a router that transfers data without complete decryption. In another embodiment, the patient display device includes an encryption unit that encrypts data destined for the implanted medical device and transmits the data to the implanted medical device via a server and the patient external device, and the server and the patient external device are configured to function as routers that transfer data without complete decryption.

[0941] According to one embodiment, the patient display device is configured to wirelessly receive an implant control interface displayed on the display from an external patient device.

[0942] According to one embodiment, at least two of the following—the server's wireless communication unit, the patient display device's wireless communication unit, the patient external device's wireless communication unit, and the implantable medical device's wireless communication unit—are configured for wireless communication using a standard network protocol.

[0943] According to one embodiment, at least two of the following are configured for wireless communication using a proprietary network protocol: 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.

[0944] According to one embodiment, the wireless communication unit of the patient's external device is configured to use a first network protocol for communication with the implantable medical device and a second network protocol for communication with the server, or to use a first network protocol for communication with the implantable medical device and a second network protocol for communication with the patient's display device.

[0945] According to one embodiment, the wireless communication unit of the patient's external device is configured to use a first frequency band for communication with the implantable medical device and a second frequency band for communication with the server, or to use a first frequency band for communication with the implantable medical device and a second frequency band for communication with the patient's display device.

[0946] According to one embodiment, the wireless communication unit of the patient display device is configured to use a first network protocol for communication with an external patient device and a second network protocol for communication with a server.

[0947] According to one embodiment, the wireless communication unit of the patient display device is configured to use a first frequency band for communication with an external patient device and a second frequency band for communication with a server.

[0948] According to one embodiment, the server's wireless communication unit is configured to use a first network protocol for communication with an external patient device and a second network protocol for communication with a patient display device.

[0949] According to one embodiment, the server's wireless communication unit is configured to use a first frequency band for communication with an external patient device and a second frequency band for communication with a patient display device.

[0950] According to one embodiment, a server, a patient display device, a patient external device, and an implantable medical device. At least one wireless communication unit of the device is equipped with a Bluetooth transceiver.

[0951] According to one embodiment, at least one wireless communication unit among the server, patient display device, patient external device, and implantable medical device comprises a UWB transceiver.

[0952] According to one embodiment, the standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0953] According to one embodiment, the wireless communication unit of the patient external device comprises a first wireless transceiver for wireless communication with an implantable medical device and a second wireless transceiver for wireless communication with a server, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0954] According to one embodiment, the wireless communication unit of the external patient device comprises a first wireless transceiver for wireless communication with an implantable medical device and a second wireless transceiver for wireless communication with a patient display device, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0955] According to one embodiment, the wireless communication unit of the patient display device comprises a first wireless transceiver for wireless communication with an external patient device and a second wireless transceiver for wireless communication with a server, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0956] According to one embodiment, the second wire transceiver has an effective range of any of the following: 2x, 4x, 8x, 20x, 50x, or 100x.

[0957] According to one embodiment, the second wireless transceiver is configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[0958] According to one embodiment, at least one of the following: The patient display device is configured to authenticate the patient external device when the distance between the patient display device and the patient external device is less than a predetermined threshold. If the distance between the patient display device and the external patient device is less than a predetermined threshold, the patient display device is configured to be authenticated by the external patient device. The patient display device is configured to authenticate the implanted medical device when the distance between the patient display device and the implanted medical device is less than a predetermined threshold. If the distance between the patient display device and the implanted medical device is less than a predetermined threshold, the patient display device is configured to be authenticated by the implanted medical device. The patient external device is configured to authenticate the patient display device when the distance between the patient external device and the patient display device is less than a predetermined threshold. If the distance between the patient external device and the patient display device is less than a predetermined threshold, the patient external device is configured to be authenticated by the patient display device. The external patient device is configured to authenticate the implantable medical device when the distance between the external patient device and the implantable medical device is less than a predetermined threshold, and If the distance between the external patient device and the implantable medical device is less than a predetermined threshold, the external patient device is configured to be authenticated by the implantable medical device.

[0959] According to one embodiment, the patient display device and the patient external display device are selected based on authentication. It is configured to allow data transfer between the device and the system.

[0960] According to one embodiment, the patient external device is configured to allow data transfer between the patient display device and the patient external device based on authentication.

[0961] According to one embodiment, the patient external device is configured to enable data transfer between the patient external device and the implantable medical device based on authentication.

[0962] According to one embodiment, the patient display device is a wearable external patient device or a portable terminal.

[0963] According to one embodiment, the data encrypted by the implantable medical device relates to at least one of the following: battery status, temperature, time, and error.

[0964] A server for use in a communication system according to any one of the above embodiments is provided.

[0965] A patient display device for use in a communication system according to any one of the above embodiments is provided.

[0966] An external patient device for use in a communication system according to any one of the above embodiments is provided.

[0967] An implantable medical device for use in a communication system according to any one of the above embodiments is provided.

[0968] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0969] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0970] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0971] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0972] According to one embodiment, the system comprises a food sensor adapted to measure whether the patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0973] A system is provided that is configured to change the pre-programmed treatment settings of an implanted medical device implanted in a patient remotely from a distance from the patient. This system consists of at least one healthcare provider (HCP), an EID external device, and an HCP private key device. The HCP EID external device is adapted to receive commands from the HCP to change the pre-programmed treatment settings of the implanted medical device, and is further adapted to be activated, authenticated, and authorized to execute the commands by the HCP providing the HCP private key device, the HCP private key device having a read slot or equivalent for the HCP private key device, and RFID The HCPEID external device is adapted to be provided to the HCPEID external device via at least one of communication or other short-range radio activation communication. The HCPEID external device comprises at least one of a read slot or equivalent for an HCP secret key device, RFID communication, and other short-range radio activation communication or electrical direct contact. The HCPEID external device further comprises at least one radio transceiver configured to communicate with a data infrastructure server DDI via a first network protocol. Furthermore, the system includes a data infrastructure server DDI adapted to receive commands from the HCPEID external device and relay the received commands to the patient EID external device without modification, the DDI comprising one radio transceiver configured to communicate with the patient external device and a patient EID external device adapted to receive commands relayed by the DDI, the implanted medical device: a reader slot or equivalent for the patient private key device, RFID communication or other near-field radio activation communication or electrical direct contact, provided by the patient: a reader slot or equivalent for the HCP private key device, RFID communication, other near-field radio activation communication or electrical direct contact, and at least one of these. The patient EID external device further comprises at least one wireless transceiver configured to communicate with the implanted medical device via a second network protocol. Furthermore, the implanted medical device is configured to treat the patient or perform a physical function.

