Steerable implant with electric motor and gear system

Abstract

To provide an operable implant adapted to be implanted in the body of a patient.SOLUTION: An operable implant comprises an operation device 110 and a body engaging portion. The operation device comprises a static part including a plurality of coils 132 and a movable part including a plurality of magnets 133. Sequential energization of the coils magnetically propels the magnets and thus propels the movable part. The operation device further comprises an enclosure 131 adapted to hermetically enclose the coils of the static part, such that a seal is created between the static part and the propelled movable part with the included magnets, such that the coils of the static part are sealed from the bodily fluids, when implanted.SELECTED DRAWING: Figure 20

Description

[Technical Field]

[0001] The present invention relates to steerable implants and to methods for energizing steerable implants. and communicating with operable implants, . [Background technology]

[0002] Reliable steering device for energized and steerable implants It has proven difficult to provide the implants. All moving parts are particularly susceptible to body-derived fluids and fibrotic tissue growth. Fibrotic tissue eventually surrounds and encapsulates any foreign body placed within the body, This may affect the function of the implant. Therefore, a more reliable and general purpose operating device would be advantageous. Summary of the Invention [Means for solving the problem]

[0003] A steerable implant adapted to be implanted in a patient's body is provided. A possible implant comprises a manipulation device and a body engaging portion. The manipulation device is: wireless a receiving unit for receiving energy; a receiving unit for receiving mechanical work having a first force and a first velocity; a second different force and a second different speed; The operating device further includes a first unit having a gear system. a second unit having an electric motor adapted to convert the first unit into mechanical work; a conductor for transmitting electrical energy from the unit to the second unit, and a power supply for the second unit; a mechanical transmission adapted to transmit mechanical work from the electric motor to the gear system of the first unit; and a distance element including a transmitting member, the distance element being configured to transmit the wireless energy to a receiving unit upon receiving the wireless energy. The first unit and the second unit are arranged so that the The device is adapted to separate the

[0004] According to one embodiment, the receiving unit converts the received wireless energy in the form of a magnetic field into electrical energy. The receiving unit includes at least one coil adapted to convert a signal into an electric signal. a first coil having at least a first number of turns, and a second coil having at least a second different number of turns; The coil may include a second coil.

[0005] According to one embodiment, the gear system comprises: an operable element; a gear having a first number of teeth on an outer circumference; a first gear having a hollow cylindrical shape; and a second gear having a larger number of teeth on its inner surface than the first gear. A hollow cylindrical second gear is provided. The operable element is adapted to engage the inside of the first gear. The outer side of the first gear may be pressed against the inner side of the second gear. , whereby the teeth of the first gear are spaced apart by at least two positions where the teeth do not interengage. and interengaging with teeth of the second gear at another position, and operation of the operable element is By advancing the position, relative rotation between the first and second gears is generated. .

[0006] According to one embodiment, the operable element comprises: a planetary gear; and a gear for interconnecting with the first gear. at least one of a structure or wheel that uses friction at least in part to do.

[0007] According to one embodiment, the second unit receives a different second force and a different second force from the first gear system. and receiving as an input a mechanical work output having a second speed such that a third different force and a third The gear system of the second unit is adapted to output mechanical work having different speeds. , may be connected in series to the gear system of the first unit via the mechanical transmission member of the distance element .

[0008] According to one embodiment, the first unit inputs mechanical work having a first force and velocity. and a second tooth adapted to output mechanical work with a different force and speed. The second gear system may be connected in series with the first gear system.

[0009] According to any of the above embodiments, the first unit may be located in the following locations: subcutaneously; subcutaneously in the abdominal wall; and within the abdomen.

[0010] The electric motor in any of the above embodiments may include a magnetic material, and the first unit is substantially unaffected by the magnetic material of the second unit during wireless energy transmission. good.

[0011] The first gear system in any of the above embodiments may include a third gear, and the third gear The inside of the third gear may have the same number of teeth as the outside of the first gear, and the teeth of the third gear may be The third gear is adapted to interengage with the teeth of the second gear, thereby rotating the third gear at least Both rotate along one interengaging position.

[0012] The second unit in any of the above embodiments may comprise: a second unit for treating fibrosis, fascia and at least one of the muscle layers, for fixing the device toward the inside of the patient's subcutaneous space. The device may have at least one fixed portion.

[0013] The distance element in any of the above embodiments is: placement through the muscle layer of the abdominal wall and the subcutaneous space. The fascia facing the fascia may be adapted for at least one of fixation to the fascia facing the fascia.

[0014] According to one embodiment, the distance element is flexible, whereby the first and second units movable relative to each other

[0015] The mechanical transmission member in any of the above embodiments is: a hydraulic tube for transmitting hydraulic pressure; Rotating shaft for transmitting rotational force; Flexible member for transmitting rotational force; Wire ;Belt; Rod; Worm gear; and gear for changing rotational force by approximately 90 degrees The mechanical transmission member may be selected from:

[0016] The steerable implant is adapted to hermetically surround the steerable implant. The device may include an enclosure.

[0017] According to one embodiment, the medical device comprises at least one of a second unit and a distance element. The device may further comprise a metal enclosure adapted to enclose one of the plurality of electrodes. The enclosure is: titanium enclosure and / or aluminum enclosure and / or may comprise at least one of a stainless steel enclosure.

[0018] One of the first and second units stores the electrical energy received by the receiving unit. The device may include a battery adapted to:

[0019] Electric motors are: alternating current (AC) electric motors; direct current (DC) electric motors; linear type Electric motors; axial electric motors; piezoelectric motors; three-phase motors; two- or more-phase motors; and shape memory metal motors.

[0020] According to one embodiment, the implantable system further comprises: a manipulation device; and a body engaging portion. a control unit for controlling at least one parameter relating to at least one can.

[0021] In one embodiment, the electric motor is an alternating current (AC) motor and the control unit Frequency converter for changing the frequency of an alternating current to control an alternating current motor may be provided.

[0022] The first unit of the maneuverable implant is connected to a hydraulically maneuverable body engaging portion. A hydraulic pump adapted to convert mechanical work into hydraulic power for power supply. The hydraulic pump may be connected to the force output of the first gear system or the second gear system. A hydraulic pump is a pump that acts by moving walls through mechanical work. One reservoir; at least one that acts as a pump to move fluid by changing volume at least one reservoir; at least one valveless pump; at least one valve pump; at least one peristaltic pump; at least one diaphragm pump; at least one gear pump; and The hydraulic pump may be selected from at least one bellows pump.

[0023] According to one embodiment, the first unit has a hydraulically operable body engaging portion. A reservoir for supplying the

[0024] The actuatable implant is adapted to provide fluid to a hydraulically actuatable body-engaging portion. The device may include a third unit having a second reservoir for the injection of the fluid. and has at least one movable wall portion.

[0025] In all cases where movement of at least one movable wall portion is possible, the reservoir: At least one bellows-shaped portion, adapted to allow movement even when covered by fibrosis and a plate-like surface.

[0026] The reservoir in any of the above embodiments may be a hydraulically operable body engaging portion. The reservoir may be in fluid communication with the at least one movable wall portion, and the reservoir may be hydraulically pumped by movement of the at least one movable wall portion. The reservoir may be adapted to manipulate the manipulable body engaging portion. The shape may be at least one of the following shapes:

[0027] The steerable implant is a threaded implant arranged to move a wall portion of the reservoir. The device may further include a support member.

[0028] In one embodiment, the manipulable implant controls the pressure and / or volume within the reservoir and To measure the pressure or flow rate from the hydraulic pump, at least one of the pump and the reservoir At least one of a pressure sensor, a flow sensor, and a position sensor arranged in connection with one of the sensors. It further comprises:

[0029] The first unit of any of the above embodiments of the steerable implant may be any other / The reservoir and / or any of the hydraulically operable body engaging portions other than the reservoir and the hydraulically operable body engaging portion. At least one inlet may be provided for supplying a fluid.

[0030] According to one embodiment, at least one of the first unit and the distance element comprises: a metal At least one of the magnetic and magnetizable components may not be provided.

[0031] At least one of the first unit and the distance element is free of magnetic components. That's fine.

[0032] The first unit of the steerable implant is an external unit that is external to the patient's body. It may comprise a communication unit adapted for wireless communication.

[0033] The operable element is configured such that the teeth of the first gear are aligned with the teeth of the second gear, and the operable element is in position 1, position 2, position 3 the first gear is arranged to interengage in at least one of four positions, The first gear may be adapted to deflect the first gear and to maintain the first gear deflected. The three or four positions are angularly spaced apart, separated by positions where the teeth do not interengage. This is the location.

[0034] A steerable implant for implantation into the body of a patient is provided. The plant includes an operating device and a body-engaging portion. The operating device includes an electric motor. , this electric motor consists of: a set of coils distributed circularly around the rotating shaft of the electric motor; A set of magnets connected to a rotatable structure that at least partially axially overlaps the coil. The coils are provided with a coil-type coil, which sequentially energizes the magnets to generate magnetic force. The operating device is a gear system. The gear system includes: an operable element; a hollow cylinder having a first number of teeth on its outer circumference; a first gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear; The manipulable element may be adapted to engage the inside of the first gear. This causes the outside of the first gear to press against the inside of the second gear, thereby The teeth of the first gear are spaced apart at least one position separated by a position where the teeth do not interengage. and operation of the operable element advances said position. The gear system generates relative rotation between the first gear and the second gear by rotating the first gear and the second gear. The second gear has a smaller diameter than the rotatable structure and is at least partially in the same axial plane. The rotatable structure is disposed within the second gear, whereby the rotatable structure is at least partially axially aligned with the second gear. The gear train is at least partially located inside the electric motor. By locating the gear system at least partly inside the electric motor, it is possible to achieve a very compact and efficient This results in a design with good efficiency.

[0035] The operable element is configured such that the teeth of the first gear are aligned with the teeth of the second gear; position 1, position 2, position 3 the first gear is arranged to interengage in at least one of four positions, and maintaining the first gear biased, The three and four positions are angularly spaced apart separated by positions where the teeth do not interengage. This is the location.

[0036] According to one embodiment of the steerable implant, the steerable element is At least two angularly spaced teeth of the second gear separated by a location where the teeth do not interengage. and biasing the first gear to interengage at spaced apart positions. It may be adapted to remain deflected.

[0037] The operable element includes: a star gear; and a first gear at least partially interconnected with the star gear. The device may include at least one of a structure or wheel that uses friction to move the device.

[0038] According to one embodiment, the operating device further comprises a second gear system, the second gear system comprising: Possible elements: a first gear having a hollow cylindrical shape and a first number of teeth on its outer circumference; and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear, and operable The movable element is adapted to engage the inside of the first gear, thereby rotating the outside of the first gear. The first gear is pressed against the inside of the second gear, causing the teeth of the first gear to interengage. and interengaging with the teeth of the second gear at at least one position separated by a non-interengaging position. and the operation of the operable element is to advance the position to move the first gear and the second gear. A first gear of the first gear system rotates relative to the second gear system. directly or indirectly connected to a gear element, whereby the first gear system is connected in series to the second gear system. whereby the first gear system generates mechanical work having a first force and a first speed. and outputs mechanical work having a second different force and a second different speed, The gear system receives as input the mechanical work output from the first gear system and converts it into a third, different and a third different speed at which mechanical work is output.

[0039] The first gear system and the second gear system in any of the above embodiments are It may be positioned coaxially along the axis of rotation of the second gear system.

[0040] At least one second gear of the first gear system and the second gear system has a rotatable structure. The structure may have a smaller diameter than the structure and may be at least partially disposed in the same axial plane. , whereby the rotatable structure is configured to rotate at least one of the first gear system and the second gear system. At least partially overlapping with one second gear in the axial direction, thereby forming a first gear system and At least one of the two gear systems is at least partially disposed inside the electric motor. .

[0041] The first gear and the second gear of the second gear system have a diameter larger than the rotatable structure. and may be at least partially arranged in the same axial plane, whereby the second gear The first gear and the second gear of the system are at least partially axially overlapping with the rotatable structure. Thus, the electric motor is at least partially disposed inside the second gear system.

[0042] According to one embodiment, a first gear set is provided to transmit force from the first gear set to the second gear set. A radial element that directly or indirectly connects a first gear of a gear system to an operable element of a second gear system. The connector further includes a connecting structure extending therethrough.

[0043] The first gear system of the operable implant may include a third gear, and the inner side of the third gear The third gear may have the same number of teeth as the outside of the first gear. The teeth of the third gear may correspond to the teeth of the first gear. The third gear is adapted to interengage with the second gear, whereby the third gear is angularly spaced apart from the second gear. The cursor rotates along the selected position.

[0044] The first gear of the first gear system is connected, via the third gear, to the operable element of the second gear system. They may be indirectly connected.

[0045] The rotatable structure of the operable elements is radially arranged inside the circularly distributed coils The coils may be arranged radially outside the circularly distributed coils.

[0046] According to one embodiment, the steerable implant is configured such that the coil is removed during operation of the steering device. a coil enclosure adapted to surround the coil so that the coil remains enclosed; Prepare for.

[0047] According to one embodiment, a first gear of at least one of the first gear system and the second gear system The gear is connected directly or indirectly to a threaded member adapted to convert a radial rotational force into an axial reciprocating force. may be indirectly connected.

[0048] The threaded member of the operable implant provides a second reservoir for varying the volume of the first reservoir. It may be directly or indirectly connected to the movable wall portion of one reservoir.

[0049] The threaded member is a movable wall portion of the second reservoir for varying the volume of the second reservoir. The threaded member may be connected directly or indirectly to the first reservoir in a first direction. When the movable wall portion of the reservoir is moved, the first reservoir expands and the volume of the reservoir increases. On the other hand, when the threaded member moves the movable wall of the second reservoir in a first direction, the second reservoir The first reservoir contracts and the volume of the second reservoir decreases.

[0050] In any of the above embodiments, the first reservoir is a first hydraulically operable body. The second reservoir may be in fluid communication with the body engaging portion, and the second reservoir may be in fluid communication with the second hydraulically operable body engaging portion. The gear system and its direct or indirect connection with the threaded member may be in fluid communication with the gear system. Operating the electric motor in a first direction via the connection: a first reservoir to a first hydraulic pressure This allows fluid to be transported to the operable body engaging portion, and the second hydraulic pressure allows the operable body engaging portion to be From the junction, the fluid is transported to a second reservoir.

