Apparatus for controlling transmission of wireless energy supplied to a medical device - Patent application

Abstract

An apparatus for delivering wireless energy to a medical device implanted in a patient is provided. [Solution] An apparatus for controlling the transmission of wireless energy between an external energy source and an implantable medical device, comprising: an internal energy receiver that supplies the wireless energy transmitted from the external energy source to the medical device; an energy stabilization unit that is installed in a patient and stabilizes and / or stores the energy received by the internal energy receiver before the energy is supplied to the medical device; and a control unit that determines an energy balance between the energy received by the internal energy receiver and the energy consumed by the medical device or the energy stored in an implantable energy storage device, and controls the transmission of the wireless energy from the external energy source based on the energy balance.

Description

[Technical field]

[0001] The present invention relates generally to methods and apparatus for providing wireless energy to a medical device implanted in a patient. In particular, the present invention relates to controlling the amount of energy transmitted from an energy source external to the patient to an energy receiver within the patient. [Background technology]

[0002] Medical devices configured to be implanted within a patient's body are typically operated by electrical power. Such medical devices include electrical and mechanical stimulation members, motors, pumps, and the like configured to assist or stimulate various bodily functions. Such implanted medical devices can be powered by batteries, which are also implanted, or by an external energy source that can provide the required amount of power intermittently or continuously without the need for repeated surgical procedures.

[0003] An external energy source can transmit wireless energy to an implanted internal energy receiver that is placed inside the patient and connected to the medical device, which supplies the received energy to the medical device. So-called TET (Transcutaneous Energy Transfer) devices are known that can transmit wireless energy in this way, thereby eliminating the need to use leads that penetrate the skin when connecting the medical device to an external energy source such as a battery.

[0004] A TET device typically comprises an external energy source including a primary coil configured to inductively transmit any amount of wireless energy by inducing a voltage in a secondary coil within an internal energy receiver, preferably implanted just beneath the patient's skin. The highest transmission efficiency is obtained when the primary coil is positioned near the skin, adjacent to and aligned with the secondary coil, i.e., when the axis of symmetry of the primary coil is parallel to the axis of symmetry of the secondary coil.

[0005] Typically, the amount of energy required to operate an implanted medical device changes over time depending on the operating characteristics of the device. For example, the device may be configured to switch on and off at intervals or to modify its operation to provide appropriate electrical or mechanical stimulation, etc. This change in operation will, of course, result in a corresponding change in the amount of energy required.

[0006] Furthermore, the location of the external energy source relative to the implanted internal energy source is a factor that affects the efficiency of energy transmission, which is highly dependent on the distance and relative angle between the energy source and the receiver. For example, when using a primary coil and a secondary coil, as the coil spacing changes, the induced voltage changes accordingly. During operation of the medical device, patient movement typically and arbitrarily changes the relative spacing between the external energy source and the internal receiver, thus significantly altering the transmission efficiency.

[0007] When transmission efficiency is low, the amount of energy delivered to the medical device may be insufficient to operate the device properly, and therefore operation of the device must be temporarily stopped, which of course impairs the device's intended medical effect.

[0008] On the other hand, if the relative positions of the external energy source and the internal receiver are unintentionally changed in a way that increases the transmission efficiency, the energy delivered to the medical device may also increase significantly. In this situation, serious problems may occur because the implant cannot suddenly "consume" a large amount of delivered energy. The excess energy that is not used must be absorbed in some way, resulting in the generation of heat, which is highly undesirable. Therefore, if too much energy is transmitted from the external energy source to the internal energy receiver, the temperature of the implant may increase, causing damage to the surrounding tissue or even adversely affecting bodily functions. It is generally believed that body temperature should not exceed 3 degrees to avoid such problems.

[0009] Therefore, it is highly desirable to provide an appropriate amount of energy to the implanted medical device to ensure proper operation and / or avoid temperature rise. Various methods are known to adjust the amount of energy transmitted depending on different conditions of the recipient implant. However, currently available solutions for controlling wireless energy transmission to the implanted medical device lack precision in this regard.

[0010] For example, US Pat. No. 5,995,874 discloses a TET system in which the amount of energy transmitted from the primary coil is adjusted according to measured characteristics of the secondary coil, such as the load current and the load voltage. The transmitted energy can be adjusted by varying the current and voltage of the primary coil, the transmission frequency, or the coil dimensions. In particular, the saturation point of the magnetic field between the coils is changed to adjust the power transmission efficiency. However, this solution is unlikely to work in practice, since no saturation point occurs in human tissue, given usable magnetic field levels. Furthermore, if the amount of energy transmission has to be significantly increased, for example to compensate for losses due to changes in the alignment and / or spacing of the coils, the significant amount of radiation generated may be damaging or unhealthy or uncomfortable for the patient, as is known. [Prior art documents] [Patent documents]

[0011] [Patent Document 1] U.S. Patent No. 5,995,874 Summary of the Invention [Problem to be solved by the invention]

[0012] Thus, there is a need for an effective solution to precisely regulate the amount of energy delivered to an implanted medical device to ensure proper operation of the medical device. Furthermore, to avoid tissue damage and ill health or discomfort to the patient, excessive energy delivery and / or power surges that would increase the temperature of the medical device must be avoided. [Means for solving the problem]

[0013] Thus, there is provided a method for controlling the transmission of wireless energy delivered to an electrically operable medical device implanted in a patient. The wireless energy is delivered from an external energy source located outside the patient and received by an internal energy receiver located inside the patient, connected to the medical device, and providing the received energy directly or indirectly to the medical device. An energy balance is determined between the energy received by the internal energy receiver and the energy used for the medical device. The transmission of energy from the external energy source is then controlled based on the determined energy balance.

[0014] Also provided is an apparatus for controlling the transmission of wireless energy delivered to an electrically operable medical device implanted in a patient. The apparatus is configured to transmit wireless energy from an external energy source disposed outside the patient, the wireless energy being received by an internal energy receiver disposed within the patient and connected to the medical device, the internal energy receiver providing the received energy directly or indirectly to the medical device. The apparatus is further configured to determine an energy balance between the energy received by the internal energy receiver and the energy used for the medical device, and to control the transmission of wireless energy from the external energy source based on the determined energy balance.

[0015] The method and apparatus may be implemented according to various embodiments and features below.

[0016] The wireless energy can be inductively transferred from a primary coil in the external energy source to a secondary coil in the internal energy receiver. A change in the energy balance can be detected and the transfer of the wireless energy can be controlled based on the detected change in the energy balance. A difference between the energy received by the internal energy receiver and the energy used for the medical device can also be detected and the transfer of the wireless energy can be controlled based on the detected energy difference.

[0017] In controlling the energy transmission, the amount of wireless energy transmission may be decreased if the detected change in the energy balance indicates that the energy balance is increasing, and the amount of wireless energy transmission may be increased if the detected change in the energy balance indicates that the energy balance is decreasing. The increase or decrease in the amount of energy transmission may also correspond to the detected rate of change.

[0018] Furthermore, the amount of transmitted wireless energy can be reduced if the detected energy difference indicates that the received energy is greater than the energy used, and the amount of transmitted wireless energy can be increased if the detected energy difference indicates that the received energy is less than the energy used, where the increase or decrease in the amount of transmitted energy can correspond to the magnitude of the detected energy difference.

[0019] As mentioned above, the energy used by the medical device may be consumed to operate the medical device and / or stored in at least one energy storage device of the medical device.

[0020] In an alternative embodiment, substantially all of the energy used by the medical device is consumed to operate the medical device (e.g., by the consumption portion 200a of FIG. 2). In this case, the energy can be consumed after being stabilized in at least one stabilization unit of the medical device.

[0021] In other embodiments, substantially all of the energy used by the medical device is stored in at least one energy storage device. In other embodiments, the energy used by the medical device is partially consumed to operate the medical device and partially stored in at least one energy storage device.

[0022] The energy received by the internal energy receiver may be stabilized by a capacitor before being delivered directly or indirectly to the medical device.

[0023] The difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy deposition can be measured directly or indirectly over time, and then an energy balance can be determined based on the detected change in the total difference.

[0024] The energy received by the internal energy receiver can be accumulated and stabilized in an energy stabilization unit before being delivered to the medical device. An energy balance can then be determined based on the detected change in the energy consumption and / or energy storage over time. Furthermore, a change in the energy consumption and / or energy storage can be detected by determining a derivative of the measured electrical parameter with respect to the energy consumption and / or energy storage over time, where the derivative at a first given instant corresponds to a rate of change at the first given instant, the rate of change including a direction and a speed of the change. Furthermore, the derivative can be determined based on the detected rate of change of the electrical parameter.

[0025] The energy received by the internal energy receiver can be supplied to the medical device by at least one constant voltage, in which case the constant voltage is generated by a constant voltage circuit. In this case, the energy can be supplied by at least two different voltages, including the at least one constant voltage.

[0026] The energy received by the internal energy receiver can also be supplied to the medical device by at least one constant current, where the constant current is generated by a constant current circuit. In this case, the energy can be supplied by at least two different currents, including the at least one constant current.

[0027] The energy balance may also be determined based on a detected difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy storage, where the detected difference is a difference in relation to an integral over time of at least one measured electrical parameter related to the energy balance. In this case, the value of the electrical parameter may be plotted against time as a graph of a parameter-time diagram, and the integral may be determined from the size of the area under the plotted graph. The integral of the electrical parameter may be related to the energy balance as an accumulated difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy storage.

[0028] The energy storage device in the medical device may include at least one of a rechargeable battery, an accumulator, and a capacitor. The energy stabilization unit may include at least one of an accumulator, a capacitor, or a semiconductor configured to stabilize the received energy.

[0029] When the energy received by the internal energy receiver is stored and stabilized in the stabilization unit before being supplied to the medical device and / or the energy storage device, the medical device and / or the energy storage device can be supplied with energy by at least one constant voltage maintained in a constant voltage circuit, in which case two different voltages, at least one of which is constant, maintained in the constant voltage circuit, can be supplied to the medical device and the energy storage device.