[0974] According to one embodiment, at least one of the patient secret key device or the HCP secret key device is composed of a hardware key.

[0975] According to one embodiment, the secret key device is at least one of a smart card, a key ring device, a wristwatch, a band on the arm or wrist, a necklace, or a device of any shape.

[0976] According to one embodiment of the system, at least two of the HCPEID external device, patient EID external device, HCP secret key device, patient secret key device, and DDI are configured for wireless communication using standard network protocols.

[0977] According to one embodiment, at least two of the HCPEID external device, patient EID external device, HCP secret key device, patient secret key device, and DDI are configured for wireless communication using their own network protocols.

[0978] 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 a second network protocol for communication with the DDI.

[0979] 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 a second frequency band for communication with the DDI.

[0980] 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 secret key device.

[0981] According to one embodiment, at least one of the HCPEID external device, patient EID external device, HCP private key device, patient private key device, and DDI includes a Bluetooth transceiver. nothing.

[0982] According to one embodiment, at least one of the HCPEID external device, patient EID external device, HCP private key device, patient private key device, and DDI is comprised of a UWB transceiver.

[0983] According to one embodiment, the standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[0984] 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, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0985] According to one embodiment, the patient secret key device comprises a first wireless transceiver for wireless communication with an HCPEID external device and a second wireless transceiver for wireless communication with a DDI, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[0986] According to one embodiment, the second wire transceiver has an effective range which is one of the following: 2x, 4x, 8x, 20x, 50x, or 100x.

[0987] According to one embodiment, the second wireless transceiver is configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[0988] According to one embodiment, the patient EID external device is configured to enable data transfer between the EID external device and the implanted medical device based on authentication of the patient EID external device.

[0989] According to one embodiment, the patient EID external device is a wearable patient external device or handset.

[0990] According to one embodiment, the data encrypted by the implantable medical device relates to at least one of the following: battery status, temperature, time, and error.

[0991] According to one embodiment, the system comprises a master secret key device configured to enable the issuance of new secret key devices, and such master secret key device is adapted so that an HCP or HCP administrator can exchange and pair a new patient secret key device or HCP secret key device with the system via an HCPEID external device.

[0992] According to one embodiment, the patient remote external device and the patient EID external device are an integrated unit.

[0993] According to one embodiment, the HCP-dedicated device and the HCPEID external device are integrated into a single unit.

[0994] According to one embodiment, the system comprises a measuring device or sensor adapted to supply measurements to at least one of a DDI, a patented EID external device, and a patient display device.

[0995] According to one embodiment, the system comprises a food sensor adapted to measure whether the patient is swallowing solid food or drinking liquid, the food sensor being connected to a control unit of a medical device to trigger an action that extends the stomach after a determined amount of food has been ingested.

[0996] A system is provided that, when implanted in a patient, is configured by the healthcare provider (HCP) to change the preprogrammed therapeutic settings of the implantable medical device in the physical presence of the patient. The system comprises at least one HCPEID external device adapted to receive commands from the HCP, directly or indirectly, to change the preprogrammed therapeutic settings in a step of the implantable medical device when the implantable medical device is implanted, the HCPEID external device is further adapted to be activated, authenticated, and authorized to execute the commands by the HCP providing an HCP secret key device consisting of the HCP secret key. The HCP secret key device consists of at least one of a smart card, a keychain device, a watch, a wristband or armband, a necklace, and a device of any shape. The HCPEID 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, activating the implanted medical device, changing the preprogrammed settings, and updating the software of the implanted medical device. The HCPEID external device is further adapted to also be activated, authenticated, and authorized to execute the commands by the patient. The system further comprises a patient secret key device, which includes at least one of a smart card, a keychain device, a watch, a wristband or armband, a necklace, and a device of any shape. The HCP secret key and the patient secret key are required for the HCPEID external device to perform at least one of the following actions when the implanted medical device is implanted: receiving information from the implanted medical device, receiving information from the patient remote external device, activating the implanted medical device, changing pre-programmed settings, and updating the software of the implanted medical device.

[0997] According to one embodiment, the HCPEID external device further comprises a wireless transceiver configured to communicate with an implantable medical device via a second network protocol.

[0998] According to one embodiment, the HCP private key device is adapted to be provided to at least one HCP external device via at least one of the following: a read slot or equivalent for the HCP private key device, RFID communication, a near-field radio activation communication unit, or direct electrical contact.

[0999] According to one embodiment, the HCPEID external device comprises at least one of the following: a read slot for an HCP secret key device or equivalent, an RFID communication and near-field radio activation communication unit, or an electrical direct contact.

[1000] According to one embodiment, the HCPEID external device is adapted to receive commands from the HCP dedicated device to modify the pre-programmed treatment steps of the implantable medical device when implanted, and the HCP dedicated device is further adapted to be activated, authenticated, and authorized to execute the commands by the HCP providing its secret key.

[1001] According to one embodiment, the HCPEID external device, the patient EID external device, the HCP secret key device, and at least two of the patient secret key devices are configured for wireless communication using a standard network protocol.