[0051] The reservoir in any of the above embodiments may be at least one of: circular and donut-shaped. It may be one shape.

[0052] According to one embodiment of the medical device, the operating device has a circular rib surrounding the operating device. The circular reservoir may include a circular reservoir adapted to compress and expand the circular reservoir. The reservoir may include a movable wall portion adapted to change the volume of the reservoir, the movable wall portion being operable by an operating device. The actuator may be connected to a chair, and manipulation of the manipulation device varies the volume of the circular reservoir.

[0053] According to one embodiment of the steerable implant, a portion of the wall of the reservoir is: a bellows structure; Shape adapted to allow movement even when covered with fibrosis; and plate-like surface and in all cases the movement of at least one movable wall section. and compression and / or expansion of the reservoir.

[0054] According to one embodiment, the steerable implant further comprises a peristaltic pump, The cap includes a hollow member for conveying fluid and an operable member adapted to engage and compress the hollow member. The first gear of the operable implant is directly or indirectly connected to the compression member. and operation of the electric motor operates the compression member such that fluid is transported into the hollow member. The operable compression member may be connected to the third gear in any of the above embodiments.

[0055] The hollow member of the peristaltic pump has a small number of operating devices that are at least partially in the same axial plane. The loop may form a part of a loop adapted to encircle at least partially the object. The device may be adapted to propel the compression member, whereby the compression member forms a loop or The hollow member is compressed toward the outer periphery of a portion of the loop.

[0056] According to one embodiment, the operating device comprises an alternating current (AC) motor, and the operating device Furthermore, a frequency converter is used to change the frequency of the alternating current to control an alternating current motor. Equipped with a data.

[0057] According to one embodiment of the steerable implant, the steerable implant is located outside the body. a separate unit having a receiving unit adapted to receive wireless energy transmitted from the The receiving unit receives wireless energy in the form of a magnetic field, an electric field, or an electromagnetic field. The device may comprise at least one coil adapted to convert electrical energy into electrical energy.

[0058] The receiving unit in the above embodiment includes a first coil having at least a first number of turns. The coil may include a first coil and a second coil having at least a second different number of turns.

[0059] According to one embodiment, the separate units are at least one of subcutaneous and subcutaneous in the abdominal wall. The sensor may be adapted to be placed in a

[0060] The steerable implant according to any one of the above embodiments may be At least a portion of the implant is inserted into at least one of the fibrosis, fascia, and muscle layer, and into the subcutaneous space of the patient. The support member may further include at least one fixing portion for fixing the support member toward the inside of the support member.

[0061] The steerable implant according to any one of the above embodiments may comprise a steering device and a separate The distance element may be connected to the separate units, and the distance element may be connected to the separate units. The device may further comprise a conductor adapted to transmit electrical energy to and from the device. The element is adapted to be placed through the muscle layer of the abdominal wall and / or secured to the fascia facing the subcutaneous space. The method may be adapted to be determined as follows.

[0062] According to one embodiment, the distance element may be flexible, thereby allowing the first and second units to be The pods are movable relative to each other.

[0063] In any of the above embodiments, the separate unit may: The device may include a reservoir for storing the

[0064] The distance element in any of the above embodiments may be manipulated to control the dimensions of the reservoir. A fluid conduit is provided for transporting fluid from the device to a separate unit or vice versa. The distance element may further be adapted to transmit mechanical work from the operating device to a separate unit. The mechanical transmission member may include a hydraulic pressure transmitting member for transmitting hydraulic pressure. Tube; Rotating shaft for transmitting rotational force; Flexible member for transmitting rotational force; A selection of gears to change the rotational force by approximately 90 degrees. The mechanical transmission member may be selected from the group consisting of:

[0065] Steerable implants are designed so that the steering device and the separate unit are sealed from body fluids during implantation. an enclosure adapted to hermetically enclose the operating device and the separate unit so that The device may further comprise an enclosure.

[0066] At least one of the operating device and the separate unit is received by the receiving unit. The separate unit may comprise a battery adapted to store the electrical energy. and / or a hydraulically operable body engaging portion. It may further comprise an inlet for supplying the

[0067] A separate unit separate from the energy receiving unit must be installed so as not to interfere with the wireless energy transmission. It may not have metallic parts and / or magnetizable parts and / or magnetic parts.

[0068] The separate unit further includes: an operating device; and a body engaging portion; The device may comprise a control unit for controlling at least one parameter of the temperature.

[0069] The separate unit is adapted to wirelessly communicate with an external unit that is outside the patient's body. The communication unit may include a

[0070] In one embodiment, the steerable implant may comprise a hydraulic pump, the hydraulic pump comprising: At least one reservoir having a wall that moves due to mechanical work, acting as a pump At least one reservoir that changes volume to move a fluid that acts as a pump at least one valveless pump; at least one valve pump; at least one peristaltic pump a pump; at least one diaphragm pump; at least one gear pump; and at least one Bellows pump is selected from.

[0071] The steerable implant may comprise an electric motor, the electric motor being: an alternating current (AC) Electric motors; DC electric motors; Linear electric motors; Axial electric motors; Piezoelectric Motors; three-phase motors; two-phase or more motors; bimetal motors; and shape memory metal motors are selected.

[0072] A steerable implant adapted for implantation into the body of a patient. The plant includes an operating device and a body-engaging portion, and the operating device is an axial type electric motor. The axial electric motor is provided with: a set of coils extending radially and at least partially radially overlapping the magnets; a set of magnets connected to a rotatable structure, which sequentially energizes the coils; By supplying a magnet, the magnet is propelled in the axial direction by magnetic force, and the rotatable structure is rotated along the axis of rotation. The steerable implant further comprises a gear system, the gear system comprising: Possible elements: a first gear having a hollow cylindrical shape and a first number of teeth on its outer circumference; and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear, and operable The movable element is adapted to engage the inside of the first gear, thereby rotating the outside of the first gear. The first gear is pressed against the inside of the second gear, causing the teeth of the first gear to interengage. and interengaging with the teeth of the second gear at at least one position separated by a non-interengaging position. and the operation of the operable element is to advance the position to move the first gear and the second gear. The gear system and the axial type electric motor generate relative rotation between the gears. The rotors are arranged coaxially along the axis of rotation, producing a compact design with few moving parts.

[0073] The operable element includes: a planetary gear; and a gear at least partially interconnected with the first gear. The device may include at least one of a structure or wheel that uses friction to move the device.

[0074] According to one embodiment, the first set of coils are distributed in a circle around the rotation axis of the electric motor. The magnetizable core structure is positioned on a radially extending rotatable structure. The magnetizable core structure and the rotatable disk are coaxially arranged. The positioned, rotatable disc is connected to a drive shaft which is connected to an operable element. will be done.

[0075] According to one embodiment, the operating device further comprises a second magnetization coil having a second set of coils. a second magnetizable core structure, the second magnetizable core structure being in contact with the magnet of the rotatable disk and a small the first set of coils are positioned coaxially so as to overlap at least partially, thereby The first coil drives the magnet on its first side, and the second set of coils drives the magnet on its second side. .

[0076] According to one embodiment, the circular shape of at least one of the first and second sets of coils. The circumference of the first gear is smaller than the inner diameter of the first gear, and the first and second coil sets are The axial electric motor is positioned in the same axial plane as the gear system. At least partially positioned.

[0077] According to one embodiment, the rotating disc is directly connected to the operable element.

[0078] The steerable implant has a coil that is spaced from and surrounds the magnet during operation of the steering device. a coil enclosure adapted to surround the coil so that the coil remains enclosed. You can prepare.

[0079] According to one embodiment, the operable element is configured such that the teeth of the first gear are aligned with the teeth of the second gear. position, two positions, three positions, four or more positions. The first gear is adapted to deflect the first gear and to maintain the first gear deflected. The two, three and four positions are angularly separated by positions where the teeth do not interengage. It is a distant position.

[0080] The manipulation device for the maneuverable implant may further comprise a second gear system, the second gear The system includes: an operable element; a first tooth element having a hollow cylindrical shape with a first number of teeth on its outer circumference; and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear. The operable element is adapted to engage the inside of the first gear, thereby The outside of the gear is pressed against the inside of the second gear, causing the teeth of the first gear to The teeth of the second gear are spaced apart by a non-interengaging position. and operation of the operable element advances the position of the first tooth. The first gear of the first gear system rotates relative to the second gear. directly or indirectly connected to an operable element of the wheel system, whereby the first gear system is connected to the second The first gear system is connected in series with the second gear system, whereby the first gear system has a first force and a first speed. and outputs mechanical work with a second different force and a second different speed. The second gear system receives the mechanical work output from the first gear system as an input. , outputting mechanical work with a third different force and a third different velocity.

[0081] The first gear system and the second gear system are synchronously rotated along the rotation axes of the first gear system and the second gear system. It may be positioned on the axis.

[0082] The steerable implant comprises a first gear system for transmitting force from the first gear system to the second gear system. directly or indirectly connecting a first gear of one gear system to an operable element of a second gear system; It may further comprise a radially extending connecting structure.

[0083] In any of the above embodiments, the first gear system includes a third gear, and the inner side of the third gear The third gear may have the same number of teeth as the outer side of the first gear. The teeth of the third gear are interdigitated with the teeth of the first gear. The third gear may be adapted to engage with the second gear such that the third gear is angularly Rotate along spaced positions.

[0084] According to one embodiment, the first gear of the first gear system is It is indirectly connected to the operable element of the second gear system via a third gear.

[0085] The first gear of the first gear system is adapted to convert a radial rotational force into an axial reciprocating force. It may be connected directly or indirectly to the threaded member.

[0086] According to one embodiment, the threaded member is adapted to change the volume of the reservoir by first or second threads. The fluid may be directly or indirectly connected to the movable wall of the reservoir.

[0087] According to one embodiment, a threaded member moves the movable wall of the first reservoir in a first direction. When exercised, the first fluid reservoir expands and the volume of the first fluid reservoir increases, while , the threaded member moves the movable wall of the second reservoir in a first direction, The reservoir contracts and the volume of the second reservoir decreases.

[0088] The first reservoir of the operable implant includes a first hydraulically operable body-engaging the second reservoir may be in fluid communication with the second hydraulically operable body engaging portion. and in fluid communication with the gear system, and the direct or indirect connection of the gear system with the threaded member. When the electric motor is operated in a first direction via the a second hydraulically operable body engaging portion configured to deliver fluid to the body engaging portion; From the portion, fluid is transported to a second reservoir.

[0089] In any of the above embodiments, the reservoir may be at least one of a circular shape and a donut shape. In one embodiment, the control device may have a circular shape surrounding the control device. a circular reservoir adapted to compress and expand the circular reservoir; The volume of the reservoir is changed by providing a movable wall portion, and the movable wall portion is connected to an operating device. The circular reservoir is connected to a control device, and operation of the control device changes the volume of the circular reservoir.

[0090] Part of the reservoir wall is a bellows structure; it allows movement even when covered by fibrosis. and a plate-like surface, in all cases In which movement of at least one movable wall portion is possible, and compression of the reservoir and / or Expansion is possible.

[0091] The steerable implant further comprises a peristaltic pump, the peristaltic pump comprising a hollow member for transporting fluid. and an operable compression member adapted to engage and compress the hollow member. The gear is in direct or indirect communication with the compression member, whereby the operation of the electric machine is fluid The compression member is manipulated so that the material is transported into the hollow member.

[0092] The operable compression member connects to the third gear of any of the previous embodiments. 2. The operable implant according to claim 2.

[0093] The hollow member of the peristaltic pump has a small number of operating devices that are at least partially in the same axial plane. forming a loop or part of a loop adapted to at least partially encircle the operating device. The chair is adapted to propel the compression member, whereby the compression member is attached to the loop or loops. The hollow member is compressed toward the outer periphery of a portion of the cap.

[0094] According to one embodiment, the operating device comprises an alternating current (AC) motor, and the operating device Furthermore, a frequency converter is used to change the frequency of the alternating current to control an alternating current motor. Equipped with a data.

[0095] The steerable implant in any of the above embodiments is delivered from outside the body. a separate unit comprising a receiving unit adapted to receive wireless energy from the The separate units may be placed subcutaneously and / or subcutaneously in the abdominal wall. The separate unit may be adapted to supply fluid to the hydraulic implant. The device may include a reservoir for storing the liquid.

[0096] According to one embodiment, the receiving unit receives wireless energy in the form of a magnetic field, an electromagnetic field, The receiving unit includes at least one coil adapted to convert electrical energy. The coil includes a first coil having at least a first number of turns and a second coil having at least a different number of turns. The device may include a second coil having a number of coils.

[0097] The steerable implant may comprise a fibrous or fascial membrane that swells at least a portion of the steerable implant. and at least one of the muscle layers, for fixing the device toward the inside of the patient's subcutaneous space. The device may have at least one fixed portion.

[0098] The steerable implant further comprises a distance sensor connecting the steering device to a separate unit. The distance element may be provided for transmitting electrical energy between the separate unit and the operating device. The device may include a conductor adapted to transmit the signal.

[0099] The distance element is configured to be placed through the muscle layer of the abdominal wall and / or through the muscle facing the subcutaneous space. It may be adapted to be fixed to a membrane.

[0100] The distance element may be flexible, allowing the first and second units to move movably relative to each other. It is moving.

[0101] The distance element in any of the above embodiments may be manipulated to control the dimensions of the reservoir. Fluid conduits may be provided for transporting fluid to and from the vice.

[0102] The distance element is further adapted to transmit mechanical work from the operating device to a separate unit. The mechanical transmission member may include a hydraulic tube for transmitting hydraulic pressure. Rotating shaft for transmitting rotational force; Flexible member for transmitting rotational force; Wire ; belt; rod; worm gear; and gear to change the rotational force by about 90 degrees The mechanical transmission member may be a

[0103] Steerable implants are designed so that the steering device and the separate unit are sealed from body fluids during implantation. an enclosure adapted to hermetically enclose the operating device and the separate unit so that The device may further comprise an enclosure.