[0030] Alternatively, the energy received by the internal energy receiver can be stored and stabilized in a stabilization unit before being supplied to the medical device and / or the energy storage device, and the energy can be supplied to the medical device and / or the energy storage device by at least one constant current maintained in a constant current circuit, in which case two different currents, at least one of which is constant, can be supplied to the medical device and the energy storage device, maintained in a constant current circuit.

[0031] The wireless energy may initially be transmitted according to a predetermined energy consumption and storage rate, in which case the transmission of wireless energy may be turned off when a predetermined total amount of energy has been transmitted, in which case the energy received by the internal energy receiver may also be stored and stabilized in an energy stabilization unit before being consumed to operate the medical device and / or stored in the energy storage device until the predetermined total amount of energy has been consumed and / or stored.

[0032] Additionally, the wireless energy may be first transmitted at a predetermined energy rate and then transmitted based on an energy balance that may be determined by detecting the total energy stored in the energy stabilization unit. Alternatively, the energy balance may be determined by detecting a change in the current energy stored in the energy stabilization unit. In other alternative embodiments, the energy balance may be determined by detecting a direction and rate of change in the current energy stored in the energy stabilization unit.

[0033] The transmission of wireless energy can be controlled such that the rate of energy reception at the internal energy receiver corresponds to the rate of energy consumption and / or storage, in which case the transmission of wireless energy can be turned off when a predetermined total amount of energy has been consumed.

[0034] The energy received by the internal energy receiver may first be stored and stabilized in the energy stabilization unit, and then consumed or stored by the medical device until a predetermined total amount of energy is consumed. In that case, the energy balance may be determined based on the detected total amount of energy stored in the energy stabilization unit. Alternatively, the energy balance may be determined by detecting a change in the current amount of energy stored in the energy stabilization unit. In another alternative embodiment, the energy balance may be determined by detecting a direction and rate of change in the current amount of energy stored in the energy stabilization unit. The sensor may be used to measure certain characteristics of the medical device and / or to detect a current state of the patient that in some way reflects the energy requirement required to properly operate the medical device. Thus, electrical and / or physical parameters of the medical device and / or physical parameters of the patient may be determined, and then energy may be transmitted at a transmission rate determined based on the parameters. Furthermore, the transmission of wireless energy may be controlled such that the total amount of energy transmitted is an amount based on the parameters.

[0035] The energy received by the internal energy receiver can first be stored and stabilized in an energy stabilization unit and then consumed until a predetermined total amount of energy is consumed. Furthermore, the transmission of wireless energy can be controlled such that the energy reception rate at the internal energy receiver corresponds to a predetermined energy consumption rate.

[0036] Furthermore, electrical and / or physical parameters of the medical device and / or physical parameters of the patient can be determined and a total energy transmission amount can be determined based on the parameters, in which case the energy received by the internal energy receiver can be first stored and stabilized in an energy stabilization unit and then stored until a predetermined total amount of energy is consumed.

[0037] Energy is stored in the energy storage device according to a predetermined storage rate. The transmission of wireless energy can then be turned off when a predetermined total amount of energy has been stored. Further, the transmission of wireless energy can be controlled such that an energy reception rate at the internal energy receiver corresponds to the predetermined storage rate.

[0038] The energy storage device of the medical device may include a first storage device and a second storage device, in which case the energy received by the internal energy receiver is first stored in the first storage device and then supplied from the first storage device to the subsequent second storage device.

[0039] Using the first and second storage devices in the energy storage device, the energy balance can be determined in different ways. First, the energy balance can be determined by detecting the current amount of energy stored in the first storage device, and then the transmission of wireless energy can be controlled so that the storage rate in the second storage device corresponds to the energy reception rate in the internal energy receiver. Second, the energy balance can be determined based on the detected total amount of energy stored in the first storage device. Third, the energy balance can be determined by detecting a change in the current amount of energy stored in the first storage device. Fourth, the energy balance can be determined by detecting the direction and rate of change of the current amount of energy stored in the first storage device.

[0040] The stabilized energy may be first supplied from the first storage device to the second storage device by a constant current maintained by a constant current circuit until a voltage measured at the second storage device reaches a predetermined maximum voltage, and then supplied from the first storage device to the second storage device by a constant voltage maintained by a constant voltage circuit, in which case the transmission of wireless energy may be turned off when a predetermined minimum energy transfer rate is reached.

[0041] The energy transfer can further be controlled such that the energy reception rate by the internal energy receiver corresponds to the amount of energy stored in the second storage device. In that case, the energy transfer can be controlled such that the rate of energy reception at the internal energy receiver corresponds to the rate of energy storage in the second storage device. The energy transfer can also be controlled such that the total energy reception at the internal energy receiver corresponds to the total energy storage in the second storage device.

[0042] If the wireless energy transmission is turned off when a predetermined total amount of energy is accumulated, electrical and / or physical parameters of the medical device and / or physical parameters of the patient can be determined during a first energy accumulation procedure, and a predetermined total amount of energy can be accumulated based on the parameters during a subsequent energy accumulation procedure.

[0043] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, energy can be stored in the energy storage device at a storage rate determined based on the parameters. A total amount of energy determined based on the parameters can then be stored in the energy storage device. The transmission of wireless energy can then be automatically turned off when the total amount of energy is stored. The transmission of wireless energy can also be controlled such that the rate of energy acceptance at the internal energy receiver corresponds to the storage rate.

[0044] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, a total amount of energy determined based on the parameters can be stored in the energy storage device. The transmission of wireless energy can then be controlled such that the total amount of energy received at the internal energy receiver corresponds to the total amount of energy stored. Furthermore, the transmission of wireless energy can be automatically turned off when the total amount of energy is stored.

[0045] When some of the energy used for the medical device is consumed and some is stored, the transmission of wireless energy can be controlled based on a predetermined rate of energy consumption and a predetermined rate of energy storage, where the transmission of energy can be turned off when a predetermined total amount of consumed and stored energy is received.The transmission of energy can be turned off when a predetermined total amount of consumed and stored energy is received.

[0046] Once electrical and / or physical parameters of the medical device and / or physical parameters of the patient are determined, energy can be transmitted, consumed and stored according to a transmission rate per unit time determined based on said parameters. A total energy transmission can also be determined based on said parameters.

[0047] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, energy may be supplied from the energy storage device to the medical device and consumed at a delivery rate determined based on said parameters, such that the total amount of energy supplied from the energy storage device to the medical device and consumed may be an amount based on said parameters.

[0048] Electrical and / or physical parameters of the medical device and / or Once the patient's physical parameters are known, the total energy delivered from the energy storage device to the medical device can be calculated. The total energy supply can be supplied to the device and consumed by it, in which case the total energy supply is determined by the parameter It is required based on.

[0049] When the energy received by the internal energy receiver is stored and stabilized in the energy stabilization unit, an energy balance can be determined based on the storage rate in the energy stabilization unit, such that the storage rate in the energy storage device corresponds to the energy acceptance rate at the internal energy receiver.

[0050] An integral can be determined for the monitored voltage and / or current related to the energy balance when a difference between the total amount of energy received by the internal energy receiver and the total amount of energy consumed and / or stored is detected, and the detected difference is a difference related to an integral over time of at least one measured electrical parameter related to the energy balance.

[0051] The derivative of the measured electrical parameters with respect to energy expenditure and / or energy storage over time can be taken, and the derivative of the monitored voltages and / or currents with respect to energy balance can be taken.

[0052] When using the first and second storage devices in the energy storage device, the second storage device can directly or indirectly supply energy to the medical device, where a change in the difference corresponds to a change in the amount of energy stored in the first storage unit. In this case, the energy balance can be determined by detecting a change in the rate of energy storage in the first storage device over time, where the energy balance corresponds to the change. The change in the amount of energy storage can also be detected by determining a derivative of a measured electrical parameter indicative of the amount of energy storage over time, where the derivative corresponds to the change in the amount of energy storage. The rate of change of the electrical parameter can also be detected, where the derivative is related to the rate of change. The electrical parameter can be a measured voltage and / or current related to the energy balance.

[0053] The first storage device may include at least one of a capacitor and a semiconductor, and the second storage device includes at least one of a rechargeable battery, an accumulator, and a capacitor.

[0054] As mentioned above, wireless energy can be transferred inductively from a primary coil in the external energy source to a secondary coil in the internal energy receiver. However, wireless energy can also be transferred non-inductively. For example, wireless energy can be transferred by sound or pressure changes, radio waves, or light. Wireless energy can also be transferred in pulses or waves and / or by electric fields.

[0055] When wireless energy is transmitted from an external energy source to an internal energy receiver in pulses, the transmission of wireless energy can be controlled by adjusting the width of the pulses.

[0056] If the difference between the total energy reception by the internal energy receiver and the total energy expenditure is measured directly or indirectly over time, the energy balance can be determined by detecting the change in the difference. In this case, the change in the energy expenditure can be detected by determining the derivative of the measured electrical parameter with respect to the energy expenditure over time, the derivative corresponding to the rate of change of the energy expenditure, the rate of change including the direction and rate of change. In this case, the rate of change of the electrical parameter can be detected, and the derivative is related to the detected rate of change.

[0057] When using a first and a second storage device in an energy storage device, the first storage device can be configured to be charged at a relatively high energy charge rate compared to the second storage device, thereby allowing for a relatively fast charge. The first storage device can also be configured to be charged more frequently at multiple individual charge occasions compared to the second storage device, thereby allowing for a relatively long life in terms of charge occasions. The first storage device can include at least one capacitor. Typically, only the first storage device can be charged more frequently than is necessary for the second storage device.

[0058] When the second storage device needs to be charged, the first storage device is charged in multiple individual charging opportunities to reduce the time required for charging, thereby leaving time between charging opportunities for the first storage device to charge the second storage device at a relatively low energy charging rate. Once the electrical parameters of the medical device are determined, the charging of the second storage device can be controlled based on the parameters. Energy can be stored in the second storage device using a constant current circuit or a regulated voltage circuit.