[1002] According to one embodiment, the HCPEID external device, the patient EID external device, the HCP secret key device, and at least two of the patient secret key devices are configured for wireless communication using their own network protocol.

[1003] According to one embodiment, the patient EID external device uses a first network protocol for communication with the implantable medical device and a second network protocol for communication with the patient secret key device. It is configured to be used for that purpose.

[1004] 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 a second frequency band for communication with the patient secret key device.

[1005] According to one embodiment, the HCPEID external device, the patient EID external device, the HCP secret key device, and at least one of the patient secret key devices are equipped with a Bluetooth transceiver.

[1006] According to one embodiment, the HCPEID external device, the patient EID external device, the HCP secret key device, and at least one of the patient secret key devices are comprised of a UWB transceiver.

[1007] According to one embodiment, the standard network protocol is one of the following: radio frequency protocol, RFID protocol, WLAN protocol, Bluetooth protocol, BLE protocol, NFC protocol, 3G / 4G / 5G protocol, and GSM protocol.

[1008] According to one embodiment, the patient EID external device comprises a first wireless transceiver for wireless communication with an implantable medical device and a second wireless transceiver for wireless communication with a patient secret key device, wherein the second wireless transceiver has a longer effective range than the first wireless transceiver.

[1009] According to one embodiment, the second wire transceiver has an effective range which is one of the following: 2x, 4x, 8x, 20x, 50x, or 100x.

[1010] According to one embodiment, a second wireless transceiver is configured to be disabled in order to enable wireless communication using the first wireless transceiver.

[1011] According to one embodiment, the patient EID external device is configured to enable data transfer between the EID external device and the implanted medical device based on authentication of the patient EID external device.

[1012] According to one embodiment, the patient EID external device is a wearable patient external device or handset.

[1013] According to one embodiment, the data encrypted by the implantable medical device relates to at least one of the following: battery status, temperature, time, and error.

[1014] A system is provided which is configured to modify pre-programmed and pre-selected therapeutic actions of an implantable medical device implanted in a patient, based on commands from the patient. The system comprises an implantable medical device, a patient remote external device, a wireless transceiver configured to communicate with the implantable medical device via a second network protocol when the medical device is implanted, and a remote display portal. The remote display portal is configured to receive content delivered from the patient remote external device and expose buttons for the patient to indicate their intention to activate the functions of the implantable medical device through the patient remote external device, and is further configured to remotely present a display portal on the patient display device that enables the patient to activate the functions of the implantable medical device through the display portal of the patient remote external device visualized on the patient display device.

[1015] According to one embodiment, a wireless transceiver, a remote display portal, and a remote display portal It is configured within the patient's remote external device.

[1016] According to one embodiment, the system further comprises a patient display device, which may include an assistance application, a display hosting a remote display portal, and a private key for the patient display device.

[1017] According to one embodiment, the remote display portal can generate commands that are signed by the private key of the patient display device.

[1018] According to one embodiment, the patient remote external device is adapted to receive input from the patient via the patient display device through its remote display portal.

[1019] According to one embodiment, the patient remote external device consists of a graphical user interface arranged on a touch-responsive display that exposes buttons representing the operating functions of the transplant medical device.

[1020] According to one embodiment, the system is configured so that the patient can activate the implant at home via a patient remote external device, with authorization granted by the patient's secret key.

[1021] According to one embodiment, the patient's secret key consists of at least one of a smart card, a keychain device, a watch, an arm or wristband, a necklace, and a device of any shape.

[1022] According to one embodiment, the system is configured to allow the patient to operate the implantable medical device at home via a remote external device, using authorization granted by the patient's private key, once implanted.

[1023] According to one embodiment, the system further comprises a patient EID external device including a read slot or equivalent for a patient secret key device, RFID communication, short-range wireless activation communication, or direct electrical contact.

[1024] According to one embodiment, the patient EID external device is adapted to synchronize with the patient remote external device.

[1025] According to one embodiment, the patient EID external device further comprises at least one of a patient, a wireless transceiver configured to communicate with a remote external device, and a wired connector for communicating with the patient remote external device.

[1026] According to one embodiment, the patient EID external device is adapted to generate authorization via the patient EID external device, which is signed by a patient secret key installed in at least one of the patient remote external device and implantable medical devices.

[1027] According to one embodiment, the system includes a patient display device that includes a support application capable of displaying a remote display portal using content delivered from a remote external device for the patient.

[1028] According to one embodiment, the remote display portal and the patient remote external device are adapted to expose buttons for the patient to express their intention to activate the f...

Claims

1. 1. An implantable medical device for actively stretching a patient's stomach wall to induce satiety, comprising: A first member, a first member comprising: a first member rotating portion configured to rotate about a first axis; and a first member fixing portion coupled to the first member rotating portion and configured to be fixed to a first portion of the stomach wall; a second member coupled to the first member rotation portion, the second member including a second member fastening portion configured to be fastened to a second portion of the stomach wall; a manipulator coupled to the first member rotating portion, the manipulator configured to induce rotation of the first member rotating portion about the first axis; Equipped with the first member fixing portion is configured to describe rotation about the first axis between a first position of the first member fixing portion and a second position of the first member fixing portion in response to rotation of the first member rotating portion; The first member rotation portion and the operating device are each disposed below a first reference plane perpendicular to the first axis, and the first member fixing portion rotates in such a manner that, during at least a part of the rotation of the first member fixing portion, Located above the first reference plane, When the first member fixing portion is rotated toward the second position of the first member fixing portion, the stomach wall between the first portion and the second portion is increasingly stretched. Medical devices.

2. 10. The medical device of claim 1, The medical device, wherein the first member rotating portion is configured to be at least partially penetrated by tissue of a stomach wall.

3. 3. The medical device according to claim 1 or 2, A medical device in which at least one of the first member rotating portion and the first member fixing portion is a rod with a circular cross-sectional area.