[0104] At least one of the operating device and the separate unit is received by the receiving unit. The device may include a battery adapted to store electrical energy.

[0105] The separate units in any of the above embodiments may be reservoirs other than those described above and those described above. for supplying fluid to at least one of the hydraulically operable body engaging portions; An inlet may be provided.

[0106] In one embodiment, the separate unit from the energy receiving unit comprises: metallic parts, magnetic At least one of the configurable component and the magnetic component may not be included.

[0107] The separate unit further includes: an operating device; and a body engaging portion; The device may comprise a control unit for controlling at least one parameter of the temperature.

[0108] The separate unit is adapted to wirelessly communicate with an external unit that is outside the patient's body. The communication unit may include a

[0109] According to one embodiment, the coil enclosure in any of the above embodiments comprises: carbon Materials; Boron Materials; Mixtures of Materials; Peek® Materials; Alloys of Materials; Metallic Materials; Titanium; Aluminum; Ceramic materials; Polymer materials; Polyurethane; Polyether ether and Parylene® coated silicones. The material may include materials that can be used in the manufacture of a semiconductor device.

[0110] The steering device for the steerable implant in any of the above embodiments may be: an alternating current (AC) electric motor; direct current electric motor; linear electric motor; axial electric motor Motors; piezoelectric motors; three-phase motors; motors with two or more phases; bimetal motors; and shape memory metals The motor may comprise an electric motor selected from the group consisting of:

[0111] There is further provided an operable implant adapted to be implanted in the body of a patient. The steerable implant comprises a steering device and a body engaging portion. an electric motor having a stationary part with a plurality of coils and a movable part with a plurality of magnets; whereby the magnet is energized by magnetic force by sequentially energizing the coils. The operating device further includes a coil for sealing the stationary part. The implant may include an enclosure adapted to surround the implant in a stationary state, thereby providing a stationary implant. The coil of the stationary portion is sealed from bodily fluids and has a magnet contained therein. A seal is created between the moving parts that are propelled through the shaft.

[0112] According to one embodiment, the control device further comprises at least one of the control device and the body engagement portion. a control unit for controlling at least one of the coils; It is adapted to surround the unit.

[0113] The steering device of the steerable implant further comprises a wireless signal supplied from outside the patient's body. at least one power supply adapted to indirectly receive energy derived from the energy The enclosure may include an electrical circuit, the enclosure being adapted to enclose the coil and the electrical circuit. .

[0114] According to one embodiment, the steerable implant receives signals in the form of magnetic, electric or electromagnetic fields. at least one coil adapted to convert the received wireless energy into electrical energy; The device is provided with a separate wireless energy receiving unit.

[0115] According to one embodiment, the steerable implant is configured such that the receiving unit is a stationary part of the electric motor. or so as to remain substantially unaffected by the metallic and / or magnetic parts of the moving part; a distance element adapted to generate a distance between the receiving unit and the electric motor; .

[0116] The electric motor in any of the above embodiments may be an axial electric motor; In this motor: the coils are distributed circularly around the rotation axis of the implantable electric motor. , whereby the central axis of the spiral of the coil is axially aligned with the axis of rotation of the embeddable electric motor. the moving part has a rotor extending radially, on which the magnets rotate; The magnets are distributed circularly around the rotation axis, and face the coil in the axial direction, so that the magnets at least partially radially overlapping the coils, thereby sequentially energizing the coils; By supplying a magnet, the magnet is propelled axially by magnetic force, and the magnet moves around the rotating shaft of the electric motor. This generates rotor rotation at

[0117] In an alternative embodiment, the electric motor may be a radial electric motor: the coils are embedded The coils are distributed circularly around the rotation axis of the electric motor, whereby the central axis of the coil spiral extends radially of the rotary shaft of the implantable electric motor and approximately perpendicular to the rotary shaft; The rotor may be axially extending, and the magnets may be arranged in a circular pattern around the axis of rotation on the rotor. The magnets are distributed so that they face the coil in the radial direction, so that the magnets are less likely to contact the coil. The coils are partially overlapped in the axial direction, so that the coils are sequentially supplied with energy. This causes the magnets to be propelled by magnetic force, causing the rotor to rotate around the rotation axis of the electric motor. do.

[0118] In an alternative embodiment, the electric motor is a linear electric motor: the coils are arranged to direct the movement of the moving part. The moving parts are distributed linearly along the direction of movement of the moving parts; The magnet is then energized by the coils in sequence, thereby This propels the moving part forward, generating linear motion.

[0119] The implantable electric motor may be an alternating current (AC) electric motor, and the control unit may , a frequency converter for changing the frequency of an alternating current to control an alternating current electric motor; A battery may be provided.

[0120] According to one embodiment, the implantable electric motor is further adapted to be movable from bodily fluids when implanted. a second enclosure adapted to surround the movable part so as to seal the movable part .

[0121] The second enclosure may be hermetically connected to the first enclosure, thereby Thus, the wall of the enclosure between the moving part and the stationary part is the first enclosure and the second enclosure. The first and / or second enclosures are made of: carbon material ;Boron materials;Mixtures of materials;Peek® materials;Alloys of materials;Metal materials;Titanium Aluminum; Ceramic materials; Polymer materials; Polyurethane; Polyether ether and Parylene® coated silicones. The material may include

[0122] In one embodiment, the second enclosure is sealingly connected to the first enclosure. Thus, both the moving part and the distance element between the moving part and the stationary part are It is sealed by a closure.

[0123] A mechanical work unit receives as input mechanical work having a first force and a first velocity from a rotating portion of an electric motor, and generates a different The rotor may further comprise a gear system adapted to output mechanical work having a force and a speed.

[0124] The gear system comprises: an operable element; a first gear having a hollow cylindrical shape and a first number of teeth on its outer circumference; a first gear; and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear. The vehicle may further include a first gear. The operable element may be adapted to engage an inner side of the first gear. This causes the outside of the first gear to press against the inside of the second gear, thereby The teeth of the first gear are spaced apart at least one position separated by a position where the teeth do not interengage. and operation of the operable element advances said position. This generates relative rotation between the first gear and the second gear.

[0125] According to one embodiment, the second gear has a relatively small diameter and is at least partially , located in the same axial plane as at least one of the movable part and the stationary part, whereby At least one of the movable part and the stationary part is at least partially axially overlapped with the second gear. This results in the gear system being at least partially located inside the electric motor.

[0126] The steerable implant may include a steerable element, the teeth of the first gear being aligned with the teeth of the second gear; Interlocking in at least one of the following positions: 1 position, 2 positions, 3 positions, 4 or more positions to bias the first gear to match, and to maintain the first gear biased. The two, three and four positions may be defined by positions where the teeth are not interengaged. Distant, angularly spaced positions.

[0127] According to one embodiment, the operable element is configured such that the teeth of the first gear correspond to the teeth of the second gear. Interengaging at least two angularly spaced positions separated by non-interengaging positions and maintaining the first gear biased. It will be adapted.

[0128] The operating device in any of the above embodiments further comprises: an operable element; a first number of a hollow cylindrical first gear having teeth on its outer circumference; and a second gear having more teeth than the first gear. A second gear system may be provided, which includes a hollow cylindrical second gear provided on the side surface, The movable element is adapted to engage the inside of the first gear, thereby rotating the first gear. The outer side is pressed against the inner side of the second gear, so that the teeth of the first gear are pressed against each other. and a tooth of the second gear at at least one position separated by a non-engaging position. The operation of the engaged operable element advances the position to engage the first gear and the second gear. The first gear of the first gear system rotates relative to the second gear system. The first gear system is directly or indirectly connected to the operable element, whereby the first gear system is connected to the second gear system. whereby the first gear system generates a mechanical force having a first force and a first speed. and outputting mechanical work having a second different force and a second different velocity. The second gear system receives the mechanical work output from the first gear system as an input and converts it into a third gear system. outputting mechanical work with a first different force and a third different speed.

[0129] The first gear system and the second gear system in any of the above embodiments are It is positioned coaxially along the axis of rotation of the second gear system.

[0130] At least one second gear of the first gear system and the second gear system is The rotatable structure may have a smaller diameter than any of the other rotatable structures, and may be at least partially identical. The structure, which is arranged in an axial plane and is thereby rotatable, comprises a first gear system and a second gear system. at least partially overlapping with at least one second gear in the axial direction, thereby At least one of the first gear system and the second gear system is at least partially driven by an electric motor. is placed inside.

[0131] In one embodiment, the first gear and the second gear of the second gear system are rotated by a rotatable structure. They may have a large diameter and be at least partially arranged in the same axial plane, whereby The first gear and the second gear of the second gear system are at least partially axially aligned with the rotatable structure. The electric motor is at least partially disposed inside the second gear system. can be.

[0132] The steerable implant comprises a first gear system for transmitting force from the first gear system to the second gear system. Directly or indirectly connecting a first gear of one gear system to an operable element of a second gear system The rotor may further comprise a radially extending connecting structure.

[0133] The first gear system may include a third gear, the inside of which is the same as the outside of the first gear. The third gear may have teeth, the teeth of the third gear adapted to interengage with the teeth of the first gear. Preferably, this causes the third gear to rotate along an angularly spaced position relative to the second gear. To rotate.

[0134] According to one embodiment, the first gear of the first gear system is connected to the third gear of the embodiment: It is indirectly connected to an operable element of the second gear system.

[0135] The rotatable structure in any of the above embodiments is an inner circularly distributed coil. The axially extending portions may be radially arranged.

[0136] The rotatable structure may be positioned radially outside the circularly distributed coils.

[0137] In any of the above embodiments, the coil remains enclosed during operation of the operating device. It may be possible to do so.

[0138] At least one first gear of the first gear system and the second gear system is configured to generate a radial rotational force. connected directly or indirectly to a threaded member adapted to convert the force from the The threaded member may be directly or indirectly connected to the movable wall portion of the reservoir.

[0139] In any of the above embodiments, the steerable implant may be a steerable implant. At least a portion of the implant is inserted into at least one of the fibrosis, fascia, and muscle layer, and into the patient's subcutaneous space. The at least one fixing portion may be provided for fixing the inner surface of the space between the first and second fixing portions.

[0140] The steerable implant is adapted to receive wireless energy transmitted from outside the body. There may further be a separate unit with an integrated receiving unit.

[0141] The maneuverable implant includes a first hydraulically maneuverable body engaging portion in fluid communication with the first hydraulically maneuverable body engaging portion. The operating device may further comprise: a hydraulically operable reservoir from the first reservoir; The device may be adapted to cause transport of fluid to the body engaging portion.

[0142] Part of the reservoir wall is a bellows structure, designed to allow movement even when covered by fibrosis. and / or a plate-like surface, in all cases In which movement of at least one movable wall portion is possible, and compression of the reservoir and / or Expansion is possible.

[0143] According to one embodiment, the operating device comprises a hydraulically operable body fluid from a first reservoir. The hydraulic pump is provided for the delivery of fluid to the body-engaging portion. At least one reservoir having a wall that moves due to mechanical work used; as a pump At least one reservoir that changes volume to move the working fluid; at least one valveless pump; at least one valve pump; at least one peristaltic pump; at least one diaphragm pump; at least one gear pump; and at least one bellows pump The pump may be a hydraulic pump selected from:

[0144] Electric motors are: alternating current (AC) electric motors; direct current electric motors; linear electric motors Motors; axial electric motors; piezoelectric motors; three-phase motors; two-phase or more motors; bimetal and shape memory metal motors.

[0145] The operation device includes: a receiving unit for receiving wireless energy; and a first force and a second velocity. and receiving mechanical work having a second different force and a second different speed. a first unit including a first gear system adapted to output electrical energy; a second unit including an electric motor adapted to convert the electric power into mechanical work; and a first a conductor for transmitting electrical energy from the unit to a second unit; a mechanical gear adapted to transmit mechanical work from the electric motor to the gear system of the first unit; a distance element including a transmission member, the distance element being configured to transmit the wireless energy to a receiving unit upon receiving the wireless energy; The first unit and the second unit are connected to each other so that the first unit is not substantially affected by the second unit. The device is adapted to separate the knit.

[0146] According to one embodiment, the second unit receives a different second force and a different second force from the first gear system. and receiving as an input a mechanical work output having a second speed such that a third different force and a third and the gear system of the second unit is adapted to output mechanical work having different speeds of: The distance element is connected in series to the gear system of the first unit via a mechanical transmission member.

[0147] The first unit receives as input mechanical work having a first force and velocity and generates a different There may be a second gear system adapted to output mechanical work having a force and a velocity. The second gear set may be connected in series to the first gear set.

[0148] The first unit of the steerable implant is located in the following locations: subcutaneously; subcutaneously in the abdominal wall; and abdominal The sensor may be adapted to be disposed on at least one of the

[0149] The motor may comprise a magnetic material, and the first unit may be configured to drive the second unit during wireless energy transmission. Adapted to be substantially unaffected or not significantly affected by magnetic materials in the knit It is okay to do so.

[0150] The first unit includes a reservoir for supplying fluid to a hydraulically operable body engaging portion. A server may be provided.

[0151] The first unit is mechanically connected to a hydraulically operable body engaging portion for powering the hydraulically operable body engaging portion. The hydraulic pump may comprise a hydraulic pump adapted to convert hydraulic work into hydraulic power, the hydraulic pump comprising: It is connected to the force output of the first gear system or the second gear system.

[0152] The steerable implant may further comprise a gear system, said gear system comprising: a steerable element; a hollow cylindrical first gear having a first number of teeth on its outer circumference; and A second gear is provided which is hollow and cylindrical and has a number of teeth on its inner surface. , adapted to engage the inside of the first gear, whereby the outside of the first gear engages the second gear. The teeth of the first gear are pressed against the inside of the gear, so that the teeth of the first gear are in a position where they are not interengaged. The first gear interengages with the teeth of the second gear at at least one location separated by a distance. The operation of the possible elements is to advance the position to change the first gear and the second gear. The gear system and the axial type electric motor are connected to the rotating shaft of the electric motor. are arranged coaxially along the

[0153] According to one embodiment, the operable element comprises a planetary gear and a gear for interconnecting with the first gear. at least one of a structure or wheel that uses friction at least in part to do.