[0059] System for controlling wireless energy supply based on a feedback system Transmission of wireless energy from an external energy source can be controlled by applying electrical pulses from a first electrical circuit having rising and falling edges to the external energy source to transmit wireless energy, varying the length of a first time interval between successive rising and falling edges of the electrical pulses and / or the length of a second time interval between successive falling and rising edges of the electrical pulses, and transmitting wireless energy generated from the electrical pulses having a power that varies depending on the length of the first and / or second time intervals.

[0060] Accordingly, there is provided a method for transmitting wireless energy from an external energy transmission device located outside a human body to an internal energy receiver located inside the human body, comprising: Applying an electrical pulse having a rising edge and a falling edge from a first electrical circuit to an external transmitting device to transmit wireless energy; Varying a length of a first time interval between successive leading and trailing edges of the electrical pulse and / or a length of a second time interval between successive leading and trailing edges of the electrical pulse; and transmitting wireless energy generated from electrical pulses having a power that varies depending on the length of the first and / or second time intervals.

[0061] 1. An apparatus configured to transmit wireless energy from an external energy transmission device disposed outside a human body to an internal energy receiver disposed inside the human body, comprising: a first electrical circuit configured to provide an electrical pulse having a leading edge and a trailing edge to an external transmission device configured to provide wireless energy; the electrical circuit is configured to vary a length of a first time interval between successive leading and trailing edges of the electrical pulse and / or a length of a second time interval between successive trailing and leading edges of the electrical pulse; An apparatus is also provided in which the transmitted wireless energy is generated from electrical pulses having a power that varies depending on the length of the first and / or second time intervals.

[0062] The method and apparatus may be implemented according to various embodiments and features below.

[0063] In that case, the frequency of the electrical pulses may be substantially constant when varying the first and / or second time intervals. When applying the electrical pulses, the electrical pulses may not be varied except for varying the first and / or second time intervals. The amplitude of the electrical pulses may be substantially constant when varying the first and / or second time intervals. Furthermore, the electrical pulses may be varied only by varying the length of the first time interval between successive rising and falling edges of the electrical pulses.

[0064] Two or more trains of electrical pulses can be provided in a train, where when the pulse train is applied, the pulse train has a first electrical pulse at a beginning of the pulse train and a second electrical pulse at an end of the pulse train, and the two or more pulse trains can be provided in a train, where the length of the second time interval between the falling edge of the second electrical pulse in the first pulse train followed by the rising edge of the first electrical pulse in the second pulse train is varied.

[0065] When applying the electrical pulses, the electrical pulses may have a substantially constant current and a substantially constant voltage. The electrical pulses may have a substantially constant current and a substantially constant voltage. Additionally, the electrical pulses may have a substantially constant frequency. Similarly, the electrical pulses within a pulse train may have a substantially constant frequency.

[0066] When an electrical pulse is applied to the external energy source, the electrical pulse can generate an electromagnetic field on the external energy source that varies by varying the first and second time intervals, and the electromagnetic field can induce an electrical pulse in the internal energy receiver that carries the energy that is transmitted to the internal energy receiver. In that case, the wireless energy is transmitted from the external energy source to the internal energy receiver almost purely inductively.

[0067] The electrical pulses can be emitted from the first electrical circuit at a frequency and / or time period between successive pulses such that varying the first and / or second time intervals results in varying the energy transmitted. When the electrical pulses are applied, the electrical pulses can have a substantially constant frequency.

[0068] The circuit formed by the first electrical circuit and the external energy source may have a first characteristic time period or a first time constant, and such frequency period may be less than or equal to the first characteristic time period or time constant when effectively changing the energy transmitted.

[0069] One embodiment of the device and method for use with an energy feedback system Wireless energy can be used to control the flow of fluids and / or other bodily substances within a lumen formed by a tissue wall of a patient's organ, where at least a portion of the tissue wall can be gently constricted to affect flow within the lumen, and the constricted wall can be stimulated to contract the wall to further affect flow within the lumen.

[0070] The object of the present embodiment is to provide an apparatus or method configured to control the flow of fluids and / or body substances within a lumen formed by a tissue wall of a body organ, which at least substantially eliminates, or in some cases completely eliminates, the problem of tissue wall damage caused by implanted prior art techniques that constrict such body organs.

[0071] In accordance with this object of the invention, there is provided an apparatus or method configured to control the flow of fluids and / or body substances within a lumen formed by a tissue wall of a body organ, the apparatus comprising an implantable constriction device for gently constricting a portion of the tissue wall to affect flow within the lumen, a stimulation device for stimulating a portion of the tissue wall, and a control device for controlling the stimulation device to stimulate the wall as the constriction device constricts the wall, causing the wall to contract and further affect flow within the lumen.

[0072] The present invention provides an advantageous combination of a constriction device and a stimulation device that affects the flow of fluids and / or other body substances in a body organ in two stages. Thus, the constriction device can gently constrict a tissue wall by applying a relatively weak force to the wall, and the stimulation device can stimulate the constricted wall to have a desired final effect on flow within the lumen. The phrase "mildly constricting a portion of a tissue wall" should be understood as constricting the wall without substantially impeding blood circulation within the tissue wall.

[0073] Thus, a method for controlling flow within a lumen and a method configured to control flow within a lumen are provided. Both devices may be implemented according to various embodiments and features below.

[0074] Preferably, the stimulation device is configured to stimulate different regions of the wall as the constriction device constricts the wall, and the control device controls the stimulation device to intermittently and individually stimulate each region of the wall. Such intermittent and individual stimulation of different regions of the organ wall allows tissue in the wall to maintain substantially normal blood circulation during operation of the apparatus of the present invention.

[0075] The combination of the constriction device and the stimulation device allows the application of the apparatus or method of the present invention to any location in any type of organ, particularly but not limited to tubular organs, which is a significant advancement over conventional stimulation devices that are limited to electrical stimulation to cause sphincter dysfunction.

[0076] In most applications of the present invention, the implanted constriction device is adjusted daily. Thus, in a preferred embodiment of the present invention, the constriction device is adjustable to allow the constriction of the wall to be adjusted as needed, and the control device then controls the constriction device to adjust the constriction of the wall. The control device can control the constriction device and the stimulation device independently of each other and simultaneously. Optionally, the control device can control the stimulation device to stimulate the wall or not stimulate the wall while controlling the constriction device to change the constriction of the wall.

[0077] First, the control device can be used to calibrate the constriction device by controlling the stimulation device to stimulate the wall while controlling the constriction device to adjust the constriction of the wall until a desired restriction of flow within the lumen is obtained.

[0078] Flow restriction The apparatus of the present invention is well suited to restrict the flow of fluids and / or other body substances in a lumen of a body organ. Thus, in a principle embodiment of the present invention, the constriction device is configured to constrict the wall to at least restrict the flow in the lumen, and the control device controls the stimulation device to contract the constricted wall and thus at least further restrict the flow in the lumen. In particular, the constriction device is configured to constrict the wall to a constricted state in which blood circulation within the constricted wall is substantially unrestricted and flow in the lumen is at least restricted, and the control device controls the stimulation device to contract the wall and thus at least further restrict the flow in the lumen when the wall is maintained in the constricted state by the constriction device.

[0079] The constriction device and the stimulation device can be controlled to constrict and stimulate, respectively, to an extent that depends on the flow restriction that is desired to be achieved in a particular application of the apparatus of the invention. Thus, according to a first flow restriction mode, the control device controls the constriction device to constrict the wall, thus restricting or stopping the flow in the lumen, and controls the stimulation device to stimulate the constricted wall to contract, thus further restricting or more safely stopping the flow in the lumen. More precisely, the control device controls the stimulation device in a first mode to stimulate the constricted wall to further restrict or stop the flow in the lumen, a) controlling the stimulation device in a second mode to cease stimulation of the wall and increase flow within the lumen; b) controlling the stimulation device and the constriction device in a second mode to stop stimulation of the wall and release the wall to restore flow within the lumen.

[0080] Movement of Fluids and / or Other Bodily Substances Within a Lumen In one embodiment, the constriction device is configured to constrict a wall to restrict or alter flow within the lumen, and the control device controls the stimulation device to gradually stimulate the constricted wall in a downstream or upstream direction of the lumen, gradually contracting the wall to move fluids and / or other bodily substances within the lumen.

[0081] The stimulation control device may control the stimulation device to stimulate one or more areas of the wall at once, for example by sequentially stimulating each different area. Further, the control device may control the stimulation device to propagate the stimulation of each region, preferably cyclically along the wall according to a predefined stimulation pattern. The control device may control the stimulation device to vary, preferably cyclically, the intensity of the stimulation of the wall, in order to obtain a desired response of the tissue wall upon stimulation of the tissue wall.

[0082] In a preferred embodiment of the invention, the control device controls the stimulation device to stimulate each region of the wall intermittently, preferably with pulses forming a pulse train. At least a first region and a second region of each region of the wall can be repeatedly stimulated with a first pulse train and a second pulse train, respectively, such that the first and second pulse trains are offset in time with respect to each other. For example, the first region can be stimulated with the first pulse train while the second region is not stimulated with the second pulse train, and the second region can be stimulated with the second pulse train while the first region is not stimulated with the first pulse train. Alternatively, the first and second pulse trains can be offset in time with respect to each other such that the first and second pulse trains at least partially overlap.

[0083] The pulse trains can be configured in a number of different ways. Thus, the control device can control the stimulation device to vary the amplitude of the pulses in the pulse train, the duty cycle of the individual pulses in each pulse train, the width of each pulse in the pulse train, the length of each pulse train, the repetition frequency of each pulse in the pulse train, the repetition frequency of each pulse train, the number of pulses in each pulse train, and / or the off-time period between each pulse train. Several pulse trains, each in a different configuration, can be used to achieve a desired effect.

[0084] If the control device controls the stimulation device to vary the off-time period between each pulse train stimulating a respective region of the wall, it is also possible to control each off-time period between each pulse train to last for a period of time sufficient to restore approximately normal blood circulation in that region when that region is not stimulated during the off-time period.