4. 4. The medical device of claim 3, The medical device, wherein the first member further includes a first member connecting portion that connects the first member rotating portion and the first member fixing portion.

5. 5. The medical device of claim 4, The first member coupling portion of the medical device has a circular cross-sectional area.

6. 6. The medical device of claim 5, The first member connecting portion is a medical device located above the first reference plane.

7. 7. The medical device of claim 6, A medical device in which the first member connecting portion is a rod arranged obliquely with respect to the first axis.

8. The medical device according to any one of claims 3 to 7, A medical device in which the first member fixing portion is parallel to the first member rotating portion.

9. The medical device according to any one of claims 1 to 8, The medical device further comprises a main part, and the operating device is a local part disposed on the main part. A medical device comprising:

10. 10. The medical device of claim 9, A medical device, the main portion configured to be at least partially invaded by tissue of the stomach wall.

11. The medical device according to any one of claims 1 to 10, The first member fixation portion is further configured to describe rotation about the first axis while maintaining a constant distance from the first axis.

12. The medical device according to any one of claims 9 to 10, the local portion of the operating device comprises a first conversion device; The first conversion device a receiving portion configured to receive an input local force; and a transmission portion coupled to the receiving portion and the first member rotating portion; Equipped with the transmission unit is configured to convert the input local force into an output local force that induces rotation of the first member rotation unit about the first axis. Medical devices.

13. 13. The medical device of claim 12, The medical device, wherein the receiving portion is positioned at a distance from the transmitting portion, the distance being a characteristic distance of the first conversion device.

14. 14. The medical device of claim 13, the first conversion device is a first pulley; The first pulley is a rim configured to engage a flexible wire, the rim being a receiving portion of the first transducer device; a central portion, the central portion being a transmission portion of the first conversion device; Medical devices.

15. 15. The medical device of claim 14, The rim of the first pulley is circular; the first pulley has a radius, the radius of the first pulley being a characteristic distance of the first pulley; Medical devices.

16. The medical device according to any one of claims 11 to 15, The characteristic distance of the first conversion device is in a range of 0.3 to 2 times the distance of the first member fixing part from the first axis. Medical devices.

17. The medical device according to any one of claims 11 to 15, The characteristic distance of the first conversion device is within a range of 0.5 to 1.2 times the distance of the first member fixing portion from the first axis. Medical devices.

18. The medical device according to any one of claims 11 to 15, The characteristic distance of the first conversion device is within a range of 0.95 to 1.05 times the distance of the first member fixing portion from the first axis. Medical devices.

19. The medical device according to any one of claims 14 to 18, The medical device, wherein the steering device comprises a first flexible wire configured to engage a rim of the first pulley to guide rotation of the first pulley.

20. 20. The medical device of claim 19, the first flexible wire configured to engage a rim of the first pulley is further configured to pull the first pulley in a first rotational direction of the first pulley; the medical device further comprising a first spring mechanism coupled to the first pulley and configured to bias the first pulley toward a second rotational direction of the first pulley opposite the first rotational direction of the first pulley. Medical devices.

21. 20. The medical device of claim 19, the first flexible wire configured to engage a rim of the first pulley is further configured to pull the first pulley in a first rotational direction of the first pulley; the medical device further comprising a second flexible wire configured to engage a rim of the first pulley and pull the first pulley in a second rotational direction of the first pulley opposite the first rotational direction of the first pulley; Medical devices.

22. The medical device according to any one of claims 12 to 21, the local portion of the manipulation device further comprises a first local motor coupled to a receiving portion of the first conversion device, the first local motor configured to generate motion having a first input local force and a first input local velocity; Medical devices.

23. 23. The medical device of claim 22, the first local motor is a piezoelectric motor; Medical devices.

24. 24. The medical device according to claim 22 or 23, the first conversion device is a gear system configured to decrease the first input local velocity and increase the first input local force; Medical devices.

25. The medical device according to any one of claims 12 to 21, the medical device further comprises a remote unit configured to be placed at a remote location within the patient's body, and the operating device further comprises a remote portion disposed within the remote unit. Medical devices.

26. 26. The medical device of claim 25, the remote portion of the control device further comprises a first remote motor coupled to the receiving portion of the first conversion device and configured to generate motion having a first input remote velocity and a first input remote force; Medical devices.

27. 27. The medical device of claim 26, the first remote motor is a piezoelectric motor; Medical devices.

28. 28. The medical device according to claim 26 or 27, the remote portion of the control device further comprises a first remote gear system configured to decrease the first input remote speed and increase the first input remote force; Medical devices.

29. The medical device according to any one of claims 26 to 28, the remote portion of the operating device further includes a second remote motor coupled to the receiving portion of the first conversion device and configured to generate motion having a second input remote velocity and a second input remote force; Medical devices.

30. 30. The medical device of claim 29, the second remote motor is a piezoelectric motor; Medical devices.

31. 31. The medical device of claim 29 or 30, the remote portion of the control device further includes a second remote gear system configured to decrease the second input remote speed and increase the second input remote force. Medical devices.

32. The medical device according to any one of claims 26 to 31, the operating device further comprises a first flexible wire configured to transmit the first input remote force from the first remote motor to a receiving portion of the first conversion device; Medical devices.

33. The medical device according to any one of claims 29 to 32, the operating device further comprising a second flexible wire configured to transmit the second input remote force from the second remote motor to a receiving portion of the first conversion device; the first flexible wire is configured to guide rotation of the first member rotating portion in a first rotation direction of the first member rotating portion; the second flexible wire is configured to guide rotation of the first member rotating portion in a second rotation direction of the first member rotating portion opposite the first rotation direction of the first member rotating portion. Medical devices.

34. The medical device according to any one of claims 26 to 31, the operating device further includes a first hydraulic system configured to transmit the first input remote force from the first remote motor to a receiving portion of the first conversion device. Medical devices.