[0154] A first set of coils, distributed circularly around the rotating shaft of the electric motor, is The radially extending rotatable structure may be positioned on the rotor structure, and the radially extending rotatable structure may be positioned on the rotor structure. The surface portion of the magnetizable core structure and the rotatable disk may be coaxially The positioned, rotatable disc is connected to a drive shaft which is connected to an operable element. will be done.

[0155] In one embodiment, the operating device comprises: an electric motor having a force output; a gear system connected to the output, the gear system having an operable element and a first number of teeth on an outer circumference thereof; a hollow cylindrical first gear having a larger number of teeth on its inner surface than the first gear; a second gear having a cylindrical shape, the manipulable element being adapted to engage the inside of the first gear. The outer side of the first gear is pressed against the inner side of the second gear, Thus, the teeth of the first gear are spaced apart by a location where the teeth do not interengage. and the second gear teeth interengage with the teeth of the second gear at the position, and operation of the operable element advances the position. A gear system in which a first gear and a second gear are rotated relative to each other by rotating the first gear and the second gear in a parallel fashion. and the first gear of the gear train, so as to provide power directly or indirectly to the body engaging part. a gear system force output adapted to the gear system, the gear system force output being adapted to the gear system for power supply; of a gear system having a magnetic coupler for magnetically connecting directly or indirectly to a body-engaging part Power output section; and An enclosure may be provided for sealingly enclosing the operating device.

[0156] According to one embodiment, the magnetic coupler comprises at least one magnet or magnetic or magnetizable material. an inner rotatable structure installed inside an enclosure having a portion comprising a functional material; The magnet or any part containing magnetic or magnetizable material is enclosed in a sealed enclosure. A sealed enclosure is provided to provide power directly or indirectly to the body engaging parts through the actuator. The rotor may be adapted to rotate to transmit power to a corresponding rotatable structure outside the rotor. stomach.

[0157] According to one embodiment, the steerable implant provides power directly or indirectly to the body engaging portion. and a corresponding rotatable structure outside the sealed enclosure for efficiently supplying the good.

[0158] According to one embodiment, the operable implant comprises a reservoir for holding hydraulic fluid. The reservoir further comprises a movable wall portion adapted to vary the volume of the reservoir. The moving wall portion may be connected directly or indirectly to the force output of the gear system, thereby allowing the electric motor Manipulation of the motor changes the volume of the reservoir via a gear system.

[0159] According to one embodiment, the device further comprises a corresponding rotatable structure outside the sealed enclosure. The corresponding rotatable structure is adapted to convert a radial rotational force into an axial reciprocating force. The threaded member is connected directly or indirectly to the threaded member.

[0160] In any of the above embodiments, the threaded member may be a screw thread for varying the volume of the reservoir. It may be directly or indirectly connected to the movable wall of the reservoir of embodiment 4.

[0161] The steerable implant may further comprise a peristaltic pump, the peristaltic pump comprising a central pump for fluid transport. a hollow member and an operable compression member adapted to engage and compress the hollow member. The force output of the gear system is connected to the compression member through a magnetic coupler, which allows the electric motor Operation of the rotor operates the compression member through a gear system so that fluid is transported into the hollow member.

[0162] According to one embodiment, the control device further comprises at least one of the control device and the body engagement portion. a control unit for controlling at least one of the control units; It is adapted to surround the operating device it comprises.

[0163] The steering device of the steerable implant further comprises a wireless signal supplied from outside the patient's body. at least one receiving unit adapted to receive energy, The enclosure is installed away from the operation device, and the operation device and the The distance element is adapted to accommodate both the receiving unit and the distance element connecting the chair and the receiving unit. can be.

[0164] The distance elements of the steerable implant include a wireless energy receiver and an electric motor and magnetic link. and adapted to provide a distance between the wireless antenna and at least one of the terminals. The energy receiver is substantially connected to the metal and / or magnetic parts of the electric motor and the magnetic coupler. Not affected or not significantly affected.

[0165] The receiving unit converts the received wireless energy in the form of a magnetic field, an electric field or an electromagnetic field into electrical energy. The at least one coil is adapted to convert the

[0166] The electric motor of the steerable implant is: circularly distributed around the rotation axis of the electric motor A plurality of coils, whereby the central axes of the coil spirals are aligned in the axial direction of the electric motor, a plurality of coils extending parallel to the rotation axis of the electric motor; and a plurality of coils extending radially Circularly distributed magnets on a rotatable structure, the magnets being The magnets are distributed circularly around the axis of rotation, with the magnets facing the coil in the axial direction, thereby at least partially radially overlap the coils, thereby sequentially energizing the coils. By doing so, the magnet is propelled axially by magnetic force, causing the electric motor to rotate around the rotating shaft. It may be an axial electric motor with a magnet that generates rotation of a rotatable structure. stomach.

[0167] In one embodiment, the electric motor comprises: A plurality of coils are arranged in such a way that the central axis of the coil spiral is a plurality of coils extending radially and substantially perpendicularly to the rotation axis of the motor; and a plurality of coils extending axially; A plurality of magnets distributed in a circular pattern on a rotatable structure, in which the magnets The stones are distributed in a circle around the axis of rotation, and the magnets face the coil in the radial direction, thereby The magnets at least partially axially overlap the coils, thereby sequentially energizing the coils. By supplying a magnetic field, the magnet is propelled by magnetic force, causing the electric motor to rotate around the rotating shaft. A radial electric motor having a plurality of magnets that generates rotation of a rotatable structure. .

[0168] The electric motor in any of the above embodiments may be a linear electric motor. The rods are distributed linearly along the direction of movement of the moving part of the linear electric motor; The magnets are distributed linearly along the direction of movement of the moving part, which allows the coils to be energized sequentially. By supplying a magnetic field, the magnet is propelled by magnetic force, generating linear motion of the moving part.

[0169] The electric motor of the operating device may be an alternating current (AC) electric motor, and the control unit The frequency converter is used to change the frequency of alternating current to control an alternating current electric motor. A converter may be provided.

[0170] According to one embodiment, the enclosure is made of: a carbon material; a boron material; a mixture of materials; Pe ek® materials; alloys of materials; metallic materials; titanium; aluminum; ceramic materials ;Polymer materials;Polyurethane;Polyetheretherketone;Silicone;and Par The material may include a material selected from ylene coated silicone.

[0171] The operating device delivers hydraulic fluid from the reservoir to the hydraulically operable body-engagement portion. A hydraulic pump for this purpose may be provided.

[0172] According to one embodiment, the electric motor may be: an alternating current (AC) electric motor; a direct current electric motor; Linear electric motors; Axial electric motors; Piezoelectric motors; Three-phase motors; Two or more phases and a shape memory metal motor. .

[0173] An electric motor is: at least one motor with a wall moved by mechanical work that acts as a pump another reservoir; a small volume that changes volume to move the fluid that acts as a pump. At least one reservoir; at least one valveless pump; at least one valve pump; at least one peristaltic pump; at least one membrane pump; at least one gear pump; and and at least one bellows pump The hydraulic pump may be adapted to drive an included hydraulic pump selected from:

[0174] According to one embodiment, the electric motor comprises: coils distributed circularly around the rotation axis of the electric motor; a set of coils; and a rotatable structure that at least partially overlaps the coils in the axial direction. A set of connected magnets is provided, which sequentially energizes the coils. Thus, the magnet is driven by magnetic force to rotate the rotatable structure around the axis of rotation. The gear has a smaller diameter than the rotatable structure and is at least partially in the same axial plane. whereby the rotatable structure is at least partially axially aligned with the second gear. The overlapping arrangement positions the gear train at least partially inside the electric motor.

[0175] According to one embodiment, the operable element is configured such that the teeth of the first gear are aligned with the teeth of the second gear. interengage in at least one of the following positions: one, two, three, four or more positions and adapted to deflect the first gear so as to maintain the first gear deflected. and the two, three and four positions are separated by positions where the teeth do not interengage. Angularly spaced positions.

[0176] The operable element is configured such that the teeth of the first gear do not interengage with the teeth of the second gear. so as to interengage at at least two angularly spaced positions spaced apart by , adapted to deflect the first gear and to maintain the first gear deflected. good.

[0177] The operating device may further comprise a second gear system, the second gear system comprising: an operable element; a hollow cylindrical first gear having one tooth on its outer circumference; and a second gear having a hollow cylindrical shape and having a number of teeth on its inner surface, and the operable element is a The first gear is adapted to engage with the inside of the second gear, whereby the outside of the first gear is adapted to engage with the inside of the second gear. The teeth of the first gear are pressed against the inside of the second gear, thereby forcing the teeth of the first gear into a position where they are not interengaged. and interengaging with the teeth of the second gear at at least one spaced apart location, and operable The operation of the element is to advance the position, thereby adjusting the relationship between the first gear and the second gear. The first gear of the first gear system rotates directly against the operable element of the second gear system. directly or indirectly connected, whereby the first gear system is connected in series with the second gear system; This causes the first gear system to receive mechanical work having a first force and a first speed, The second gear system outputs mechanical work having a second different force and a second different speed. receiving as input the mechanical work output from the gear system of the first gear and generating a third different force and a third output mechanical work with different speeds.

[0178] The first gear system and the second gear system are synchronously rotated along the rotation axes of the first gear system and the second gear system. It may be positioned on the axis.

[0179] According to one embodiment, a second gear of at least one of the first gear system and the second gear system The gear has a smaller diameter than the rotatable structure and is at least partially in the same axial plane. The structure arranged and rotatable thereby is at least one of the first gear system and the second gear system. At least partially overlapping with at least one second gear in the axial direction, thereby At least one of the first gear system and the second gear system is at least partially disposed inside the electric motor. It will be placed.

[0180] The first gear and the second gear of the second gear system are rotatable gears incorporated from embodiment 20. The structure may have a larger diameter than the structure and may be at least partially disposed in the same axial plane. whereby the first gear and the second gear of the second gear system are rotatable structures. at least partially axially overlapping, whereby the electric motor is at least partially It is placed inside the gear system.

[0181] The steerable implant comprises a first gear system for transmitting force from the first gear system to the second gear system. 23. A first gear of a gear system of claim 1 directly or indirectly connected to an operable element of a second gear system of claim 23. The device may further comprise a radially extending connecting structure for connecting the device to the outside of the device.

[0182] The first gear system may include a third gear, the inside of which is the same as the outside of the first gear. The teeth of the third gear may be adapted to interengage with the teeth of the first gear. Preferably, this causes the third gear to rotate along an angularly spaced position relative to the second gear. To rotate.

[0183] The first gear of the first gear system is connected, via the third gear, to the operable element of the second gear system. It may be adapted to be indirectly connected.

[0184] The rotatable structure of any of the above embodiments may be arranged inside or outside the circularly distributed coils. The axial direction of the ...

[0185] The coil of the steerable implant remains enclosed during operation of the steering device It may be adapted to:

[0186] According to one embodiment, a first gear of at least one of the first gear system and the second gear system The gear is connected directly or indirectly to a threaded member adapted to convert a radial rotational force into an axial reciprocating force. The threaded member is connected directly or indirectly to the movable wall portion of the reservoir. It may be continued.

[0187] The steerable implant may comprise at least a portion of the steerable implant, which may be used to treat fibrosis, muscle atrophy, or other conditions. and at least one of the membrane and the muscle layer, for fixing the device to the inside of the patient's subcutaneous space. It may further comprise at least one fixed portion.

[0188] According to one embodiment, the first reservoir is connected to a hydraulically operable body engaging portion and a fluid The operating device is in communication with: a first reservoir to a hydraulically operable body engaging portion; It is adapted to cause the transport of a fluid.

[0189] Part of the reservoir wall is a bellows structure; it allows movement even when covered by fibrosis. and a plate-like surface, in all cases In which movement of at least one movable wall portion is possible, and compression of the reservoir and / or Expansion is possible.

[0190] There is further provided a steerable implant that may include a steering device and a body engaging portion. The operating device includes: an electric motor having a force output; and a body-engagement portion coupled to the force output of the electric motor. an initiation resistance delay member positioned between the body and the initiation resistance delay member, the initiation resistance delay member delaying the body for a certain period of time; A weak force or weak frictional force induced by direct or indirect connection with a body-engaging part and adapted to operate an electric motor by at least one of the Electric motors can start even with weak resistance.

[0191] According to one embodiment, the force output of the electric motor is connected directly or indirectly to the force input of the gear system. The gear system may be connected to: an operable element; a first number of teeth on an outer circumference; a hollow cylindrical first gear; and a hollow circular gear having more teeth on its inner surface than the first gear. The drive mechanism may include a cylindrical second gear, the operable element being adapted to engage the inside of the first gear. The outer side of the first gear is pressed against the inner side of the second gear, The teeth of the first gear are spaced apart by at least one location where the teeth do not interengage. and operation of the operable element advances the position. By rotating the first gear and the second gear, relative rotation occurs, and the gear system It has a force output section connected to gear 1.

[0192] In any of the above embodiments, the operable implant includes a first gear system and a starting resistance. The second gear system further includes a first gear and a second gear positioned between the first gear and the anti-retardation portion. A force input connected to an operable element that is directly or indirectly connected to a force output of the vehicle system a first gear having a hollow cylindrical shape and a first number of teeth on its outer circumference; and a second gear having a hollow cylindrical shape and having a larger number of teeth on its inner surface, and operable The element is adapted to engage the inside of the first gear, whereby the outside of the first gear is The teeth of the first gear are pressed against the inside of the second gear, so that the teeth of the first gear do not interengage. interengages with teeth of the second gear at at least one location separated by a second location; The operation of the operable element is performed by advancing the position of the first gear and the second gear. The second gear system generates a relative rotation between the first gear of the second gear system and the second gear system. The output section is provided with:

[0193] The start resistance delay member may be located between the power output of the electric motor and the power input of the gear system, or between the power output of the electric motor and the power input of the gear system. It may be positioned between the force output of the system and the body engaging portion.

[0194] In an alternative embodiment, the initiation resistance delay member is: a force output of the first gear system and a force output of the second gear system between the force input portion of the second gear system and the body-engaging portion; and between the force output portion of the second gear system and the body-engaging portion. It is positioned.