[0085] The electrical stimulation device suitably comprises at least one, preferably a plurality of, electrical members such as electrodes, which engage the wall portion and stimulate the wall portion with electrical pulses. Optionally, the electrical members may be arranged in a fixed orientation relative to each other. The control device controls the electrical stimulation device to energize the electrical members one at a time or groups of electrical members at a time. The control device preferably controls the electrical stimulation device to energize the members cyclically with electrical pulses. Optionally, the control device may control the stimulation device to energize the electrical members one at a time in sequence or such that several electrical members or groups of electrical members are energized simultaneously. Furthermore, groups of electrical members may be energized randomly or sequentially according to a predefined pattern.

[0086] The electrical members can form any pattern of electrical members. Preferably, the electrical members form an elongated pattern of electrical members, where the electrical members can be attached to the wall of the patient's organ such that the elongated pattern of electrical members extends lengthwise along the wall of the organ and the electrical members abut respective regions of the wall. The elongated pattern of electrical members can include one or more rows of electrical members extending lengthwise along the wall of the organ. Each row of electrical members can form a linear, helical, or zigzag path of electrical members, or a path of any shape. The control device can control the stimulation device to energize the electrical members sequentially longitudinally along the elongated pattern of electrical members, counter-directional or co-directional to the flow in the patient's lumen.

[0087] According to a preferred embodiment of the invention, the electrical members form a multi-member group, each group forming a series of groups extending along the patient's organ in the flow direction in the patient's lumen. The electrical members of each electrical member group can form a member path extending along at least a portion of the circumference of the patient's organ. In a first alternative embodiment, the electrical members of each electrical member group can form more than two member paths extending on different sides of the patient's organ, preferably substantially transverse to the flow direction in the patient's lumen. The control device can control the stimulation device to energize the electrical members in the series of groups randomly or according to a predetermined pattern. Alternatively, the control device can control the stimulation device to energize the electrical members in the series of groups sequentially from a position approximately in the center of the constricted wall in a direction opposite to or in the same direction as the flow in the patient's lumen, or in both directions. For example, the groups of energized electrical members may form forward waves of energized electrical members as described above, i.e., the control device may control the stimulation device to energize each group of electrical members to form two waves of energized electrical members that simultaneously advance in two opposite directions from the center of the constricted wall portion toward both ends of the elongated pattern of electrical members.

[0088] Mechanical operation The operating device may be non-expandable if it mechanically operates the constriction device of the constriction / stimulation unit. Furthermore, the operating device may comprise a servo system, which may include a gearbox. The term "servo system" encompasses the usual definition of a servo mechanism, i.e. an automatic device that controls a large force by a very small force, but may alternatively or additionally encompass the definition of a mechanism that converts a weak force acting on a moving member having a long stroke into a strong force acting on another moving member having a short stroke. The operating device preferably operates the constriction device non-magnetically and / or non-manually. A motor may be operably connected to the operating device. The operating device may be operable to perform at least one reversible function, and the motor may be capable of reversing this function.

[0089] Hydraulic Actuation If the actuation device hydraulically operates the constriction device of the restriction / stimulation unit, the actuation device comprises hydraulic means for adjusting the constriction device.

[0090] In one embodiment of the invention, the hydraulic means comprises a reservoir and an inflatable / contractable cavity in the constriction device, where the operating device distributes hydraulic fluid from the reservoir to expand the cavity and distributes hydraulic fluid from the cavity to the reservoir to contract the cavity. The cavity may be formed by a balloon of the constriction device abutting a tissue wall of the patient's organ, so that the wall of the patient constricts upon cavity expansion and releases upon cavity contraction.

[0091] Alternatively, the cavity can be formed by a relatively large constricting member of the constriction device, for example a bellows member that displaces a large balloon against the wall, so that the patient's wall is constricted upon contraction of the bellows member and released upon expansion of the bellows member. Thus, the addition of a relatively small amount of hydraulic fluid to the bellows member significantly increases the constriction of the wall. Such a bellows member could also be replaced by a suitably configured piston / cylinder mechanism.

[0092] When the hydraulic means comprises a cavity in the constriction device, the apparatus of the present invention may be constructed according to the embodiments listed below.

[0093] 1) The reservoir comprises a first and a second wall, and the manipulation device displaces the first and second walls relative to each other to change the volume of the reservoir, thus dispersing fluid from the reservoir to the cavity or from the cavity to the reservoir.

[0094] 1a) The first and second walls of the reservoir are displaceable relative to one another by at least one of a magnetic device, a hydraulic device, and an electrical control device.

[0095] 2) The device comprises a fluid conduit between the reservoir and the cavity, where the reservoir forms part of the conduit. There are no check valves in the conduit, reservoir and device. The reservoir forms a fluid chamber having a variable volume, dispersing fluid from the chamber to the cavity by reducing the volume of the chamber and withdrawing fluid from the cavity by increasing the volume of the chamber. The device further comprises a motor driving the reservoir with a movable wall that changes the volume of the chamber.

[0096] In a special embodiment of the invention, the operating device comprises a reversing servo operatively linked to the hydraulic means. The term "reversing servo" is to be understood as a mechanism that converts a strong force acting on a moving member with a short stroke into a weak force acting on another moving member with a long stroke, i.e. the reverse function of a normal servo mechanism. Thus, a small change in the amount of fluid in a smaller reservoir is converted by the reversing servo into a large change in the amount of fluid in a larger reservoir. The reversing servo is particularly suitable for its manual operation.

[0097] Configuration of the control device The control device preferably controls the constriction / stimulation unit from outside the patient's body. The control device is preferably operable by the patient. For example, the control device may comprise a manual switch for switching the constriction / stimulation unit on and off, where the switch is configured to be subcutaneously implanted in the patient and to be operated manually or magnetically from outside the patient's body. Alternatively, the control device may conveniently comprise a hand-held wireless remote control operable by the patient to switch the constriction / stimulation unit on and off. The wireless remote control may also be configured to be attached to the patient's body like a wristwatch. Such a wristwatch-type remote control may emit control signals that cause the patient's body to follow the implanted signal response means of the device.

[0098] The transmission of wireless energy from the external energy transmission device can be controlled by applying electrical pulses from a first electrical circuit having rising and falling edges to the external energy transmission device, varying the length of a first time interval between successive rising and falling edges of the electrical pulses and / or the length of a second time interval between successive falling and rising edges of the electrical pulses, and transmitting wireless energy generated from the electrical pulses having power that varies depending on the length of the first and / or second time intervals.

[0099] Accordingly, there is provided a method for controlling the transmission of wireless energy, comprising the steps of: Applying an electrical pulse having a rising edge and a falling edge from a first electrical circuit to an external transmitting device to transmit the wireless device; Varying a length of a first time interval between successive leading and trailing edges of the electrical pulse and / or a length of a second time interval between successive leading and trailing edges of the electrical pulse; and transmitting wireless energy generated from electrical pulses having a power that varies depending on the length of the first and / or second time intervals.

[0100] The apparatus is further configured to transmit wireless energy from an external energy transmission device disposed outside the human body to an internal energy receiver disposed inside the human body, the apparatus comprising: a first electric circuit configured to supply an electric pulse having a leading edge and a trailing edge to the external energy transmission device configured to supply the wireless energy; the electrical circuit is configured to vary a length of a first time interval between successive leading and trailing edges of the electrical pulse and / or a length of a second time interval between successive trailing and leading edges of the electrical pulse; An apparatus is provided in which the transmitted energy is generated from electrical pulses having a power that varies depending on the length of the first and / or second time intervals. [Brief description of the drawings]

[0101] [Figure 1] FIG. 1 is a schematic block diagram illustrating an arrangement for providing precise amounts of energy to an electrically operable medical device. [Diagram 2] FIG. 1 is a more detailed block diagram of an apparatus for controlling the transmission of wireless energy supplied to an electrically operable medical device implanted in a patient. [Diagram 3] FIG. 2 is a schematic circuit diagram illustrating a proposed configuration of an apparatus for controlling the transmission of wireless energy according to a possible embodiment. [Figure 4] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Diagram 5] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 6] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 7] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 8] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 9] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 10] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 11] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 12] 4A-4C show various measurements obtained when implementing the method and device of the invention according to the circuit diagram of FIG. [Figure 13a] 1A-1D show schematic diagrams of different operating states of a generic embodiment of the device according to the invention; [Figure 13b] 1A-1D show schematic diagrams of different operating states of a generic embodiment of the device according to the invention; [Figure 13c] 1A-1D show schematic diagrams of different operating states of a generic embodiment of the device according to the invention; [Figure 13d] 1A-1D show schematic diagrams of different operating states of a generic embodiment of the device according to the invention; [Figure 13e] 1A-1D show schematic diagrams of different operating states of a generic embodiment of the device according to the invention; [Figure 13f] 1A-1C show different operating states of variants of the general embodiment; [Figure 13g] 1A-1C show different operating states of variants of the general embodiment; [Figure 13h] 1A-1C show different operating states of the variants of the general embodiment. [Figure 13i] FIG. 13 illustrates another mode of operation of the variant of the general embodiment. [Figure 13j] FIG. 13 illustrates another mode of operation of the variant of the general embodiment. [Figure 13k] FIG. 13 illustrates another mode of operation of the variant of the general embodiment. [Figure 14] FIG. 1 is a longitudinal cross-sectional view of a preferred embodiment of an apparatus according to the invention comprising a constriction device and an electrical stimulation device. [Figure 15] FIG. 11 is a cross-sectional view taken along line III-III in FIG. [Figure 16] 12A-12C are the same cross-sectional views as shown in FIG. 11, but showing the device in different operating states. [Figure 17a] FIG. 13 is a diagram showing modified examples of a pulse. [Figure 17b] FIG. 13 is a diagram showing a modified example of a pulse train. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0102] The present invention will now be described in detail with reference to the accompanying drawings.

[0103] Briefly, wireless energy is transmitted from an external energy source located outside the patient and received by an internal energy receiver located inside the patient. The internal energy receiver is connected to an electrically operable medical device implanted in the patient and supplies the received energy directly or indirectly to the medical device. An energy balance is determined between the energy received by the internal energy receiver and the energy used for the medical device, and the transmission of wireless energy is then controlled based on the determined energy balance. Thus, the energy balance accurately indicates the correct amount of energy needed, sufficient to properly operate the medical device without excessively increasing its temperature.