35. 35. The medical device of claim 34, The first hydraulic system a first hydraulic conduit; a first remote hydraulic cylinder disposed in the remote portion of the operating device, the first remote hydraulic cylinder coupled to the first remote motor and the first hydraulic conduit; A first local hydraulic cylinder disposed in a local portion of the operating device, a first local hydraulic cylinder coupled to the first hydraulic conduit and to a receiving portion of the first converter; Medical devices.

36. The medical device according to any one of claims 29 to 31, 34 and 35, the operating device further comprising a second hydraulic system configured to transfer the second input remote force from the second remote motor to a receiving portion of the first conversion device; the first hydraulic system is configured to induce rotation of the first member rotating portion in a first rotational direction of the first member rotating portion; the second hydraulic system is configured to induce rotation of the first member rotating portion in a second rotational direction of the first member rotating portion opposite the first rotational direction of the first member rotating portion. Medical devices.

37. 37. The medical device of claim 36, The second hydraulic system a second hydraulic line; a second remote hydraulic cylinder disposed in the remote portion of the operating device, the second remote hydraulic cylinder coupled to the second remote motor and the second hydraulic line; a second local hydraulic cylinder disposed in a local portion of the operating device, the second local hydraulic cylinder being coupled to the second hydraulic conduit and a receiving portion of the first conversion device; Medical devices.

38. The medical device according to any one of claims 9 to 37, the second member being inoperably secured to the main portion; Medical devices.

39. 39. The medical device of claim 38, the second member is configured to be at least partially invaded by tissue of the stomach wall. Medical devices.

40. 40. The medical device of claim 39, the second member is a rod having a circular cross-sectional area; Medical devices.

41. 41. The medical device of claim 40, The second member is parallel to the first member fixing portion. Medical devices.

42. The medical device according to any one of claims 1 to 41, Medical devices a third member coupled to the first member rotation portion, the third member including a third member fastening portion configured to be fastened to a third portion of the stomach wall; When the first member fixing portion is rotated toward the first position of the first member fixing portion, the stomach wall between the first portion and the third portion is increasingly stretched. Medical devices.

43. The medical device according to any one of claims 38 to 42, the third member being inoperably secured to the main portion; Medical devices.

44. 44. The medical device of claim 43, the third member is configured to be at least partially invaded by tissue of the stomach wall. Medical devices.

45. 45. The medical device of claim 44, the third member is a rod having a circular cross-sectional area; Medical devices.

46. 46. ​​The medical device of claim 45, The third member is parallel to the first member fixing portion. Medical devices.

47. The medical device according to any one of claims 1 to 37, The second member is a second member rotating portion coupled to the first member rotating portion and configured to rotate about a second axis; a second member fixing portion coupled to the second member rotating portion and configured to be fixed to a second portion of the stomach wall; Equipped with the manipulator is further coupled to the second member rotating portion and is further configured to induce rotation of the second member rotating portion about the second axis; the second member fixing portion is configured to describe rotation about the second axis between a first position of the second member fixing portion and a second position of the second member fixing portion in response to rotation of the second member rotating portion; The second member rotation portion and the operating device are each located below a second reference plane perpendicular to the second axis, and the second member fixing portion rotates in such a manner that, during at least a part of the rotation of the second member fixing portion, Located above the second reference plane, When the second member fixing portion is rotated toward the first position of the second member fixing portion, the stomach wall between the first portion and the second portion is increasingly stretched. Medical devices.

48. 48. The medical device of claim 47, the second member rotating portion is configured to be at least partially invaded by tissue of the stomach wall. Medical devices.

49. The medical device according to any one of claims 47 to 48, At least one of the second member rotating portion and the second member fixing portion is a rod having a circular cross-sectional area. Medical devices.

50. 50. The medical device of claim 49, The second member further includes a second member connecting portion that connects the second member rotating portion and the second member fixing portion. Medical devices.

51. 51. The medical device of claim 50, The second member connecting portion has a circular cross-sectional area. Medical devices.

52. 52. The medical device of claim 51, The second member connecting portion is located above a second reference plane. Medical devices.

53. 53. The medical device of claim 52, The second member connecting portion is a rod disposed inclined with respect to the second axis. Medical devices.

54. The medical device according to any one of claims 49 to 53, The second member fixing portion is parallel to the second member rotating portion. Medical devices.

55. The medical device according to any one of claims 49 to 54, The second member fixing portion is parallel to the first member fixing portion. Medical devices.

56. The medical device according to any one of claims 47 to 55, The second axis is parallel to the first axis. Medical devices.

57. The medical device according to any one of claims 47 to 56, The second member fixing portion is further configured to describe rotation about the second axis while maintaining a constant distance from the second axis. Medical devices.

58. The medical device according to any one of claims 9, 10, and 47 to 57, the local portion of the operating device comprises a second conversion device; The second conversion device a receiving portion configured to receive an input local force; a transmission portion coupled to the receiving portion of the second conversion device and the second member rotating portion; Equipped with a transmission portion of the second conversion device configured to convert an input local force received by a receiving portion of the second conversion device into an output local force that induces rotation of the second member rotation portion about the second axis. Medical devices.

59. 59. The medical device of claim 58, the receiving portion of the second conversion device is disposed at a distance from the transmitting portion of the second conversion device; the distance is a characteristic distance of the second conversion device; Medical devices.

60. 60. The medical device of claim 59, the second conversion device is a second pulley; The second pulley is a rim configured to engage a flexible wire, the rim of the second pulley being a receiving portion of the second conversion device; a central portion, the central portion of the second pulley being a transmission portion of the second conversion device; Medical devices.

61. 61. The medical device of claim 60, the rim of the second pulley is circular, the second pulley has a radius, and the radius of the second pulley is a characteristic distance of the second pulley; Medical devices.