[0195] According to one embodiment, the initiation resistance delay member comprises a spring, which may be a helical spring or a leaf spring. It can be ne.

[0196] In an alternative embodiment, the initiation resistance delay member includes mechanical play, and the mechanical play is: The mechanical play may be one of a linear mechanical play and a straight mechanical play.

[0197] The initiation resistance delay member initiates the onset of the electric motor before the force output directly or indirectly engages the drive member. The power output part of the motor is 1 / 10 rotation speed, 1 / 8 rotation speed, 1 / 6 rotation speed, 1 / 4 rotation speed , 1 / 2 rotation speed, and 1 rotation speed. It may include radial mechanical play.

[0198] According to one embodiment, the initiation resistance delay member is: a force output part of the first gear system and a force output part of the second gear system and the force input of the second gear system; and between the force output of the second gear system and the body engaging portion. The initiation resistance delay section is positioned between at least one of the force output section and the drive member. The force output part of the gear system in front is 1 / 10 rotation speed, 1 / 8 rotation speed, 1 / 6 rotation speed, 1 / 4 At least one of rotation speed, 1 / 2 rotation speed, and full rotation speed can be performed. This may include radial mechanical play that allows the force output of the electric motor to be adjusted by 1 / 10 rotation speed * gear transmission, 1 / 8 rotation speed * gear transmission 1 / 6 speed gear transmission, 1 / 4 speed gear transmission Transmission, 1 / 2 speed gear transmission, and 1 speed gear transmission It is possible to perform at least one of the transmissions.

[0199] In an alternative embodiment, the starting resistance delay device may comprise a friction clutch.

[0200] In a further alternative embodiment, the initiation resistance delay device is adapted to be operated by centrifugal force. The at least one element may be integrated into an electric motor. When the centrifugal force on the element exceeds the centrifugal retarding force, the element may be directly connected to the body engaging portion. or adapted to indirectly engage.

[0201] According to one embodiment, the operable elements of the first and / or second gear system are operated by centrifugal force. The gear system may comprise an element adapted to be driven by the gear train, whereby the operable element of the gear train The first gear engages when the centrifugal force acting on the element exceeds the centrifugal retarding force.

[0202] Electric motors are: alternating current (AC) electric motors; direct current electric motors; linear electric motors Motors; axial electric motors; piezoelectric motors; three-phase motors; two-phase or more motors; bimetal and shape memory metal motors.

[0203] According to one embodiment, the body engaging portion is adapted to operate the hydraulically operable body engaging portion. a hydraulically operable body engaging portion connected to a hydraulic pump that delivers hydraulic fluid to The hydraulic pump may comprise a reservoir having at least one movable wall portion, Another movable wall portion may be connected directly or indirectly to an electric motor, whereby an electric A motor is positioned to operate the movable wall portion to vary the volume of the reservoir.

[0204] According to one embodiment, the power output of the electric motor is configured to convert the radial rotational force of the electric motor into an axial rotational force. It is connected directly or indirectly to a threaded member adapted to convert a reciprocating force. The threaded member is directly or indirectly connected to a movable wall portion of the reservoir for changing the volume of the reservoir. may be connected.

[0205] According to one embodiment of the steerable implant, the threaded member is It is directly or indirectly connected to a movable wall portion of a second reservoir for varying its volume.

[0206] The threaded member moves the movable wall portion of the first reservoir in a first direction. The first fluid reservoir may expand to increase the volume of the first reservoir. Thus, when the movable wall portion of the second reservoir is moved in the first direction, the second reservoir is retracted. The volume of the second reservoir decreases as it contracts.

[0207] According to one embodiment, the first reservoir is coupled to a first hydraulically operable body engaging portion. the second reservoir is in fluid communication with a second hydraulically operable body engaging portion. When the electric motor is operated in a first direction by connecting with the threaded member: The fluid is delivered from the reservoir to a first hydraulically operable implant and to a second hydraulically operable implant. Fluid is transported from the actuable body engaging portion to a second fluid reservoir.

[0208] The reservoir may be, for example, circular or donut-shaped. According to an embodiment, the steerable implant comprises a circular reservoir surrounding the steering device. The circular reservoir has a movable wall portion adapted to compress and expand the circular reservoir. The movable wall portion is connected to an electric motor, which Thus, operation of the electric motor changes the volume of the circular reservoir.

[0209] Part of the reservoir wall is a bellows structure; it allows movement even when covered by fibrosis. and a plate-like surface, in all cases In which movement of at least one movable wall portion is possible, and compression of the reservoir and / or Expansion is possible.

[0210] In one embodiment, the steerable implant comprises a hydraulic pump, the hydraulic pump comprising: a hollow member for transporting a body; and an operable member adapted to engage and compress the hollow member. The pump may include a peristaltic pump having a compression member, the electric motor being directly or indirectly connected to the compression member. The electrical equipment is operated by a compression section which causes fluid to be transported into the hollow member. Manipulate the material.

[0211] There is further provided an operable implant adapted to be implanted in the body of a patient. The steerable implant comprises a steering device and a body engaging portion. The steering device: an operable element; a first gear having a hollow cylindrical shape and a first number of teeth on an outer circumference thereof; a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear, The manipulable element is adapted to engage the inside of the first gear, This causes the outside of the first gear to press against the inside of the second gear, thereby The gear teeth are spaced apart at least in one position separated by a position where the teeth do not interengage. The actuation of the operable element advances the interengaged position. By rotating the first gear and the second gear, relative rotation is generated. The system further comprises: an operable element; and a first hollow cylindrical element having a first number of teeth on its outer circumference. and a hollow cylindrical second gear having more teeth on its inner surface than the first gear. The manipulable element is adapted to engage the inside of the first gear. The outer side of the first gear is pressed against the inner side of the second gear, Thus, the teeth of the first gear are spaced apart by a location where the teeth do not interengage. The actuation of the operable element interengages the teeth of the second gear at the position. By advancing one position, relative rotation between the first and second gears is created To make.

[0212] The first gear of the first gear system is arranged so that the first and second gear systems function as a single gear system. The gear train is connected directly or indirectly to an operable element of the second gear train.

[0213] According to one embodiment, the first gear of the first and second gear system comprises a deflectable wall. The movable element is adapted to deflect the first gear and to maintain the first gear deflected. The teeth of the first gear are adapted to be spaced apart by locations where the teeth do not interengage. and interengages with the teeth of the second gear at at least one angularly spaced position. Operation is by advancing angularly spaced positions by rotation, and the first gear and the second gear are This generates relative rotation between the gears.

[0214] According to one embodiment, the operable element is adapted to deflect the first gear and the first tooth. The first gear is adapted to maintain the wheel biased so that the teeth of the first gear interengage. At least two angularly spaced positions separated by a non-existent position and at least three interengages with the teeth of the second gear at at least one of four angularly spaced positions. do.

[0215] In one embodiment of the steerable implant, at least one of the first and second gear systems The third gear has a hollow cylindrical shape. The inside of the third gear has the same number of teeth as the outside of the first gear. the teeth of the third gear being adapted to interengage with the teeth of the first gear, thereby The third gear rotates relative to the second gear along at least one interengaging position. .

[0216] In one embodiment of the steerable implant, the first gear system includes a hollow cylindrical third gear. The third gear has an inner side with the same number of teeth as the first gear of the first gear system. The teeth of the gear are adapted to interengage with the teeth of the first gear, whereby the third gear and rotating along at least one interengaging position relative to the second gear, The operable element was directly or indirectly connected to the third gear of the first gear system.

[0217] The first gear system may be positioned at least partially radially inside the second gear system. This causes the second gear system to at least partially overlap the first gear system in the axial direction. In an alternative embodiment, the first and second gear systems are coaxial along the axes of rotation of the first and second gear systems. The sensor may be positioned at

[0218] According to one embodiment, the steerable implant transfers force from the first gear system to the second gear system. A first gear of a first gear system is connected directly or indirectly to an operable element of a second gear system to transmit further comprising a radially extending connecting structure that indirectly connects the

[0219] The first and second gear systems are arranged so as to be sealed from body fluids when implanted. It may further comprise an enclosure adapted to hermetically enclose the same.

[0220] The operable elements of the first and second gear systems in any of the above embodiments may include: planetary gears; and It may further comprise at least one of a structure or a wheel with a friction surface connection.

[0221] In one embodiment, the steerable implant further comprises an electric motor. : Alternating current (AC) electric motor; Direct current electric motor; Linear electric motor; Axial Type electric motors; piezoelectric motors; three-phase motors; two-phase or more motors; bimetal motors; and types The electric motor may include a memory metal motor.

[0222] The steerable implant in any of the above embodiments includes a first gear system and an electric motor. The device may further comprise an enclosure adapted to hermetically enclose the controller. The gearbox is designed to transmit force from a sealed, enclosed first gear system to a second gear system. The rotary force may further comprise a sealed output.

[0223] In any of the above embodiments, the operable implant may include a first gear system, a second gear system, and a system enclosure adapted to hermetically enclose the vehicle system and the electric motor. good.

[0224] The steerable implant is operated from a hermetically enclosed second gear system. It may further comprise a sealed output for the rotational power so that the power can be transmitted to the plant.

[0225] The operable implant comprises an enclosure adapted to hermetically surround an electric motor. The enclosure may further comprise a first enclosure from the hermetically enclosed motor. The gear train may further include a sealed output for the rotational force so that the force is transmitted to the gear train of the first gear. .

[0226] The steerable implant comprises at least two coils, and at least one coil; and adapted to hermetically surround a stationary part of an electric motor comprising at least one of The device may further comprise an enclosure.

[0227] According to one embodiment, the enclosure of the stationary part of the motor may comprise a wall, and an operable The implant is wirelessly rotated from a stationary, hermetically enclosed part through a sealed wall. and forming a magnetizing element including at least one magnet, a magnetizable material, and at least one coil. and adapted to generate a rotational force that rotates a rotor portion of a motor having at least one Preferably, the rotor is adapted to be further connected, directly or indirectly, to the first gear system.

[0228] According to one embodiment, the steerable implant comprises a rotor portion of an electric motor, as well as a first and at least one of the first and second gear systems. The device further comprises an enclosure.

[0229] There is further provided an operable implant adapted to be implanted in the body of a patient. The steerable implant comprises a steering device and a body engaging portion. The steering device: The magnet or magnetic or magnetizable material can be moved along the moving magnetic field of the external unit. , a small device adapted to be influenced by a moving magnetic field generated by an external unit when implanted. At least one magnet, at least one magnetic material, and at least one magnetizable material. The operation device comprises at least one of: a moving magnetic field of an external unit; At least one magnet, magnetic material or magnetizable material is provided so as to be propelled by the magnet or magnetic material. A manipulable element connected directly or indirectly to the material and having a first number of teeth on its outer periphery. a hollow cylindrical first gear having a larger number of teeth on its inner surface than the first gear; and a second gear having a cylindrical shape. The outer side of the first gear is adapted to engage with the inner side of the second gear. The teeth of the first gear are pressed against each other so that the teeth of the first gear are spaced apart by a location where the teeth do not interengage. The operable element interengages with the teeth of the second gear at at least one position. The operation is to advance the position to increase the relative rotation between the first gear and the second gear. Generates.

[0230] Any of the above embodiments of the operating device may be adapted to be implanted subcutaneously, It may be implanted subcutaneously in the abdomen.

[0231] In any of the above embodiments, the operation device includes a first unit and a second unit. and at least one magnet, magnetic material or magnetizable material is provided in the first unit. The gear system is installed in the second unit.

[0232] The steerable implant is adapted to provide a fixed distance between the first and second units. The distance element may further comprise a distance element associated with the abdominal wall. The distance element may be: The distance element is adapted to at least one of the following: fixation to the inner fascia between the distance element and the inner fascia; The distance element may be: The device may be adapted to be secured to at least one of the fascia and muscle layers of the abdominal wall, thereby The distance between the first portion of the operating device and the patient's skin is controlled by the distance element. a mechanical transmission member adapted to transmit force from the first unit to the second unit; whereby force is transmitted from at least one magnet, magnetic material or magnetizable material to the operating force of the gear system. The data is transmitted to the operable element.

[0233] In one embodiment, the operable implant is operable to seal from the patient's bodily fluids; a movable implant, an operating device, a body engaging portion, a first unit, a second unit, and an enclosure adapted to hermetically enclose at least one of the distance elements; Prepare further.

[0234] In one embodiment, the enclosure provides fluid to the hydraulically operable body engaging portion. a reservoir for supplying at least one magnet, magnetic material or magnetized material; The material and gear system are placed inside the reservoir.

[0235] The steerable implant comprises a movable wall portion adapted to vary the volume of the reservoir. The movable wall portion is connected directly or indirectly to the first gear of the gear system, Manipulation of the gear system thereby changes the volume of the reservoir.

[0236] The first gear of the gear system is directly connected to a threaded member adapted to convert rotational force into a reciprocating force. They may be directly or indirectly connected.

[0237] The threaded member is connected directly or indirectly to a movable wall portion of the reservoir for varying the volume of the reservoir. The power supply may be indirectly connected.

[0238] The steerable implant may further comprise a peristaltic pump. The peristaltic pump may comprise a pump for transporting fluid. a hollow member having a diameter of 10 mm and an operable compression member adapted to engage and compress the hollow member; The first gear of the gear system is directly or indirectly connected to the compression member, whereby the operation of the gear system is , manipulating the compression member so that fluid is transported into the hollow member.

[0239] The steerable implant in any of the above embodiments may comprise: a steerable element; a first a hollow cylindrical first gear having a number of teeth on its outer circumference; and a second gear system including a second gear having a hollow cylindrical shape with teeth on an inner surface thereof; The operable element may be adapted to engage an interior of the first gear, thereby The outer side of the first gear is pressed against the inner side of the second gear, thereby The teeth are spaced apart by a location where the teeth are not interengaged. Operation of the operable element, which interengages with the gear teeth, advances the element at least one position. This generates relative rotation between the first gear and the second gear, and the first gear of the first gear system The gear is directly or indirectly connected to an operable element of a second gear system, thereby The first and second gear systems function as a single gear system.