[0104] 1, an arrangement for delivering a precise amount of energy to an electrically operable medical device 100 implanted in a patient is shown, with the patient's skin indicated by a vertical line S separating the patient's interior "Int" from the exterior "Ext". The medical device 100 is connected to an internal energy receiver 102 located inside the patient, preferably just beneath the skin S. Generally speaking, the energy receiver 102 may be located in the abdomen, chest, fascia (e.g., within the subwall), subcutaneously, or any other suitable location. The energy receiver 102 is configured to receive wireless energy E from an external energy source 104 located outside the skin S, proximate to the energy receiver 102.

[0105] As known in the art, the wireless energy E may generally be delivered by any suitable TET device, such as a device including a primary coil disposed in the energy source 104 and an adjacent secondary coil disposed in the energy receiver 102. When a current is sent through the primary coil, energy in the form of a voltage is induced in the secondary coil, and this energy may be used to operate a medical device after, for example, storing the received energy in an energy storage device or accumulator, such as a battery or capacitor. However, the present invention is generally not limited to a particular energy transmission technology, TET device, or energy storage device, and any type of wireless energy may be used.

[0106] The amount of energy to be transmitted can be adjusted by an external control unit 106 controlling the energy source 104 based on the energy balance determined as described above. To transmit the correct amount of energy, the energy balance and the energy requirement can be determined by an internal control unit 108 connected to the medical device 100. The control unit 108 can be configured to receive various measurements obtained by suitable sensors or the like (not shown) measuring certain characteristics of the medical device 100 that in some way reflect the required amount of energy required to properly operate the medical device 100. Furthermore, the current condition of the patient can be detected by suitable measuring devices or sensors to obtain parameters reflecting the patient's condition. Such characteristics and / or parameters can thus be related to the current state of the medical device 100, such as power consumption, operating mode, temperature, and the patient's condition reflected by, for example, body temperature, blood pressure, pulse, respiration.

[0107] Furthermore, an energy storage device or accumulator (not shown) can be connected to the energy receiver 102 to store the received energy for later use by the medical device 100. Alternatively or additionally, characteristics of the energy storage device can be measured, which also reflect the energy requirement. The energy storage device can be a battery, and the measured characteristics can be related to the current state of the battery, such as voltage, temperature. It should be clearly understood that to provide sufficient voltage and current to the medical device 100 and also to avoid excessive heating, the battery needs to be optimally charged by receiving the right amount of energy from the energy receiver 102, i.e., neither too little nor too much. The energy storage device can also be a capacitor with corresponding characteristics.

[0108] For example, the characteristics of the battery may be measured periodically to determine the current state of the battery, which may then be stored as status information in suitable storage means within the internal control unit 108. Thus, each time a new measurement is made, the stored battery status information may be updated accordingly. In this way, the state of the battery may be "calibrated" by transferring the correct amount of energy to maintain the battery in an optimal state.

[0109] Thus, the internal control unit 108 is configured to determine an energy balance and / or a current energy requirement (amount of energy per unit time or amount of energy storage) based on measurements by the above-mentioned sensors or measuring devices in the medical device 100, or the patient, or the energy storage device if an energy storage device is used, or any combination thereof. The internal control unit 108 is further connected to an internal signal transmitter 110 configured to transmit a control signal reflecting the determined energy requirement to an external signal receiver 112 connected to the external control unit 106. Thus, the amount of energy transmitted from the energy source 104 can be adjusted depending on the received control signal.

[0110] Alternatively, the sensor measurements can be sent directly to the external control unit 106, in which case the energy balance and / or the current energy requirement can be determined by the external control unit 106, thus integrating the above-mentioned functions of the internal control unit 108 in the external control unit 106. In this case, the internal control unit 108 can be omitted and the sensor measurements are fed directly to a signal transmitter 110 which sends the measurements to the receiver 112 and the external control unit 106. The energy balance and the current energy requirement can thus be determined by the external control unit 106 on the basis of such sensor measurements.

[0111] The solution therefore uses feedback of information indicative of the required energy, which is more efficient than previous solutions since it is based on a comparison of the received energy with the actual energy use, for example with respect to the amount of energy, the energy difference, the energy acceptance rate with respect to the energy use rate by the medical device. The medical device can use the received energy to consume the energy or store it in an energy storage device or the like. Thus, if necessary, the above mentioned difference parameters can be used as a means to further determine the actual energy balance. However, such parameters may also be required in principle for any measures taken to operate the medical device in particular in the body.

[0112] The internal signal transmitter 110 and the external signal receiver 112 may be implemented as separate units using suitable signal transfer means such as radio signals, IR (infrared) signals, ultrasonic signals, etc. Alternatively, the signal transmitter 110 and the signal receiver 112 may be incorporated into the internal energy receiver 102 and the energy source 104, respectively, to carry the control signals in the reverse direction to the energy transmission using essentially the same transmission technology. The control signals may be modulated with respect to frequency, phase, or amplitude.

[0113] In conclusion, the energy supply arrangement shown in Fig. 1 can basically operate as follows: First, an energy balance is determined by the internal control unit 108. A control signal S reflecting the energy requirement is also generated by the internal control unit 108, which is transmitted from the signal transmitter 110 to the signal receiver 112. Alternatively, the energy balance can be determined by the external control unit 106 depending on the embodiment as described above. In that case, the control signal S can carry measurements from various sensors. Thus, for example, the amount of energy emitted from the energy source 104 can be adjusted by the external control unit 106 based on the determined energy balance in response to the received control signal S. This process can be repeated intermittently at certain intervals during an ongoing energy transmission or can be performed substantially continuously during the energy transmission.

[0114] The amount of energy delivered can generally be adjusted by adjusting various delivery parameters in the energy source 104, such as voltage, current, amplitude, wave frequency, and pulse characteristics.

[0115] 2 illustrates several different embodiments of how received energy is delivered to and used by the medical device 200. Similar to the example of FIG. 1, an internal energy receiver 202 receives wireless energy E from an external energy source 204 controlled by a transmission control unit 206. The internal energy receiver 202 may include a constant voltage circuit, shown in the figure as a dashed box "constant V", that delivers energy to the medical device 200 at a constant voltage. The internal energy receiver 202 may include a constant current circuit, shown in the figure as a dashed box "constant C", that delivers energy to the medical device 200 at a constant current.

[0116] The medical device 200 comprises an energy consumer 200a, which may be a motor, a pump, a restriction device, or any other medical equipment that requires energy to be electrically operated. The medical device 200 may further comprise an energy storage device 200b, which stores the energy provided by the internal energy receiver 202. Thus, the provided energy can be directly consumed by the energy consumer 200a or stored by the energy storage device 200b, or the provided energy can be partially consumed and partially stored. The medical device 200 may further comprise an energy stabilization unit 200c, which stabilizes the energy provided by the internal energy receiver 202. Thus, the energy can be provided in a fluctuating state so that it needs to be stabilized before being consumed or stored.

[0117] The energy provided by the internal energy receiver 202 may be further stored and / or stabilized by a separate energy stabilization unit 208 located outside the medical device 200 before being consumed and / or stored by the medical device 200. Alternatively, the energy stabilization unit 208 may be incorporated into the internal energy receiver 202. In either case, the energy stabilization unit 208 may include a constant voltage circuit and / or a constant current circuit.

[0118] 1 and 2 show some possible but non-limiting examples of how the various illustrated functional components and functional components may be arranged and connected to one another, however, those skilled in the art will readily appreciate that numerous variations and modifications may be made within the scope of the invention.

[0119] Thus, there is provided a method for controlling the transmission of wireless energy delivered to an electrically operable medical device implanted in a patient, the wireless energy being delivered from an external energy source disposed outside the patient and received by an internal energy receiver disposed inside the patient, the internal energy receiver being connected to the medical device and providing the received energy directly or indirectly to the medical device, an energy balance being determined between the energy received by the internal energy receiver and the energy used for the medical device, and then the transmission of wireless energy from the external energy source being controlled based on the determined energy balance.

[0120] Also provided is an apparatus for controlling the transmission of wireless energy delivered to an electrically operable medical device implanted in a patient. The apparatus is configured to transmit wireless energy from an external energy source disposed outside the patient that is received by an internal energy receiver disposed inside the patient, the internal energy receiver being connected to the medical device and providing the received energy directly or indirectly to the medical device. The apparatus is further configured to determine an energy balance between the energy received by the internal energy receiver and the energy used for the medical device, and to control the transmission of wireless energy from the external energy source based on the determined energy balance.

[0121] The method and apparatus may be implemented according to various embodiments and features below.

[0122] The wireless energy can be inductively transferred from a primary coil in the external energy source to a secondary coil in the internal energy receiver. A change in the energy balance can be detected and the transfer of the wireless energy can be controlled based on the detected change in the energy balance. A difference between the energy received by the internal energy receiver and the energy used for the medical device can also be detected and the transfer of the wireless energy can be controlled based on the detected energy difference.

[0123] The energy transmission can be controlled by decreasing the amount of wireless energy transmission when the detected change in the energy balance indicates that the energy balance is increasing and increasing the amount of wireless energy transmission when the detected change in the energy balance indicates that the energy balance is decreasing. Further, the increase or decrease in the amount of energy transmission can correspond to the detected rate of change.

[0124] The amount of wireless energy transmission can be further reduced if the detected energy difference indicates that the received energy is greater than the energy used, and the amount of wireless energy transmission can be further increased if the detected energy difference indicates that the received energy is less than the energy used, where the increase or decrease in the amount of energy transmission can correspond to the magnitude of the detected energy difference.

[0125] As mentioned above, energy used by the medical device may be consumed to operate the medical device and / or stored in at least one energy storage device of the medical device.

[0126] In an alternative embodiment, substantially all of the energy used by the medical device is consumed to operate the medical device (e.g., by the consumer 200a of FIG. 2). In that case, the energy can be consumed after being stabilized in at least one energy stabilization unit of the medical device.