62. The medical device according to any one of claims 57 to 61, The characteristic distance of the second conversion device is within a range of 0.3 to 2 times the distance of the second member fixing portion from the second axis. Medical devices.

63. The medical device according to any one of claims 57 to 61, The characteristic distance of the second conversion device is within a range of 0.5 to 1.2 times the distance of the second member fixing portion from the second axis. Medical devices.

64. The medical device according to any one of claims 57 to 61, The characteristic distance of the second conversion device is within a range of 0.95 to 1.05 times the distance of the second member fixing portion from the second axis. Medical devices.

65. The medical device according to any one of claims 60 to 64, the operating device includes a third flexible wire configured to engage a rim of the second pulley to induce rotation of the second pulley. Medical devices.

66. 66. The medical device of claim 65, the third flexible wire configured to engage a rim of the second pulley is further configured to pull the second pulley in a first rotational direction of the second pulley; the medical device further comprising a second spring mechanism coupled to the second pulley and configured to bias the second pulley in a second rotational direction of the second pulley opposite the first rotational direction of the second pulley. Medical devices.

67. 66. The medical device of claim 65, the third flexible wire configured to engage a rim of the second pulley is further configured to pull the second pulley in a first rotational direction of the second pulley; the medical device further comprising a fourth flexible wire engaged with the rim of the second pulley and configured to pull the second pulley in a second rotational direction opposite the first rotational direction of the second pulley. Medical devices.

68. The medical device according to any one of claims 19, 20, 65 to 66, the first flexible wire configured to engage the rim of the first pulley is the same as the third flexible wire configured to engage the rim of the second pulley; It is configured to pull the first pulley and the second pulley in opposite rotational directions. Medical devices.

69. 68. The medical device of claim 21 or 67, the first flexible wire configured to engage the rim of the first pulley is the same as the third flexible wire configured to engage the rim of the second pulley, and the second flexible wire configured to engage the rim of the first pulley is the same as the fourth flexible wire configured to engage the rim of the second pulley; a first rotation direction of the first pulley is opposite to a first rotation direction of the second pulley, and a second rotation direction of the first pulley is opposite to a second rotation direction of the second pulley; Medical devices.

70. The medical device according to any one of claims 58 to 69, the local portion of the manipulation device further comprises a second local motor coupled to a receiving portion of the second conversion device, the second local motor configured to generate motion having a second input local force and a second input local velocity. Medical devices.

71. 71. The medical device of claim 70, the second local motor is a piezoelectric motor; Medical devices.

72. The medical device according to any one of claims 70 to 71, the second transformation device is a gear system configured to decrease the second input local velocity and increase the second input local force. Medical devices.

73. The medical device according to any one of claims 26 to 31 and 58 to 69, the remote portion of the control device further includes a third remote motor coupled to the receiving portion of the second conversion device and configured to generate motion having a third input remote speed and a third input remote force; Medical devices.

74. 74. The medical device of claim 73, the third remote motor is a piezoelectric motor; Medical devices.

75. 75. The medical device of claim 73 or 74, the remote portion of the control device further comprises a third remote gear system configured to decrease the third input remote speed and increase the third input remote force; Medical devices.

76. The medical device according to any one of claims 73 to 75, the remote portion of the operating device further includes a fourth remote motor coupled to the receiving portion of the second conversion device and configured to generate motion having a fourth input remote speed and a fourth input remote force. Medical devices.

77. 77. The medical device of claim 76, the fourth remote motor is a piezoelectric motor; Medical devices.

78. 78. The medical device of claim 76 or 77, the control device remote further comprising a fourth remote gear system configured to decrease the fourth input remote speed and increase the fourth input remote force; Medical devices.

79. The medical device according to any one of claims 73 to 78, the operating device further comprises a third flexible wire configured to transmit the third input remote force from the third remote motor to a receiving portion of the second conversion device. Medical devices.

80. 80. The medical device according to any one of claims 76 to 79, the operating device further comprising a fourth flexible wire configured to transmit the fourth input remote force from the fourth remote motor to a receiving portion of the second conversion device; the third flexible wire is configured to guide rotation of the second member rotating portion in a first rotation direction; the fourth flexible wire is configured to guide rotation of the second member rotating portion in a second rotation direction opposite to the first rotation direction of the second member rotating portion. Medical devices.

81. 80. The medical device of claim 32 or 79, the first flexible wire is the same as the third flexible wire, the first remote motor is the same as the third remote motor, and the first flexible wire is configured to rotate the first member rotating portion and the second member rotating portion in opposite rotational directions. Medical devices.

82. 81. The medical device of claim 33 or 80, the first flexible wire is the same as the third flexible wire, the first remote motor is the same as the third remote motor, the second flexible wire is the same as the fourth flexible wire, the second remote motor is the same as the fourth remote motor, a first rotation direction of the first member rotating part is opposite to a first rotation direction of the second member rotating part, and a second rotation direction of the first member rotating part is opposite to a second rotation direction of the second member rotating part; Medical devices.

83. The medical device according to any one of claims 73 to 78, the operating device further includes a third hydraulic system configured to transmit the third input remote force from the third remote motor to a receiving portion of the second conversion device. Medical devices.

84. 84. The medical device of claim 83, the third hydraulic system a third hydraulic line; a third remote hydraulic cylinder disposed in a remote portion of the operating device, the third remote hydraulic cylinder being coupled to the third remote motor and the third hydraulic line; a third local hydraulic cylinder disposed on the local portion of the operating device, the third local hydraulic cylinder coupled to the third hydraulic conduit and a receiving portion of the second conversion device; Medical devices.

85. The medical device according to any one of claims 76 to 78, 83 and 84, the operating device further comprising a fourth hydraulic system configured to transfer a fourth input remote force from the fourth remote motor to a receiving portion of the second conversion device; the third hydraulic system is configured to induce rotation of the second member rotating portion in a first rotational direction of the second member rotating portion; the fourth hydraulic system is configured to induce rotation of the second member rotating portion in a second rotational direction of the second member rotating portion opposite a first rotational direction of the second member rotating portion. Medical devices.