[0240] The operable element of one of the first and second gear systems is a planetary gear, and a rotational force is transmitted. At least one of the structures or wheels that utilize friction at least in part to enable may also have one.

[0241] The steerable implant in any of the above embodiments may be: wirelessly from an external unit; receiving a communication signal; and transmitting a wireless communication signal to an external unit. The wireless communication unit may further include an integrated wireless communication unit.

[0242] There is also provided an external unit for supplying force to the implanted operating device. The unit includes: at least one magnet or magnetic material or magnetic element in the embedded operating device; and forming a moving magnetic field outside the patient's skin, the moving magnetic field being adapted to affect the activatable material. an adapted external drive unit, whereby the magnet or magnetic material is driven by the external drive unit; It moves along the moving magnetic field of

[0243] The external drive unit is a set of coils distributed circularly around the axis of rotation of the external unit. whereby sequential energy supply to the coils is controlled by an implanted steering device. forming a rotating magnetic field adapted to affect magnets or magnetic or magnetizable materials in the , whereby the magnet or magnetic material moves along the moving magnetic field of the external drive unit.

[0244] The external device unit further includes a rotating structure having at least one magnet or magnetic material. The rotation of the rotatable structure may be induced by a magnet or magnetic material or may affect the magnetizable material and cause it to rotate, thereby forming a magnet or magnetic material or The magnetizable material rotates along the rotatable structure of the external unit.

[0245] According to one embodiment, the external unit further comprises a wireless communication unit, The kit includes: receiving wireless communication signals from the implantable unit; and transmitting wireless communication signals to the implantable unit. The device is adapted for at least one of transmitting a line communication signal.

[0246] There is further provided a medical system, the medical device comprising: and an external unit according to any one of the preceding embodiments. Prepare.

[0247] In one of the above embodiments, the operating device includes at least one magnet, at least one and at least one of at least one magnetic material and at least one magnetizable material. and adapted to be influenced by an externally generated movable magnetic field. A rotatable structure is provided, whereby the rotatable structure rotates.

[0248] The operable implant may be adapted to seal from the patient's bodily fluids; a rotatable structure according to any of the preceding embodiments, a reservoir according to any of the preceding embodiments, and and adapted to sealingly surround at least one of the threaded members The device may further comprise an enclosure.

[0249] In any of the above embodiments, the operating device may include a reservoir adapted to contain hydraulic fluid. It may comprise a reservoir and at least one movable wall portion for varying the volume of the reservoir. The operating device is adapted to operate the movable wall of the reservoir, and the operating device is disposed within the reservoir. a gear system disposed on an outer periphery of the gear system, the gear system comprising: an operable element; a gear system having a first number of teeth on an outer periphery of the gear system; a hollow cylindrical first gear; and a second gear having a larger number of teeth on its inner surface than the first gear. A hollow cylindrical second gear is provided, and the operable element is adapted to engage the inside of the first gear. The outer side of the first gear is pressed against the inner side of the second gear, Thus, the teeth of the first gear are spaced apart by a location where the teeth do not interengage. and the second gear teeth interengage with the teeth of the second gear at the position, and operation of the operable element advances the position. By rotating the first gear and the second gear, relative rotation is generated between the first gear and the second gear.

[0250] There is also provided a steerable implant adapted for implantation in the body of a patient. The operable implant includes a hydraulic operating device for supplying hydraulic force and a device for receiving hydraulic force. The hydraulic operating device comprises: a body engaging portion adapted to contain a hydraulic fluid; a reservoir having at least one movable wall portion for varying the volume of the reservoir; and an operating device adapted to operate the movable wall and comprising a gear system disposed within the reservoir; The gear system comprises: an operable element; a hollow cylindrical element having a first number of teeth on its outer circumference; a first gear having a shape of a hollow cylinder; and a second gear having a larger number of teeth on its inner surface than the first gear. the operable element is adapted to engage the inside of the first gear, thereby The outer side of the first gear is pressed against the inner side of the second gear, thereby The teeth of the second tooth are spaced apart by a location where the teeth are not interengaged. and the operation of the operable element is by advancing said position. , generating relative rotation between the first gear and the second gear.

[0251] The first gear of the steerable implant is adapted to convert rotational force into reciprocating force. It connects directly or indirectly to the threaded member.

[0252] The threaded member may be directly or indirectly connected to the movable wall portion of the reservoir, thereby Thus, operation of the operating device changes the volume of the reservoir.

[0253] The steerable implant according to any one of the above embodiments is disposed inside the reservoir. a rotatable structure positioned on the gear train and connected to an operable element of the gear train, The structure includes at least one magnetic field adapted to be magnetically coupled to a rotating magnetic field outside the reservoir. stone, at least one magnetic material, or at least one magnetizable material, Thus, a rotating magnetic field outside the reservoir propels a rotatable structure inside the reservoir.

[0254] The rotatable structure of the steerable implant includes a radially extending structure having a plurality of magnets. The rotating magnetic field may be adapted to be axially magnetically coupled to the disk. stomach.

[0255] According to one embodiment, the steerable implant comprises a circumferential wall positioned inside the reservoir. A plurality of axially positioned coils circularly distributed around the axis of rotation of the rollable structure. The coil further includes a drive unit having a central axis extending in the axial direction. , which is substantially parallel to or substantially aligned with the center of the axis of rotation of the rotatable structure. The sequential energization of the coils generates a rotating magnetic field that propels the rotatable structure axially. Form.

[0256] The steerable implants are comprised of multiple implants distributed in a circular pattern around the axis of rotation of the rotatable structure. The drive rotatable structure may further comprise a magnetic coupling, the drive rotatable structure comprising a magnet. The structure is adapted to magnetically couple to a rotatable structure positioned inside the reservoir. and the drive rotatable structure may comprise an electric motor adapted to propel the drive rotatable structure. The rotor is connected to a pneumatic motor, which drives a rotatable structure positioned inside the reservoir. Rotate along the rotatable structure.

[0257] The rotatable structure includes a cylinder having a plurality of magnets positioned on the peripheral surface thereof. a cylinder extending radially outward, the plurality of magnets being arranged to be magnetically coupled to the rotating magnetic field in a radial direction. It will be adapted.

[0258] The steerable implant comprises a rotatable structure positioned inside the reservoir. A drive unit comprising a plurality of radially positioned coils distributed circularly around an axis The coil may further include a central axis of the spiral extending in the radial direction, and a rotatable structure. The coils are substantially parallel to the axis of rotation of the rotatable structure, and sequential energization of the coils propels the rotatable structure. It creates a rotating magnetic field that propels the

[0259] The steerable implants are comprised of multiple implants distributed in a circular pattern around the axis of rotation of the rotatable structure. The drive unit may further comprise a drive rotatable structure comprising a magnet. The active structure is radially magnetically coupled to a rotatable structure positioned inside the reservoir. The drive rotatable structure may be adapted to propel the drive rotatable structure. The reservoir may be connected to a rotatable electric motor positioned inside the reservoir. The rotatable structure rotates along a driving rotatable structure adapted to rotate radially outwardly of the rotatable structure. To rotate.

[0260] According to one embodiment, the drive unit is positioned external to the patient's skin and is a hydraulically operated device. An external drive unit adapted to propel a rotatable structure within the chair.

[0261] According to one embodiment, the hydraulic operating device is adapted to propel an operable element of a gear system. The electric motor is: an alternating current (AC) electric motor, a direct current electric motor Motors, linear electric motors, axial electric motors, radial electric motors, three-phase motors Choose from 2 or more phase motors, piezoelectric motors, bimetal motors, and shape memory metal motors The motor may be an electric motor.

[0262] The electric motor may be adapted to be positioned inside the reservoir.

[0263] The operable implant according to any one of the above embodiments may comprise: a fluid reservoir wall; Penetration, not penetrating the reservoir wall, force from outside the reservoir to inside the reservoir and transmitting power between the motor and the gear system inside the reservoir; The device may further include a power transmission member adapted to at least one of the plurality of power transmission members.

[0264] The power transmission member may be connected to an operable element of an implantable electric motor and gear system; It may be adapted to transmit rotational power from the electric motor to the operable element.

[0265] The steerable implant may further comprise a second gear system, the second gear system comprising: possible elements; a first gear having a hollow cylindrical shape with a first number of teeth on its outer circumference; and a first a second gear having a hollow cylindrical shape and having a larger number of teeth on its inner surface than the first gear, The element is adapted to engage the inside of the first gear, whereby the outside of the first gear is The teeth of the first gear are pressed against the inside of the second gear, so that the teeth of the first gear do not interengage. interengages with teeth of the second gear at at least one location separated by a second location; The actuation of the operable element advances the first gear by at least one position. The first gear of the first gear system rotates relative to the second gear system. and a second gear system connected to the first and second operable elements, whereby the first and second gear systems are treated as a single gear system. It functions as such.

[0266] According to one embodiment, at least one operable element of the first and second gear systems a planetary gear and a direct or indirect frictional connection between the operable element and the first gear; The vehicle comprises at least one of a wheel or structure adapted for use therewith.

[0267] The hydraulic operating device is adapted to receive wireless energy supplied from outside the patient's body. The system further comprises at least one receiving unit integrated therewith.

[0268] The receiving unit of the steerable implant receives the wireless signals in the form of a magnetic or electromagnetic field. The device includes at least one coil adapted to convert energy into electrical energy.

[0269] The steerable implant comprises a receiving unit and at least one of a reservoir and an electric motor. The device may further comprise a distance element adapted to provide a distance between the two devices, whereby The receiving unit does not substantially affect the metal and / or magnetic parts of the reservoir and / or electric motor. The distance element is placed through the muscle layer of the abdominal wall and faces the inside of the subcutaneous space. Fixation of the muscle to the fascia;

[0270] According to one embodiment, the distance element is flexible, whereby the wireless energy reservoir The distance element is movable relative to the reservoir and / or the electric motor. The first part of the implantable unit may be adapted to be fixed to one muscle layer, thereby The distance between the component and the patient's skin can be controlled, or the movement of the distance element, including rotation, can be controlled. is minimized, or both are achieved.

[0271] The steerable implant may be a fluid reservoir or a hydraulically operated steerable implant. It may further comprise an inlet for directly or indirectly supplying the implant.

[0272] An implantable generator for converting mechanical work into electrical energy is further provided. The integrable generator comprises: at least one magnet, at least one magnetic material, or at least The magnetic field generating device comprises a magnetizable material and is adapted to be magnetically coupled to an external drive unit that generates a moving magnetic field. The implantable generator includes a movable structure coupled to the implantable magnetic field, thereby moving along the movable magnetic field. a generator connected to the movable structure and adapted to convert the motion of the movable structure into electrical energy; The device further includes an electric unit.

[0273] The generator unit comprises: a moving generator part having at least one magnet and connected to a moving structure; and at least one coil magnetically coupled to the at least one magnet, Movement of the movable generating part relative to the coil induces a current in the coil.

[0274] According to one embodiment, the movable structure comprises a rotatable disk and at least one magnet Alternatively, the magnetic material may be positioned on a rotatable disk and connected to an external unit that creates a rotating magnetic field. The generator unit is adapted to be magnetically coupled to a rotating generator connected to a rotatable disk. A rotating generator unit is a rotating device that can be rotated to induce a current. It rotates along with or is part of the disk.

[0275] The movable structure is adapted to perform reciprocating motion and is magnetically coupled to an external unit for reciprocating motion. It is adapted to generate a magnetic field, thereby causing reciprocating motion along the reciprocating magnetic field.

[0276] According to one embodiment, the movable structure is connected to a resilient element or spring, whereby the movable structure The body is moved in a first direction by a magnetic force supplied by an external unit and in a second direction by a resilient element or spring. in a second direction by

[0277] The elastic element may be an elastic material, a flexible material, or a structure adapted to produce elastic movement. and a spring.

[0278] In one embodiment, the power generating unit may be a linear power generating unit. The unit comprises: at least one magnet and is connected to a movable structure adapted to perform a reciprocating movement; a movable generating part connected to the magnet; and a movable generating part connected to the magnet; The reciprocating motion of the structure is transmitted to the moving generating part, inducing a current in at least one coil. It has at least one coil.

[0279] According to one embodiment, the implantable generator further comprises a battery connected to the power generating unit. The battery is adapted to store the electrical energy generated by the power generation unit.

[0280] The implantable generator is provided with an enclosure adapted to hermetically surround the implantable generator. The implantable generator may further include a seal to seal the implantable generator from the patient's body fluids.

[0281] The implantable generator may further comprise a wireless communication unit, the wireless communication unit being: receiving wireless communication signals from the unit and transmitting wireless communication signals to an external unit; It is adapted to do at least one of the following:

[0282] The implantable generator may be adapted for subcutaneous implantation, such as subcutaneous implantation within the abdomen. It may be.

[0283] There is also provided an external unit for supplying power to the implantable generator. The implantable generator may include at least one magnet, at least one magnetic material, or is external to the patient's skin adapted to affect at least one magnetizable material. an external drive unit adapted to generate a moving magnetic field, whereby a magnet or magnetic The material moves along the moving magnetic field of the external drive unit.

[0284] According to one embodiment, the external drive unit is adapted to be alternately energized. at least one of an electromagnet and an electromagnet adapted to be de-energized; This affects at least one magnet or magnetic material of the implantable generator. An alternating magnetic field is created to

[0285] The external drive unit may include at least one permanent magnet, the positive pole of which may be implanted. the negative pole of the permanent magnet is adapted to affect the permanent magnet of the implantable generator. The at least one permanent magnet may be adapted to influence a positive pole and a The negative pole is adapted to move to alternately affect the permanent magnet of the implantable generator. stomach.

[0286] According to one embodiment, the external drive unit comprises a set of circularly distributed coils, This allows the sequential energization of the coils by the magnets, magnetic material or magnetizable material of the implantable generator. and forming a rotating magnetic field adapted to affect the magnet, magnetic material or The magnetizable material rotates along the rotating magnetic field of the external drive unit.