[0127] In other alternative embodiments, substantially all of the energy used by the medical device is stored in at least one energy storage device. In other alternative embodiments, a portion of the energy used by the medical device is consumed to operate the medical device and a portion is stored in at least one energy storage device.

[0128] The energy received by the internal energy receiver may be stabilized by a capacitor before being delivered directly or indirectly to the medical device.

[0129] The difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy storage can be measured directly or indirectly over time, and the energy balance can then be determined based on the change in the detected total difference.

[0130] Furthermore, the energy received by the internal energy receiver can be stored and stabilized in an energy stabilization unit before being delivered to the medical device. In that case, an energy balance can be determined based on the detected change in the energy consumption and / or energy storage over time. Furthermore, a change in the energy consumption and / or energy storage can be detected by determining a derivative of the measured electrical parameter with respect to the energy consumption and / or energy storage over time, where the derivative at a first given instant corresponds to a rate of change at the first given instant, the rate of change including a direction and a speed of the change. Furthermore, the derivative can be determined based on the detected rate of change of the electrical parameter.

[0131] The energy received by the internal energy receiver can be supplied to the medical device by at least one constant voltage, in which case the constant voltage is generated by a constant voltage circuit. In this case, the energy can be supplied by at least two different voltages, including the at least one constant voltage.

[0132] The energy received by the internal energy receiver can also be supplied to the medical device by at least one constant current, where the constant current is generated by a constant current circuit. In this case, the energy can be supplied by at least two different currents, including the at least one constant current.

[0133] The energy balance may also be determined based on a detected difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy storage, where the detected difference is a difference in relation to the integral over time of at least one measured electrical parameter related to the energy balance. In this case, the value of the electrical parameter may be plotted against time as a parameter-time graph, and the integral may be determined from the size of the area under the plotted graph. The integral of the electrical parameter may be related to the energy balance as the accumulated difference between the total energy reception by the internal energy receiver and the total energy expenditure and / or total energy storage.

[0134] The energy storage device in the medical device may include at least one of a rechargeable battery, an accumulator, and a capacitor. The energy stabilization unit may include at least one of an accumulator, a capacitor, or a semiconductor configured to stabilize the received energy.

[0135] When the energy received by the internal energy receiver is stored and stabilized in the stabilization unit before being supplied to the medical device and / or the energy storage device, the medical device and / or the energy storage device can be supplied with energy by at least one constant voltage maintained in a constant voltage circuit, in which case two different voltages, at least one of which is constant, maintained in the constant voltage circuit can be supplied to the medical device and the energy storage device.

[0136] Alternatively, the energy received by the internal energy receiver can be stored and stabilized in a stabilization unit before being supplied to the medical device and / or the energy storage device, and the energy can be supplied to the medical device and / or the energy storage device by at least one constant current maintained in a constant current circuit, in which case two different currents, at least one of which is constant, can be supplied to the medical device and the energy storage device, maintained in a constant current circuit.

[0137] The wireless energy may initially be transmitted according to a predetermined energy consumption and storage rate, in which case the transmission of wireless energy may be turned off when a predetermined total amount of energy has been transmitted, in which case the energy received by the internal energy receiver may also be stored and stabilized in an energy stabilization unit before being consumed to operate the medical device and / or stored in the energy storage device until the predetermined total amount of energy has been consumed and / or stored.

[0138] Additionally, the wireless energy may be first transmitted at a predetermined energy rate and then transmitted based on an energy balance that may be determined by detecting the total energy stored in the energy stabilization unit, or by detecting a change in the current energy stored in the energy stabilization unit, or in other alternative embodiments, the energy balance may be determined by detecting a direction and rate of change in the current energy stored in the energy stabilization unit.

[0139] The transmission of wireless energy can be controlled such that the rate of energy acceptance at the internal energy receiver corresponds to the rate of energy consumption and / or storage, in which case the transmission of wireless energy can be turned off when a predetermined total amount of energy has been consumed.

[0140] The energy received by the internal energy receiver may first be stored and stabilized in the energy stabilization unit, and then consumed or stored by the medical device until a predetermined total amount of energy is consumed. In that case, the energy balance may be determined based on the detected total energy storage amount in the energy stabilization unit. Alternatively, the energy balance may be determined by detecting a change in the current energy storage amount in the energy stabilization unit. In another alternative embodiment, the energy balance may be determined by detecting a direction and rate of change in the current energy storage amount in the energy stabilization unit.

[0141] As discussed in relation to Figure 1, suitable sensors may be used to measure certain characteristics of the medical device and / or to detect a current condition of the patient that in some way reflects the energy requirement required to properly operate the medical device. Thus, electrical and / or physical parameters of the medical device and / or physical parameters of the patient may be determined, and energy may then be transmitted at a transmission rate determined based on the parameters. Furthermore, the transmission of wireless energy may be controlled such that the total energy transmission is an amount based on said parameters.

[0142] The energy received by the internal energy receiver can be first stored and stabilized in an energy stabilization unit and then consumed until a predetermined total amount of energy is consumed. Furthermore, the transmission of wireless energy can be controlled such that the energy acceptance rate at the internal energy receiver corresponds to a predetermined energy consumption rate.

[0143] Furthermore, electrical and / or physical parameters of the medical device and / or physical parameters of the patient can be determined and a total energy transmission amount can be determined based on the parameters, in which case the energy received by the internal energy receiver can be first stored and stabilized in an energy stabilization unit and then consumed until a predetermined total amount of energy is consumed.

[0144] Energy is stored in the energy storage device according to a predetermined storage rate. The transmission of wireless energy can then be turned off when a predetermined total amount of energy has been stored. Further, the transmission of wireless energy can be controlled such that an energy acceptance rate at the internal energy receiver corresponds to the predetermined storage rate.

[0145] The energy storage device of the medical device may include a first storage device and a second storage device, in which case the energy received by the internal energy receiver is first stored in the first storage device and then supplied from the first storage device to the subsequent second storage device.

[0146] Using the first and second storage devices in the energy storage device, the energy balance can be determined in different ways. First, the energy balance can be determined by detecting the current amount of energy stored in the first storage device, and then the transmission of wireless energy can be controlled so that the storage rate in the second storage device corresponds to the energy reception rate in the internal energy receiver. Second, the energy balance can be determined based on the detected total amount of energy stored in the first storage device. Third, the energy balance can be determined by detecting a change in the current amount of energy stored in the first storage device. Fourth, the energy balance can be determined by detecting the direction and rate of change of the current amount of energy stored in the first storage device.

[0147] The stabilized energy may be first supplied from the first storage device to the second storage device by a constant current maintained by a constant current circuit until a voltage measured at the second storage device reaches a predetermined maximum voltage, and then supplied from the first storage device to the second storage device by a constant voltage maintained by a constant voltage circuit, in which case the transmission of wireless energy may be turned off when a predetermined minimum energy transfer rate is reached.

[0148] The energy transfer can further be controlled such that the energy reception rate by the internal energy receiver corresponds to the amount of energy stored in the second storage device. In that case, the energy transfer can be controlled such that the rate of energy reception at the internal energy receiver corresponds to the rate of energy storage in the second storage device. The energy transfer can also be controlled such that the total energy reception at the internal energy receiver corresponds to the total energy storage in the second storage device.

[0149] If the wireless energy transmission is turned off when a predetermined total amount of energy is accumulated, electrical and / or physical parameters of the medical device and / or physical parameters of the patient can be determined during a first energy accumulation procedure, and a predetermined total amount of energy can be accumulated based on the parameters during a subsequent energy accumulation procedure.

[0150] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, energy can be stored in the energy storage device at a storage rate determined based on the parameters. A total amount of energy determined based on the parameters can then be stored in the energy storage device. The transmission of wireless energy can then be automatically turned off when the total amount of energy is stored. The transmission of wireless energy can also be controlled such that the rate of energy acceptance at the internal energy receiver corresponds to the storage rate.

[0151] Upon determining the electrical and / or physical parameters of the medical device and / or the physical parameters of the patient, a total amount of energy determined based on the parameters can be stored in the energy storage device. In that case, a total amount of energy determined based on the parameters can be stored in the energy storage device. Then, the transmission of wireless energy can be controlled such that the total amount of energy received at the internal energy receiver corresponds to the total amount of energy stored. Furthermore, the transmission of wireless energy can be automatically turned off when the total amount of energy is stored.

[0152] When some of the energy used for the medical device is consumed and some is stored, the transmission of wireless energy can be controlled based on a predetermined rate of energy consumption and a predetermined rate of energy storage, where the transmission of energy can be turned off when a predetermined total amount of consumed and stored energy is received. The transmission of energy can also be turned off when a predetermined total amount of consumed and stored energy is received.

[0153] Once electrical and / or physical parameters of the medical device and / or physical parameters of the patient are determined, energy can be transmitted, consumed and stored according to a transmission rate per unit time determined based on said parameters. A total energy transmission can also be determined based on the parameters.

[0154] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, energy may be supplied from the energy storage device to the medical device and consumed at a delivery rate determined based on said parameters, such that the total amount of energy supplied from the energy storage device to the medical device and consumed may be an amount based on said parameters.

[0155] Upon determining electrical and / or physical parameters of the medical device and / or physical parameters of the patient, a total amount of energy can be supplied from the energy storage device to the medical device for consumption, where the total amount of energy supply is determined based on the parameters.

[0156] When the energy received by the internal energy receiver is stored and stabilized in the energy stabilization unit, an energy balance can be determined based on the storage rate in the energy stabilization unit, such that the storage rate in the energy storage device corresponds to the energy acceptance rate at the internal energy receiver.

[0157] An integral can be determined for the monitored voltage and / or current related to the energy balance when a difference between the total amount of energy received by the internal energy receiver and the total amount of energy consumed and / or stored is detected, and the detected difference is a difference related to an integral over time of at least one measured electrical parameter related to the energy balance.

[0158] The derivative of the measured electrical parameters with respect to energy expenditure and / or energy storage over time can be taken, and the derivative of the monitored voltages and / or currents with respect to energy balance can be taken.