86. 86. The medical device of claim 85, the fourth hydraulic system a fourth hydraulic line; a fourth remote hydraulic cylinder disposed in a remote portion of the operating device, the fourth remote hydraulic cylinder being connected to the fourth remote motor and the fourth hydraulic line; a fourth local hydraulic cylinder arranged in a local portion of the operating device, the fourth local hydraulic cylinder being coupled to the fourth hydraulic line and a receiving portion of the second conversion device; Medical devices.

87. 85. The medical device of any one of claims 34, 35, 83 and 84, the first hydraulic system is the same as the third hydraulic system, the first remote motor is the same as the third remote motor, and the first hydraulic system is configured to rotate the first member rotating portion and the second member rotating portion in opposite rotational directions. Medical devices.

88. 87. The medical device of any one of claims 36, 37, 85 and 86, the first hydraulic system is the same as the third hydraulic system, the first remote motor is the same as the third remote motor, the second hydraulic system is the same as the fourth hydraulic system, and the second remote motor is the same as the fourth remote motor; a first rotation direction of the first member rotation part is opposite to a first rotation direction of the second member rotation part, and a second rotation direction of the first member rotation part is opposite to a second rotation direction of the second member rotation part; Medical devices.

89. The medical device according to any one of claims 1 to 41, a third member; The third member is a third member rotating portion coupled to the second member and configured to rotate about a third axis; and a third member fixing portion coupled to the third member rotating portion and configured to be fixed to a third portion of the stomach wall, the operating device is further coupled to the third member rotating portion and is further configured to induce rotation of the third member rotating portion about the third axis; the third member fixing portion is configured to describe rotation about the third axis between a third member fixing portion first position and a third member fixing portion second position in response to rotation of the third member rotating portion; The third member rotation portion and the operating device are each located below a third reference plane perpendicular to the third axis, and the third member fixing portion is configured to: Located above the third reference plane, When the third member securing portion rotates toward the first position of the third member, the stomach wall between the second portion and the third portion is increasingly stretched. Medical devices.

90. 90. The medical device of claim 89, the third member rotating portion is configured to be at least partially invaded by tissue of the stomach wall. Medical devices.

91. The medical device according to any one of claims 89 to 90, At least one of the third member rotating portion and the third member fixing portion is a rod having a circular cross-sectional area. Medical devices.

92. 92. The medical device of claim 91, the third member further includes a third member connecting portion that connects the third member rotating portion and the third member fixing portion, Medical devices.

93. 93. The medical device of claim 92, the third member connecting portion has a circular cross-sectional area; Medical devices.

94. 94. The medical device of claim 93, the third member connecting portion is located above the third reference plane, Medical devices.

95. 95. The medical device of claim 94, The third member connecting portion is a rod disposed inclined with respect to the third axis. Medical devices.

96. The medical device according to any one of claims 91 to 95, the third member fixing portion is parallel to the third member rotating portion; Medical devices.

97. The medical device according to any one of claims 89 to 96, The third axis is parallel to the first axis. Medical devices.

98. The medical device according to any one of claims 89 to 97, The third member fixing portion is further configured to describe rotation about the third axis while maintaining a constant distance from the third axis. Medical devices.

99. The medical device according to any one of claims 9, 10, and 89 to 98, the local portion of the operating device comprises a second conversion device; The second conversion device a receiving portion configured to receive an input local force; a transmission part coupled to the receiving part of the second conversion device and the third member rotating part, a transmission portion of the second conversion device configured to convert an input local force received by a receiving portion of the second conversion device into an output local force that induces rotation of the third member rotation portion about the third axis; Medical devices.

100. 100. The medical device of claim 99, the receiving portion of the second conversion device is disposed at a distance from the transmitting portion of the second conversion device, the distance being a characteristic distance of the second conversion device; Medical devices.

101. 101. The medical device of claim 100, the second conversion device is a second pulley; The second pulley is a rim configured to engage a flexible wire, the rim of the second pulley being a receiving portion of the second conversion device; a central portion, the central portion of the second pulley being a transmission portion of the second conversion device; Medical devices.

102. 102. The medical device of claim 101, the rim of the second pulley is circular, the second pulley has a radius, and the radius of the second pulley is a characteristic distance of the second pulley; Medical devices.

103. The medical device according to any one of claims 98 to 102, The characteristic distance of the second conversion device is in a range of 0.3 to 2 times the distance of the third member fixing part from the third axis. Medical devices.

104. The medical device according to any one of claims 98 to 102, The characteristic distance of the second conversion device is within a range of 0.5 to 1.2 times the distance of the third member fixing portion from the third axis. Medical devices.

105. The medical device according to any one of claims 98 to 102, The characteristic distance of the second conversion device is within a range of 0.95 to 1.05 times the distance of the third member fixing portion from the third axis. Medical devices.

106. The medical device according to any one of claims 101 to 105, the operating device includes a third flexible wire configured to engage a rim of the second pulley to guide rotation of the second pulley. Medical devices.

107. 107. The medical device of claim 106, the third flexible wire configured to engage a rim of the second pulley is further configured to pull the second pulley in a first rotational direction of the second pulley; the medical device further comprising a second spring mechanism coupled to the second pulley and configured to bias the second pulley toward a second rotational direction of the second pulley opposite the first rotational direction of the second pulley. Medical devices.

108. 107. The medical device of claim 106, the third flexible wire configured to engage a rim of the second pulley is further configured to pull the second pulley in a first rotational direction of the second pulley; the medical device further comprising a fourth flexible wire configured to engage a rim of the second pulley and pull the second pulley in a second rotational direction opposite the first rotational direction of the second pulley. Medical devices.