[0287] In one embodiment, the external unit comprises a set of linearly distributed coils, Thus, the sequential energization of the coils is achieved by the magnet or magnetic or magnetizable material of the implantable generator. and forming a linear moving magnetic field adapted to affect the magnet, magnetic material or The magnetizable material moves along the linear magnetic field of the external unit.

[0288] The external unit comprises a rotatable structure comprising at least one magnet or magnetic material. Preferably, the rotation of the rotatable structure is induced by a magnet or magnetic field of an implantable generator that generates the rotation. The magnet or magnetic material may be attached to a rotatable structure of the external unit. Rotates along the body.

[0289] The external drive unit comprises at least one of: a magnetic material, a permanent magnet, and an electromagnet. The reciprocating structure may include: a) a first portion proximate to the patient's skin; and moving a magnetic material, a permanent magnet, or an electromagnet between the subject's skin and a second portion spaced from the subject's skin; This allows for a forward movement of the implantable generator, adapted to affect the magnet or magnetic material. a) a reciprocating magnetic field is formed; or b) a small magnetic field is generated while the reciprocating structure is substantially stationary. and adapted to intermittently receive an electric pulse to at least one electromagnet and generate a magnetic field motion. may be combined.

[0290] According to an embodiment, the external unit further comprises a wireless communication unit, Receiving wireless communication signals from an implantable generator and transmitting wireless communication signals to an implantable generator The device is adapted to perform at least one of transmitting a signal.

[0291] There is also provided a system for generating an electrical current inside a patient's body. An implantable generator according to any one of the above embodiments, and a or one external unit.

[0292] There is further provided an actuatable hydraulic implant comprising a hydraulic actuation device. The hydraulic operating device is adapted to contain hydraulic fluid for operating the hydraulic implant. and a combined reservoir and a mechanical work of a first force and velocity as input, and a different force and velocity are A gear system adapted to output mechanical work having a certain speed and a certain temperature is enclosed in a sealed state. The reservoir and gear system are sealed from body fluids when implanted. .

[0293] The reservoir may comprise at least one movable wall portion for varying the volume of the reservoir. .

[0294] In one embodiment, the gear system connects to a movable wall for varying the volume of the reservoir. In this state, the operable hydraulic implant is connected to a gear system and surrounded by an enclosure. The vehicle further comprises an electric motor.

[0295] In one of the above embodiments, the gear system includes: an operable element, a first number of teeth, a hollow cylindrical first gear having an outer periphery; and a second gear having a larger number of teeth than the first gear on an inner surface thereof. A second gear wheel having a hollow cylindrical shape is provided on the top, and the operable element is located inside the first gear wheel. The gears are adapted to engage with each other, whereby the outer side of the first gear is pressed against the inner side of the second gear. The teeth of the first gear are compressed together, so that the teeth of the first gear are spaced apart by a small distance apart where the teeth do not interengage. and interengaging the teeth of the second gear in at least one position, and operation of the operable element is By advancing the position, relative rotation between the first gear and the second gear is generated. do.

[0296] In one embodiment of the operable hydraulic implant, the operable elements of the gear system are electrically The gear system is adapted to receive mechanical work from the motor at a first force and speed. The car supplies mechanical work to at least one wall portion with a different second force and velocity. and connected directly or indirectly to at least one movable wall portion for the electric motor. Operation of moves the movable wall portion, changing the volume of the reservoir.

[0297] In one embodiment, the first gear of the gear system is adapted to convert a radial rotational force into an axial reciprocating force. Directly or indirectly connected to an adapted threaded member, the threaded member being adapted to the volume of the reservoir. In one embodiment, the threaded portion The material may be attached directly to a movable wall portion of the second fluid reservoir for varying the volume of the second reservoir. It may be connected indirectly.

[0298] Movement of the movable wall portion of the first reservoir is effected by a threaded member in a first direction. The reservoirs are expanded, increasing the volume of the first reservoir and the movable wall portion of the second reservoir. The movement causes the threaded member in a first direction to contract the second reservoir and Reduce the volume of the server.

[0299] The first reservoir may be in fluid communication with the first hydraulically operable body engaging portion; The second reservoir may be in fluid communication with a second hydraulically operable body engaging portion, The operation of the electric motor unit in one direction is achieved by the connection with the threaded member: a first hydraulically operable body engaging portion for transporting fluid from the reservoir to the body engaging portion; This may effect the transfer of fluid from the operable body engaging portion to the second reservoir.

[0300] According to one embodiment of the operable hydraulic implant, the wall of the enclosure comprises a reservoir. and at least one movable wall portion between the reservoir and the gear system. and a part of the at least one movable wall portion may be positioned in such a manner that the part of the at least one movable wall portion is fitted with a gear system. Separating the reservoir from a portion of the surrounding enclosure, thereby sealing the gear system from the reservoir. It will be closed.

[0301] The operable hydraulic implant is a second gear system surrounded by an enclosure. The second gear system further comprises a second gear unit for receiving a second force and speed mechanism from the output of the first gear system. and adapted to receive mechanical work and output mechanical work having a third different force and velocity. Ta.

[0302] The second gear system includes: an operable element and a hollow cylinder having a first number of teeth on its outer circumference; a first gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear; and two gears, the operable element being adapted to engage the inside of the first gear, The outer side of the first gear is pressed against the inner side of the second gear, thereby The gear teeth are spaced apart at least one location where the teeth do not interengage. Interengaging with the teeth of the second gear, operation of the operable element is by advancing said position. This generates relative rotation between the first gear and the second gear, and the first gear of the first gear system directly or indirectly connects to an operable element of the second gear system, thereby connecting the first and second The gear system functions as a single gear system.

[0303] According to one embodiment, at least one operable element of the first and second gear systems The gear includes at least one of a planetary gear and a wheel or structure utilizing a frictional connection. It's okay.

[0304] The hydraulically operated implant is enclosed in an enclosure and energized by an electric motor. The device may further comprise at least one battery adapted to supply power.

[0305] According to one embodiment, the operable hydraulic implant is delivered from outside the patient's body. The device further comprises a receiving unit adapted to receive the wireless energy transmitted therethrough.

[0306] The receiving unit is adapted to be surrounded by an enclosure, whereby the receiving unit The pouch is sealed from body fluids.

[0307] The operable hydraulic implant consists of a receiving unit and at least one of a gear system and an electric motor. The device may further comprise a distance element adapted to provide a fixed distance between at least one of the This allows the receiving unit to be isolated from the metal and / or magnetic parts of the gear train and / or electric motor. Be separated.

[0308] The receiving unit is adapted to charge a battery according to any one of the above embodiments. good.

[0309] In one embodiment, the steerable hydraulic implant further comprises a magnetic coupler, The connector is connected to an operable element of the gear system and includes a first portion surrounded by an enclosure. and a second portion: positioned outside the enclosure and an electric motor positioned so that operation of the electric motor operates a second portion of the magnetic coupler; a first portion of the magnetic coupler that rotates along a second portion of the magnetic coupler, Thus, the first magnetic coupling allows the electric motor to propel the gear train through the wall of the enclosure. Magnetically connect to part 1.

[0310] According to one embodiment, the operable hydraulic implant further comprises an implanted electric motor. The second part may be connected to an implantable electric motor. The first unit is driven by an external drive unit adapted to propel the first unit from outside the patient's body. You may connect.

[0311] Electric motors are: alternating current (AC) electric motors, direct current electric motors, linear electric motors motors, axial electric motors, radial motors, three-phase motors, motors with two or more phases, piezoelectric an electric motor selected from a motor, a bimetal motor, and a shape memory metal motor; good.

[0312] The enclosure for the embeddable hydraulic unit is made of: carbon material; boron material; mixture of materials ;Peek® Materials;Material Alloys;Metallic Materials;Titanium;Aluminum;Ceramics polymeric materials; polyurethanes; polyetheretherketones; silicones; and The material may include a material selected from Parylene® coated silicone.

[0313] A steerable implant for implantation into the body of a patient is provided. The component is composed of at least one fascia, at least one bone fascia, at least one one cortical bone layer, at least one muscle layer, fibrous tissue, any part of the abdominal wall, any part of the subcutaneous space an implant operable to at least one of the site of displacement and the surrounding area; at least one fixing member adapted to fix directly or indirectly an adjustable distance element at one end of which the steerable implant is attached to at least one of the and at the other end, directly or indirectly connected to a fixed member. A maneuverable implant part and a fixation part connected to an adjustable distance element and at least one adjustable distance element adapted to adjust the distance between the material. can.

[0314] Steerable implants are defined in the following list: Steerable devices; Control units; Wireless energy receiving unit for receiving radio energy; coil for receiving radio energy; magnetic field or electromagnetic a receiving unit for receiving the field; a magnetic force transmission coupler; an electrical circuit; and an operable implant. Push button to control the function of the energy storage device; adjustable distance adjustment element a depressible structure adapted to generate kinetic energy; a wireless energy integrated operating device and receiving unit for receiving a magnetic or electromagnetic field; a case for enclosing at least one of the different portions of the implant; each case two or more implants for surrounding at least one of the different portions of the steerable implant within the implant; The at least one component may be selected from one of more cases. The adjustable distance element: adjusts the distance between the fixed member and at least one of the above-mentioned components. The device may be adapted to adjust the

[0315] According to one embodiment of the steerable implant, at least one fixation member comprises: a control unit; a receiving unit for receiving wireless energy; Coils for receiving; receiving units for receiving magnetic or electromagnetic fields; magnetic force transmission couplers; Electrical circuitry; push buttons to control the functions of operable implants; energy storage devices Vise; Depressible structure for adjusting adjustable distance element; Kinetic energy generating Integrated operation for receiving wireless energy, magnetic or electromagnetic fields adapted to a device and a receiving unit; and at least one of the different parts of the implant that can be operated. a case for enclosing one of the implants; and a case for enclosing the different parts of the implant that can be operated within each case. Two or more cases for enclosing at least one; Integrate with at least one of the integrated units. The element is: a fixation element integrated with one or more parts of the steerable implant and a The device is adapted to adjust the distance between one or more components of the plant.

[0316] According to one embodiment, at least one adjustable distance element is adjustable from outside the patient's body. It is possible to manufacture.

[0317] According to one embodiment, at least one adjustable distance element is provided for adjusting the distance from outside the patient's body. At least one adjustable distance element can be adjusted electrically or manually. The distance measuring device may include one or more adjustable distance elements.

[0318] According to one embodiment, at least one adjustable distance element is provided for adjusting the distance. It includes a threaded member for converting rotary motion to linear motion.

[0319] At least one adjustable distance element or steerable implant is X-ray detectable The distance sensor may include an element, whereby the distance adjusted by the at least one adjustable distance element may be The distance can be measured by X-ray imaging and / or by at least one adjustable distance element or manipulator. The operable implant may include an ultrasonically detectable element, thereby allowing for A distance adjusted to at least one adjustable distance element can be measured ultrasonically.

[0320] At least one part of the steerable implant is adapted for subcutaneous placement. and / or the manipulation device may be adapted for subcutaneous placement.

[0321] The manipulation device of the maneuverable implant is configured to manipulate at least one fascial layer of the abdominal wall and It may be adapted to be secured to at least one of the at least one muscle layer.

[0322] The at least one adjustable distance element may be configured to extend beyond at least one fascial layer and at least one minor layer of the abdominal wall. The implant may be adapted to be placed through at least one of at least one muscle layer.

[0323] At least one adjustable distance element in any of the above embodiments may be operable The different parts of the implant may be flexible so that they can bend relative to each other.

[0324] In one embodiment, the receiving unit receives wireless energy in the form of an electric field, a magnetic field or an electromagnetic field. at least one coil adapted to convert electrical energy into electrical energy; or The receiving unit includes a first coil having at least a first number of turns, and at least a second coil having at least a third number of turns. A second coil is provided having two different numbers of turns.

[0325] The steerable implant comprises at least one component of the steerable implant and / or at least one enclosure adapted to hermetically surround the adjustable distance element; You may also have more Ja.

[0326] At least one adjustable distance element in any of the above embodiments receives a current. Conductors may be provided for transmission from the unit to the operating device.

[0327] The steerable implant is a device that allows the user to select at least one parameter of the steerable implant. The control unit may further comprise a control unit for controlling the external unit. The control unit may be adapted for wireless communication, whereby the control unit may be controlled wirelessly from outside the body. It becomes possible to do this.

[0328] According to one embodiment, the receiving unit and at least one adjustable distance element At least one of the may not include a magnetic component.

[0329] At least one enclosure in any of the above embodiments may include two or more enclosures. and at least one adjustable distance element adjusts the distance between the enclosures. may be adapted to adjust

[0330] At least one fixation member of the steerable implant and the steerable implant and an operable implant that allows the distance between at least one of the components to be adjusted. The present invention further provides a surgical kit for performing a surgical procedure, the surgical kit comprising: a first connection portion adapted to connect directly or indirectly to at least a portion of the at least some of the implants and at least one of the operable implants at least one of the operative implants for providing a first distance between the operative implant and the fixation member; and a second connection portion adapted to connect directly or indirectly to another fixing member. at least one first distance element; and directly on at least a portion of the steerable implant. a first connecting portion adapted to connect or indirectly connect to at least one of the operative implants; and a longer length between the at least one portion and the fixation member of at least one of the operable implants. at least one fixation member of the operative implant for providing a second distance and a second connection portion adapted to connect directly or indirectly to A second distance element is provided.

[0331] According to one embodiment of the surgical kit, at least one first distance element and at least one At least one of the second distance elements comprises an X-ray detectable element, At least a portion of the operable implant and at least one of the operable implants The distance between each of the fixation members can be measured on an X-ray image.

[0332] In one embodiment of the surgical kit, at least one first distance element and at least one second distance element; at least one of which comprises an ultrasonically detectable element; This allows at least a portion of the operable implants and the operable implants to be The distance between the at least one fixing member can be measured by ultrasound.

[0333] According to one embodiment, at least one first distance element and at least one second distance element are At least one of the distance elements may be adapted for subcutaneous placement.

[0334] At least one of the at least one first distance element and the at least one second distance element At least one fascia, at least one osteofascia, at least one one cortical bone layer, at least one muscle layer, fibrous tissue, any part of the abdominal wall, or the subcutaneous space and at least one of the areas surrounding the area. stomach.