[0159] When using the first and second storage devices in the energy storage device, the second storage device can directly or indirectly supply energy to the medical device, where a change in the difference corresponds to a change in the amount of energy stored in the first storage unit. In this case, an energy balance corresponding to the change can be determined by detecting a change in the rate of energy storage in the first storage device over time. The change in the amount of energy storage can also be determined by determining a derivative of a measured electrical parameter indicative of the amount of energy storage over time, where the derivative corresponds to the change in the amount of energy storage. The rate of change of the electrical parameter can also be detected, where the derivative is related to the rate of change. The electrical parameter can be a measured voltage and / or current related to the energy balance.

[0160] The first storage device may include at least one of a capacitor and a semiconductor, and the second storage device includes at least one of a rechargeable battery, an accumulator, and a capacitor.

[0161] As mentioned above, wireless energy can be transferred inductively from a primary coil in the external energy source to a secondary coil in the internal energy receiver. However, wireless energy can also be transferred non-inductively. For example, wireless energy can be transferred by sound or pressure changes, radio waves, or light. Wireless energy can also be transferred in pulses or waves and / or by electric fields.

[0162] When wireless energy is transmitted from an external energy source to an internal energy receiver in pulses, the transmission of wireless energy can be controlled by adjusting the width of the pulses.

[0163] If the difference between the total energy reception by the internal energy receiver and the total energy expenditure is measured directly or indirectly over time, the energy balance can be determined by detecting the change in the difference. In this case, the change in the energy expenditure can be detected by determining the derivative of the measured electrical parameter with respect to the energy expenditure over time, the derivative corresponding to the rate of change of the energy expenditure, the rate of change including the direction and rate of change. In this case, the rate of change of the electrical parameter can be detected, and the derivative is related to the detected rate of change.

[0164] When using a first and a second storage device in an energy storage device, the first storage device can be configured to be charged at a relatively high energy charge rate compared to the second storage device, thereby allowing for a relatively fast charge. The first storage device can also be configured to be charged more frequently at multiple individual charge occasions compared to the second storage device, thereby allowing for a relatively long life in terms of charge occasions. The first storage device can include at least one capacitor. Typically, only the first storage device can be charged more frequently than is necessary for the second storage device.

[0165] When the second storage device needs to be charged, the first storage device is charged in multiple individual charging opportunities to reduce the time required for charging, thereby leaving time between charging opportunities for the first storage device to charge the second storage device at a relatively low energy charging rate. Once the electrical parameters of the medical device are determined, the charging of the second storage device can be controlled based on the parameters. Energy can be stored in the second storage device using a constant current circuit or a regulated voltage circuit.

[0166] The transmission of wireless energy from an external energy source can be controlled by applying electrical pulses from a first electrical circuit having rising and falling edges to the external energy source to transmit wireless energy, varying the length of a first time interval between successive rising and falling edges of the electrical pulses and / or the length of a second time interval between successive falling and rising edges of the electrical pulses, and transmitting wireless energy generated from the electrical pulses having a power that varies depending on the length of the first and / or second time intervals.

[0167] In that case, the frequency of the electrical pulses may be substantially constant when varying the first and / or second time intervals. When applying the electrical pulses, the electrical pulses may not be changed except for varying the first and / or second time intervals. The amplitude of the electrical pulses may be substantially constant when varying the first and / or second time intervals. Furthermore, the electrical pulses may be changed only by varying the length of the first time interval between successive rising and falling edges of the electrical pulses.

[0168] Two or more trains of electrical pulses can be provided in a train, where when the pulse train is applied, the pulse train has a first electrical pulse at a beginning of the pulse train and a second electrical pulse at an end of the pulse train, and the two or more pulse trains can be provided in a train, where the length of the second time interval between the falling edge of the second electrical pulse in the first pulse train followed by the rising edge of the first electrical pulse in the second pulse train is varied.

[0169] When applying the electrical pulses, the electrical pulses may have a substantially constant current and a substantially constant voltage. The electrical pulses may have a substantially constant current and a substantially constant voltage. Additionally, the electrical pulses may have a substantially constant frequency. Similarly, the electrical pulses within a pulse train may have a substantially constant frequency.

[0170] When an electrical pulse is applied to the external energy source, the electrical pulse can generate an electromagnetic field on the external energy source that varies by varying the first and second time intervals, and the electromagnetic field can induce an electrical pulse in the internal energy receiver that carries the energy that is transmitted to the internal energy receiver. In that case, the wireless energy is transmitted from the external energy source to the internal energy receiver almost purely inductively.

[0171] The electrical pulses may be emitted from the first electrical circuit at a frequency and / or time period between leading edges of successive pulses such that varying the length of the first and / or second time intervals results in varying the energy transmitted. When the electrical pulses are applied, the electrical pulses may have a substantially constant frequency.

[0172] The circuit formed by the first electrical circuit and the external energy source may have a first characteristic time period or a first time constant, and such frequency period may be less than or equal to the first characteristic time period or time constant when effectively varying the energy transmitted.

[0173] Although the present invention has been described with reference to certain exemplary embodiments, this description is generally intended to be merely illustrative of the concepts of the invention and should not be considered as limiting the scope of the invention. In particular, one skilled in the art will readily appreciate that the above-described embodiments and examples may be implemented as both methods and devices. The present invention and various possible embodiments are generally defined by the following claims.

[0174] Description of the Preferred Embodiments Schematic FIG. 3 shows a circuit diagram of one of the proposed configurations for the device of the present invention for controlling the transmission of wireless energy, i.e., an energy balance control system. This shows that. This schematic shows an energy balance measurement circuit with an output signal centered on 2.5V and proportional to the energy imbalance. A signal level of 2.5V means that there is an energy balance; if the level goes below 2.5V, energy is taken from the power supply in the implant, and if the level goes above 2.5V, energy is charged to the power supply. The output signal from the circuit is usually sent to an A / D converter and converted to a digital format. This digital information is then sent to an external transmitter, allowing the external transmitter to adjust the level of power transmitted. Another possibility is to have a fully analog system that uses a comparator that compares the energy balance level to some maximum and minimum thresholds and sends information to the external transmitter if the balance deviates from the maximum / minimum window.

[0175] Schematic Figure 3 shows a circuit embodiment of a system for transmitting power from outside the body to an implant using inductive energy transmission. Inductive energy transmission systems typically use an external transmitting coil and an internal receiving coil. The receiving coil L1 is included in the schematic Figure 3, which excludes the transmitting portion of the system.

[0176] The general concept of energy balance and the method of transmitting the information to the external energy transmitter can of course be implemented in a number of different ways. The schematic of Figure 3 and the above-described method of evaluating and transmitting the information should be considered only as examples of how the control system should be implemented.

[0177] CIRCUIT DETAILS In the schematic Figure 3, the symbols Y1, Y2, Y3 etc. indicate test points in the circuit. The test points are referenced in graphs in the figures described in the text that follows. The components in the figure and their respective values ​​are values ​​that work in this particular embodiment, which is only one of an infinite number of possible configuration solutions.

[0178] The energy that drives the circuit is received by the energy receiving coil L1. The energy to the implant is transmitted at a frequency of 25 kHz in this particular case. The energy balance output signal is present at the test point Y1.

[0179] Figure 4 shows the voltage Y7x on the receiving coil L1 and the input power Y9 received by this coil from the external transmitter. The power graph Y9 is normalized and varies between 0 and 1, where 1 indicates maximum power and 0 indicates zero power, so Y9 does not indicate the absolute value of the received power level. The power test point Y9 is not present in the schematic, but is an amplitude modulated signal on the transmitter signal power. In the figure, it can be seen that the Y7x voltage on the receiving coil L1 increases as the power from the external transmitter increases. Once the Y7x voltage reaches a level where the actual charging of the power source C1 in the implant begins, the Y7x level increases at a much slower rate as the input power increases, due to the load that the power source places on the receiving coil.

[0180] The receiving coil L1 is connected to a rectifier bridge containing Schottky diodes D1x-D4x. The output voltage Y7 from the bridge is shown in Figure 5. Capacitor C6 absorbs the high frequency charging current from the bridge and, together with Schottky diode D3, prevents the 25kHz energy transfer frequency from entering the rest of the circuit. This is advantageous because the energy balance of the system is measured as the voltage across R1, which, without the C6-D3 combination, contains the high level 25kHz AC charging current. The power source in the implant is capacitor C1. Capacitor C3 is the high frequency decoupling capacitor. The resistor labeled LOAD is a virtual load for the power source in the implant. The voltage on the power source Y5 is also shown in Figure 5 along with the power graph Y9.

[0181] Voltage Y3 in Figure 6 is a regulated voltage of about 4.8V used to drive operational amplifier X1. The Y3 voltage is regulated by a fairly standard linear voltage regulator consisting of MosFet X2, Zener diode D1, capacitor C4, and resistor R3. The input voltage to the regulator is shown in Figure 6 as Y5, and the output voltage is Y3.

[0182] The X1 operational amplifier is used to amplify the energy balance signal along with R6 and R7 which set the gain of the amplifier circuit by 10x. The input signal to the circuit is shown in Figure 7. Y4 is fixed at a nearly constant level of about 2.74V by Zener diode D1. The voltage Y4 is shunted and high frequencies are filtered out by capacitor C5. A portion of the DC voltage on Y4 is coupled to the Y2 voltage by resistor R8 to center the Y1 output voltage at 2.5V when balancing the energy. The voltage Y2 is essentially the same voltage as the voltage Y6 on R1, with slightly higher frequencies filtered out by R9 and C7 and the DC level changed by the current through R8. See Figure 7 for a comparison of Y6 and Y2.

[0183] The energy balance output signal Y1 of the circuit of Figure 8 also corresponds closely to the Y6 voltage. The Y1 voltage is amplified by a factor of 10 and the DC is shifted to center around 2.5V instead of the 0V of the Y6 voltage. It is very easy to achieve a higher signal level at Y1 and a DC center point of about 2.5V in a circuit connected to the energy balance output signal.