109. The medical device according to any one of claims 19 to 20 and 106 to 107, the first flexible wire configured to engage the rim of the first pulley is the same as the third flexible wire configured to engage the rim of the second pulley and configured to pull the first pulley and the second pulley in opposite rotational directions; Medical devices.

110. 109. The medical device of claim 21 or 108, the first flexible wire configured to engage the rim of the first pulley is the same as the third flexible wire configured to engage the rim of the second pulley, the second flexible wire configured to engage the rim of the first pulley is the same as the fourth flexible wire configured to engage the rim of the second pulley, a first direction of rotation of the first pulley is opposite to a first direction of rotation of the second pulley, and a second direction of rotation of the first pulley is opposite to a second direction of rotation of the second pulley. Medical devices.

111. The medical device according to any one of claims 99 to 110, the local portion of the manipulation device further comprises a second local motor coupled to a receiving portion of the second conversion device, the second local motor configured to generate motion having a second input local force and a second input local velocity. Medical devices.

112. 112. The medical device of claim 111, the second local motor is a piezoelectric motor; Medical devices.

113. The medical device according to any one of claims 111 to 112, the second transformation device is a gear system configured to decrease the second input local velocity and increase the second input local force. Medical devices.

114. The medical device according to any one of claims 26 to 31 and 99 to 110, the remote portion of the control device further includes a third remote motor coupled to the receiving portion of the second conversion device and configured to generate motion having the third input remote velocity and the third input remote force. Medical devices.

115. 115. The medical device of claim 114, the third remote motor is a piezoelectric motor; Medical devices.

116. The medical device according to any one of claims 114 to 115, the remote portion of the control device further comprises a third remote gear system configured to decrease the third input remote speed and increase the third input remote force; Medical devices.

117. The medical device according to any one of claims 114 to 116, the remote portion of the control device further comprises a fourth remote motor coupled to the receiving portion of the second conversion device and configured to generate motion having a fourth input remote speed and a fourth input remote force; Medical devices.

118. 118. The medical device of claim 117, the fourth remote motor is a piezoelectric motor; Medical devices.

119. The medical device according to any one of claims 117 to 118, the control device remote portion further includes a fourth remote gear system configured to decrease the fourth input remote speed and increase the fourth input remote force. Medical devices.

120. The medical device according to any one of claims 114 to 119, the operating device further comprises a third flexible wire configured to transmit the third input remote force from the third remote motor to a receiving portion of the second conversion device. Medical devices.

121. The medical device according to any one of claims 117 to 120, the operating device further comprising a fourth flexible wire configured to transmit the fourth input remote force from the fourth remote motor to a receiving portion of the second conversion device; the third flexible wire is configured to guide rotation of the third member rotating portion in a first rotation direction, and the fourth flexible wire is configured to guide rotation of the third member rotating portion in a second rotation direction opposite to the first rotation direction of the third member rotating portion. Medical devices.

122. 121. The medical device of claim 32 and claim 120, a medical device, wherein the first flexible wire is the same as the third flexible wire, the first remote motor is the same as the third remote motor, and the first flexible wire is configured to rotate the first member rotating portion and the third member rotating portion in opposite rotational directions.

123. 122. The medical device of claim 33 or 121, the first flexible wire is the same as the third flexible wire, the first remote motor is the same as the third remote motor, the second flexible wire is the same as the fourth flexible wire, the second remote motor is the same as the fourth remote motor, a first rotation direction of the first member rotating part is opposite to a first rotation direction of the third member rotating part, and a second rotation direction of the first member rotating part is opposite to a second rotation direction of the third member rotating part; Medical devices.

124. The medical device according to any one of claims 114 to 119, the operating device further includes a third hydraulic system configured to transmit the third input remote force from the third remote motor to a receiving portion of the second conversion device. Medical devices.

125. 125. The medical device of claim 124, the third hydraulic system a third hydraulic line; a third remote hydraulic cylinder disposed in a remote portion of the operating device, the third remote hydraulic cylinder coupled to the third remote motor and the third hydraulic line; a third local hydraulic cylinder disposed in the local portion of the operating device; the third local hydraulic cylinder is coupled to the third hydraulic conduit and to a receptacle of the second conversion device; Medical devices.

126. The medical device according to any one of claims 117 to 119 and 124 to 125, the operating device further comprising a fourth hydraulic system configured to transmit the fourth input remote force from the fourth remote motor to a receiving portion of the second conversion device; the third hydraulic system is configured to induce rotation of the third member rotating portion in a first rotational direction of the third member rotating portion; the fourth hydraulic system is configured to induce rotation of the third member rotating portion in a second rotational direction of the third member rotating portion opposite a first rotational direction of the third member rotating portion. Medical devices.

127. 127. The medical device of claim 126, the fourth hydraulic system a fourth hydraulic line; a fourth remote hydraulic cylinder disposed in a remote portion of the operating device, the fourth remote hydraulic cylinder being connected to the fourth remote motor and the fourth hydraulic line; a fourth local hydraulic cylinder arranged in a local portion of the operating device, the fourth local hydraulic cylinder being coupled to the fourth hydraulic line and to a receiving portion of the second conversion device; Medical devices.

128. 126. The medical device of claim 34, 35, 124, or 125, the first hydraulic system is the same as the third hydraulic system, the first remote motor is the same as the third remote motor, and the first hydraulic system is configured to rotate the first member rotating portion and the third member rotating portion in opposite rotational directions. Medical devices.

129. 128. The medical device of claim 36, 37, 126, or 127, the first hydraulic system is the same as the third hydraulic system, the first remote motor is the same as the third remote motor, the second hydraulic system is the same as the fourth hydraulic system, the second remote motor is the same as the fourth remote motor, a first rotation direction of the first member rotating part is opposite to a first rotation direction of the third member rotating part, and a second rotation direction of the first member rotating part is opposite to a second rotation direction of the third member rotating part. Medical devices.

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