[0184] Figure 9 shows the relationship between the energy balance signal Y1 and the actual voltage on the implant's power supply. The energy balance signal is the derivative of the voltage level Y5 on the power supply. When the energy balance signal Y1 is negative with respect to 2.5V, the voltage level Y5 decreases, and when the energy balance signal is positive with respect to 2.5V, the voltage level Y5 increases. The more negative or positive the energy balance signal Y1 is with respect to 2.5V, the faster the Y5 voltage on the power supply increases or decreases.

[0185] Figure 10 for the other circuit state shows perhaps much more clearly how the energy balance signal corresponds to the Y5 voltage on the power supply. Each trace shows a situation where the energy put into the power supply is held at a constant level and the load is changed between 5mA and 30mA in four discrete steps. The load is 30mA for the first 25ms, 5mA for the next 25ms, and then sequentially 30mA and 5mA in the same way. When the Y5 voltage on the power supply drops at a constant level due to the 30mA load, the derivative level is at a constant level below 2.5V, and when the Y5 voltage rises, the derivative voltage becomes positive at a constant level.

[0186] The two diagrams in Figure 11 show the relationship between the energy balance signal Y1 and the energy imbalance in the circuit for a complex situation where the load changes and the power input to the implant also changes. The two traces in the first diagram of Figure 11 show the charging current and the load current to the power source. The charging current is represented by the IY12 trace and the load current is the IY10 trace. The second diagram of Figure 11 shows the Y1 voltage generated by the alternating current shown in the first diagram. As shown, when the amount of energy stored in the power source changes due to an energy imbalance, the derivative signal Y1 responds quickly to the imbalance.

[0187] In a system where the energy balance signal is used as a feedback signal to the external power transmitter that allows the external power transmitter to adjust the transmitted power according to the energy imbalance, it is possible to maintain an optimal energy balance and keep the efficiency at a maximum. Figure 12 shows the charging current and the load current to the power supply, where the charging current is represented by the IY12 trace and the load current is the IY10 trace, and Figure 12 also shows the voltage level Y5 on the power supply and the energy balance signal Y1 in such a system. It can be clearly seen that the system responds fast to changes in the load current by increasing the charging current. Small spikes on the energy balance signal are only present at the edges where the load changes fast due to the finite bandwidth of the feedback loop. Except for these small spikes, the energy is perfectly balanced.

[0188] Figures 13a-c show diagrammatically different operating states of a generally constructed device according to the invention when the device is attached to the wall of a body organ, indicated at BO. The device includes a constriction device, indicated at CSD, and a stimulation device, indicated at CD, controlling the constriction device and the stimulation device CSD. Figure 9a shows the device in an inactive state, in which the constriction device does not constrict the organ BO and the stimulation device does not stimulate the organ BO. Figure 13b shows the device in a non-constricted state, in which the control device CD controls the constriction device to lightly constrict the wall of the organ BO, resulting in a constricted state in which blood circulation within the constricted wall is hardly restricted and flow within the lumen of the wall is restricted. Figure 13c shows the device in a stimulated state, in which the control device CD controls the stimulation device to stimulate different regions of the constricted wall, thus causing almost the entire wall of the organ BO to constrict (thicken) and close off the lumen.

[0189] Figures 13d and 13e show that the stimulation of the narrowed wall is cyclically changed between a first stimulation mode in which the area to the left of the wall (see Figure 13d) is stimulated while the area to the right of the wall is not stimulated, and a second stimulation mode in which the area to the right of the wall (see Figure 13e) is stimulated while the area to the left of the wall is not stimulated, thereby maintaining sufficient blood circulation in the narrowed wall for an extended period of time.

[0190] It should be noted that the stimulation modes shown in Fig. 13d and Fig. 13e constitute only principle examples of how the constricted wall of the organ BO can be stimulated. Thus, more than two different areas of the constricted wall can be stimulated simultaneously, cyclically or sequentially. Furthermore, groups of different areas of the constricted wall can be stimulated sequentially.

[0191] Figures 13f-13h show different operating states of the variant of the general embodiment shown in Figures 13a-13e, in which the constriction and stimulation device CSD comprises several separate constriction / stimulation members, here three members CSDE1, CSDE2 and CSDE3. Figure 13f shows a state in which the member SADE1 in a first operating state is activated, constricting and stimulating the organ BO, thus closing the lumen of the organ BO, while the other two members CSDE2 and CSDE3 are not activated. Figure 13g shows a state in which the member CSDE2 in a second operating state is activated, thus closing the lumen of the organ BO, while the other two members CSDE1 and CSDE3 are not activated. Figure 13h shows a state in which the member CSDE3 in a third operating state is activated, thus closing the lumen of the organ BO, while the other two members CSDE1 and CSDE2 are not activated. By switching between the first state, the second operating state and the third operating state randomly or according to a predefined sequence, different portions of the organ can be temporarily constricted and stimulated while the organ lumen remains closed, thereby minimizing the risk of damaging the organ. Each of the members CSDE1-CSDE3 can also be actuated sequentially along the organ lumen to move fluids and / or other bodily material within the lumen.

[0192] Figures 13i to 13k show other operating modes of the variant of the general embodiment. Thus, Figure 13i shows a state in which the member CSDE1 in a first operating state is actuated to constrict and stimulate the organ BO, thus closing the lumen of the organ BO, while the other two members CSDE2 and CSDE3 are actuated to constrict but not stimulate the organ BO, thus not completely closing the lumen of the organ BO, and the members CSDE2 and CSDE3 engage the organ BO. Figure 13j shows a state in which the member CSDE2 in a second operating state is actuated to constrict and stimulate the organ BO, thus closing the lumen of the organ BO, while the other two members CSDE1 and CSDE3 are actuated to constrict but not stimulate the organ BO, thus not completely closing the lumen of the organ BO, and the members CSDE1 and CSDE3 engage the organ BO. Fig. 13k shows the next third operating state, in which the member CSDE3 is activated to constrict and stimulate the organ BO, thus closing the lumen of the organ BO, while the other two members CSDE1 and CSDE2 are activated to constrict but not stimulate the organ BO, thus not completely closing the lumen of the organ BO, and the members CSDE1 and CSDE2 engage the organ BO. By switching between the first operating state, the second operating state and the third operating state randomly or according to a predefined sequence, different parts of the organ can be temporarily stimulated, while the lumen of the organ remains closed, thereby reducing the risk of damaging the organ. It is also possible to activate the stimulating members CSDE1-CSDE3 sequentially along the lumen of the organ BO to move fluids and / or other body substances in the lumen.

[0193] Figures 14-16 show the basic components of an embodiment of a device according to the invention for controlling the flow of fluids and / or other body substances in a lumen formed by a tissue wall of an organ of a patient. The device comprises a tubular housing 1 having an open end, a constriction device 2 disposed within the housing 1, a stimulation device 3 integrated with the constriction device 2, and a control device 4 (shown in Figure 16) for controlling the constriction device 2 and the stimulation device 3. The constriction device 2 has two elongated clamping members 5, 6 which are radially movable within the tubular housing 1 towards and away from each other between a retracted position shown in Figure 15 and a clamped position shown in Figure 16. The stimulation device 3 includes a number of electrical members 7 located on the clamping members 5, 6 such that the electrical members 7 of one of the clamping members 5, 6 face the electrical members 7 of the other clamping member. Thus, in this embodiment, the constriction device and the stimulation device form a constriction / stimulation unit in which the constriction device and the stimulation device are integrated as a single member.

[0194] The constriction device and the stimulation device may be separate from each other, in which case a structure may be provided to hold the electrical members 7 in a fixed orientation relative to each other, or the electrical members 7 may comprise electrodes separately attached to the wall of the patient's organ.

[0195] Figure 17a shows an example of transmitted pulses according to an embodiment of the invention. The pulses have a constant frequency and amplitude, but the relationship between time t1 and time t2 varies.

[0196] Figure 17b shows another example of transmitted pulses according to a second embodiment of the invention. During time t1 a pulse train is transmitted and during time t2 no pulses are transmitted. The pulses have a constant frequency and amplitude. However, the relationship between time t1 and time t2 varies. [Explanation of symbols]

[0197] 100, 200 medical device; 102, 202 internal energy receiver; 104, 204 external energy source; 106, 206 external control unit; 108, 208 internal control unit; 110 internal signal transmitter; 112 external signal receiver.

Claims

1. 1. An apparatus for controlling the transmission of wireless energy between an external energy source and an electrically operable, implantable medical device, comprising: an internal energy receiver connected to the electrically operable and implantable medical device for receiving the wireless energy transmitted from the external energy source and supplying, directly or indirectly, the received energy to the electrically operable and implantable medical device; an energy stabilization unit configured to be located within a patient and to stabilize and / or store the energy received by the internal energy receiver before the energy is delivered, directly or indirectly, to the electrically operable implantable medical device; a control unit configured to determine an energy balance between the energy received by the internal energy receiver and the energy consumed by the electrically operable implantable medical device or stored in an energy storage device of the electrically operable implantable medical device, and to control the transmission of the wireless energy from the external energy source based on the energy balance; Equipped with The control unit Detecting a change over time in the amount of consumed or stored energy or the amount of consumed and stored energy by determining a derivative of a measured electrical parameter with respect to the amount of consumed or stored energy or the amount of consumed and stored energy over time, and determining the energy balance based on the detected change over time. Device.

2. The external energy source includes: A primary coil for wirelessly transmitting energy; The internal energy receiver includes: A secondary coil is provided for receiving the wirelessly transmitted energy.

2. The apparatus of claim 1.

3. The control unit and configured to reduce the amount of the wireless energy transmitted if the energy balance indicates that the received energy is greater than the energy consumed by the electrically operable implantable medical device or stored in the energy storage device.

2. The apparatus of claim 1.

4. The energy stabilization unit includes: At least one of a capacitor and a semiconductor for stabilizing the received energy. An apparatus according to any one of claims 1 to 3.

5. The energy stabilization unit includes: At least one constant voltage circuit and at least one constant current circuit An apparatus according to any one of claims 1 to 4.

6. The energy storage device is At least one of a rechargeable battery and a capacitor An apparatus according to any one of claims 1 to 5.

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