[0335] The first and second distance elements in any of the above embodiments of the surgical kit. At least one of the following is provided: a) a distance between the abdominal wall muscle layer and the manipulation device of the steerable implant; The device may be adapted to provide:

[0336] At least one of the first and second distance elements of the surgical kit is At least one fascial layer and at least one muscle layer are interposed between the fascial layer and the muscle layer. The device may be adapted to place

[0337] At least one of the first and second distance elements may be different from one another in the steerable implant. The parts may be flexible so that they are movable relative to one another.

[0338] In any of the above embodiments, at least one of the first and second distance elements is It does not need to have any magnetic parts.

[0339] At least one of the first and second distance elements transmits the current to a wireless energy receiving unit. adapted to guide a conductor for transmission from the operating device of the operable implant to the It is okay to do so.

[0340] At least one of the first and second distance elements is a wireless energy receiver within the patient's body. Secures the unit in place and prevents the body from rejecting the wireless energy receiving unit It may be adapted to:

[0341] A system for adjusting the distance of the steerable implant is also provided. The system comprises a surgical kit according to any one of the above embodiments, and an operable input The plant comprises at least one fixed element, as well as: an operating device, a control unit, a wireless energy a receiving unit for receiving radio energy, a coil for receiving radio energy, a magnetic field or an electromagnetic A receiving unit for receiving the field, a magnetic force transmission coupler, an electrical circuit, and an operable implant Push button to control the function of the energy storage device, adjustable distance adjustment element a depressible structure adapted to generate kinetic energy; integrated operating device and receiving unit for receiving a magnetic or electromagnetic field, operable - Patents.com a case for enclosing at least one of the different portions of the implant; and Each case has a different portion of the implant that can be manipulated. The device includes at least one part selected from a list of two or more cases for the purpose of At least one of the first and second distance elements is connected to the fixing member and at least one of the above-mentioned components. The two may be adapted to provide a distance between them.

[0342] At least one fixed member may include: an operating device, a control unit, a wireless energy receiving device, a receiving unit for receiving wireless energy, a coil for receiving a magnetic or electromagnetic field; receiving unit, magnetic transmission coupler, electrical circuitry, and control functions of the operable implant a push button for adjusting the energy storage device, a push button for adjusting the adjustable distance element a pressurizable structure, radio energy adapted to generate kinetic energy, a magnetic field, or Integrated operating device and receiving unit for receiving electromagnetic fields, operable implant a case for enclosing at least one of the different portions of the component, and a two or more for surrounding at least one of the different portions of the steerable implant; At least one of the first and second distance elements may be integrated into the above case. At least one of: a fixing member integrated with one or more of the above components; and The device may be adapted to provide a distance between any one or more of the other components.

[0343] According to one embodiment, at least one of the first and second distance elements is adapted to transmit the current wirelessly. A conductor is provided for transmitting energy from the energy receiving unit to the operating device.

[0344] At least a portion of the steerable implant may be adapted for subcutaneous placement, and The manipulation device may be adapted for subcutaneous placement.

[0345] According to one embodiment, the manipulation device may include at least one fascial layer and at least one fascial layer of the abdominal wall. The implant is adapted to be secured to at least one of at least one muscle layer.

[0346] The receiving unit converts the received wireless energy in the form of an electric field, a magnetic field or an electromagnetic field into electrical energy. The receiving unit may further comprise at least one coil adapted to convert a , a first coil having at least a first number of turns, and at least a second different number of turns. A second coil may be provided having a number.

[0347] The system may include at least one component according to any of the above embodiments and an adjustable and at least one enclosure adapted to hermetically enclose the distance element. You can prepare for this.

[0348] According to one embodiment, the system includes at least one of the components of any of the above embodiments. and at least one enclosure adapted to hermetically surround one of the .

[0349] The control unit of the system controls the parameters of at least one of the operable implants. the control unit may be adapted to wirelessly communicate with an external unit. The control unit may be integrated with the body so that it can be controlled wirelessly from outside the body. become.

[0350] According to one embodiment, the at least one enclosure comprises two or more enclosures. one of the first and second distance elements adjusts the distance between the two enclosures; It may be adapted to:

[0351] A steerable implant for implantation into a patient is provided. The handle comprises a body engaging portion and a manipulation device for applying a force to the body engaging portion. The actuation device receives mechanical work at a force input with a first force and velocity and at a force output with and supplying mechanical work having a different second force and a second velocity to operate the body engaging portion. The gear system includes an implantable gear system adapted to receive the force from an operable force input. a first element connected to a force output section and having a hollow cylindrical shape and a first number of teeth on its outer circumference; a first gear and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear; The operable element may be adapted to engage an interior of the first gear, which The outer side of the first gear is pressed against the inner side of the second gear, thereby The gear teeth are spaced apart at least one location where the teeth do not interengage. Interengaging with the teeth of the second gear, operation of the operable element is by advancing said position. This generates relative rotation between the first gear and the second gear.

[0352] According to one embodiment, the operable element deflects the first gear and The teeth are adapted to remain spaced apart by non-interengaging positions. The teeth of the first gear interengage with the teeth of the second gear at one or more angularly spaced locations.

[0353] The operable element is adapted to deflect the first gear and maintain the first gear deflected. The teeth may be angularly spaced apart separated by non-interengaging positions. Also, the teeth of the first gear interengage with the teeth of the second gear at at least two or more locations.

[0354] According to one embodiment, the manipulation device comprises an implanted actuator for converting electrical energy into mechanical work. The electric motor may be connected to a force input.

[0355] Electric motors are: alternating current (AC) electric motors; direct current electric motors; linear electric motors Motors; axial electric motors; piezoelectric motors; three-phase motors; two-phase or more motors; bimetal and shape memory metal motors.

[0356] The steerable implant according to any one of the above embodiments may be connected to a force input. The device may further include a magnetic coupler, whereby mechanical work of the first force and velocity is applied to the magnetic coupler. A magnetic coupler may be connected to the force output, thereby Thus, mechanical work of a second force and velocity is supplied to the body engaging portion by the magnetic coupler.

[0357] According to one embodiment, the magnetic coupler transmits at least one of a rotational force and a reciprocating force. It is adapted to

[0358] The magnetic coupler is a sealed engine that surrounds at least the gear system of the steerable implant. The closure may include a rotating element disposed inside the closure, the rotating element including at least one or a portion containing a magnet or magnetic or magnetizable material. a magnet or magnetic or magnetized element for directly or indirectly applying a force to a body engaging portion via the magnet or magnetic or magnetized element; The section containing the movable material rotates and exerts a force on a corresponding rotating element outside the sealed enclosure. The signal may be adapted to transmit:

[0359] The magnetic coupler may comprise a rotating element, the rotating element comprising at least one magnet or magnetic or located inside a sealed enclosure comprising a portion containing a magnetizable material; To provide power directly to a rotating element located inside a sealed enclosure, Transmitted from a corresponding external rotating element located outside the enclosure and outside the body. The actuator is adapted to be rotated when it receives a force.

[0360] The steerable implant is adapted to hermetically surround the steerable implant. The device may further comprise an enclosure.

[0361] The gear system in any of the above embodiments may further include a third gear having a hollow cylindrical shape. The inside of the third gear may have the same number of teeth as the outside of the first gear, and the teeth of the third gear , may be adapted to interengage with the teeth of the first gear, whereby the third gear interengages with the teeth of the second gear. Rotation relative to the gears occurs along at least one interengaging position.

[0362] According to one embodiment, the third gear connects to the second gear system, thereby connecting the first and second gears. The first gear system functions as a single gear system. The second gear system is connected to the output of the first gear system. a force input adapted to receive mechanical work at a second force and a second rate from the a force adapted to supply mechanical work to the body engaging portion having a third force and a third velocity; The second gear system includes an operable force output connected to the force input of the second gear system. element and a second gear system having a hollow cylindrical shape and a first number of teeth on its outer circumference. a first gear connected to the shaft and a hollow cylinder having more teeth on its inner surface than the first gear; and a second gear shaped like a gear. The operable element may be adapted to engage the inside of the first gear. The outer side of the first gear may be pressed against the inner side of the second gear. , whereby the teeth of the first gear are spaced apart by at least two positions where the teeth do not interengage. and interengaging with teeth of the second gear at one position, and operation of the operable element is such that By advancing one position further, relative rotation between the first and second gears is generated. To give life to.

[0363] According to one embodiment, the operable element of at least one of the first and second gear systems is Planetary gears, and structures that at least partially use frictional forces to make it possible to transfer rotational forces comprises at least one of the wheels.

[0364] In any of the above embodiments, the force output sections of the first and second gear systems are configured to output the rotational force in a linear fashion. The force may be directly or indirectly connected to a threaded member adapted to convert the force into electrical force.

[0365] According to another embodiment, the manipulable implant is adapted to vary the volume of the reservoir. The reservoir further comprises a movable wall portion having a threaded member directly or indirectly connected to the movable wall portion. may be indirectly connected, whereby manipulation of the threaded member changes the volume of the reservoir. .

[0366] In some embodiments, the steerable implant includes a second reservoir having a movable wall portion. the threaded member includes a second reservoir variable valve for varying the volume of the second reservoir. The movable wall portion of the first reservoir may be connected directly or indirectly to the movable wall portion. The first fluid reservoir is expanded in a first direction by the crested member to increase the volume of the first fluid reservoir. The movement of the movable wall portion of the second reservoir may increase the first The second reservoir may be contracted in the direction to decrease the volume of the second reservoir.

[0367] The first reservoir may be in fluid communication with the first body engaging portion and the second reservoir may be in fluid communication with the second body engaging portion. and manipulation of the manipulation device in a first direction may be in fluid communication with the body engaging portion of the threaded portion. By connecting with the material: transporting fluid from a first reservoir to a first body engaging portion, and The fluid may be transported from the body engaging portion to the second reservoir.

[0368] In any of the above embodiments, the reservoir may be at least one of a circular shape and a donut shape. It may be one shape.

[0369] The steerable implant in any of the above embodiments may further comprise a peristaltic pump. The peristaltic pump includes a hollow member for transporting fluid and a pressure sensor adapted to engage and compress the hollow member. The force output is connected directly or indirectly to the compression member. whereby operation of the operating device may be effected by a compression section such that fluid is transported into the hollow member. Manipulate the material.

[0370] The steerable implant is adapted to limit the rotational force that can be delivered by the steering device. The operating device may further include a friction coupling between the operating device and the body engaging portion. , thereby reducing the rotational force required to actuate the operating device. will be done.

[0371] The steerable implant may further comprise a reservoir for holding hydraulic fluid. The reservoir includes a movable wall portion adapted to vary the volume of the reservoir. The force output of the reservoir may be connected directly or indirectly to the gear system. Change the volume of.

[0372] The electric motor in any one of the above embodiments may be an axial electric motor, a radial electric motor, or a and a linear type electric motor. , three-phase or more phase motors.

[0373] The steerable implant includes a separate receiving unit adapted to receive wireless energy. The receiving unit may further comprise a receiving unit for receiving the received wireless signal in the form of a magnetic field, an electric field or an electromagnetic field. The device may include at least one coil adapted to convert energy into electrical energy.

[0374] The steerable implant comprises a receiving unit and a contact between the patient's skin and the steerable implant. A distance is provided between at least one of the metal part, the magnetic part, or the magnetizable part. The receiving unit may further comprise at least one distance element adapted to The implant remains substantially unaffected by the metallic and / or magnetic parts of the operable implant. will be done.

[0375] At least one distance element may be adjustable.

[0376] The operable implant may be at least partially operably implanted through the fascia, osteofascia, or fascial membrane. , at least one facing the cortical bone, the muscle layer, the fibrous tissue, and the inside of the patient's subcutaneous space. and at least one fixing member for fixing to at least one of the layers. stomach.

[0377] The energy is delivered from outside the patient's body to a steerable implant placed inside the patient's body. The medical system further provides a medical device for transmitting a medical signal to an external drive unit. The external drive unit includes a drive unit and an operable implant. and an operable interface for transmitting force to a magnet or magnetic material of an implant within the patient's body. implant magnet, magnetizable material or magnetic material and a device for inducing currents in the patient's body At least one coil of the steerable implant and at least one magnetic and at least one magnet adapted to be electrically connected to the rotating magnetic field. The medical system provided may be attached directly or indirectly to a medical implant. Dynamic rotational force can be transmitted for indirect power supply.

[0378] The magnet or magnetic material of the steerable implant may be used to steer the steerable implant. The rotating magnetic field of the external drive unit is fixed to an internal rotating structure adapted to rotate along the rotating magnetic field of the external drive unit. You may.

[0379] According to one embodiment, the magnet or magnetic material of the steerable implant is Internally adapted to match the rotating magnetic field of the external drive unit for operating the plant It may be fixed to a reciprocating structure.

[0380] The internal reciprocating structure is adapted to reciprocate by magnetic coupling with a magnetic field that reverses polarity. whereby the magnets of the internal reciprocating structure are formed by an external drive unit. The rotating magnetic field alternates between attraction and repulsion.

[0381] The outer rotating structure may have a larger diameter than the inner rotating structure, and the magnet may be A radial force is applied to the magnets, allowing the magnets in the body to rotate along with the magnets in the external rotating structure. The magnetic force exerted by the inner structure is applied to the outer structure, thereby forcing the inner structure against the outer structure, and the magnetic force is applied to the patient's skin. They may be positioned to reduce the risk of skin damage.

[0382] According to one embodiment, at least one of the internal rotating structure and the external rotating structure comprises: Reduces axial forces created by magnetic couplings between internal and external magnets and / or magnetic materials The device may include a repelling magnet adapted to generate a squeezing effect on the patient's skin. The results are reduced.

[0383] The force of the repulsive or attractive magnet may be adjustable, thereby reducing the amount of pressure applied to the patient's skin. The effect can be adjusted.

[0384] The attracting magnet in any of the above embodiments may be an attracting electromagnet, and the force of the repelling magnet may be an electromagnetic force. This may be adjusted by varying the current to the stone.

[0385] According to one embodiment, the repulsive magnets are permanent magnets, and the force of the repulsive permanent magnets is determined by the This may be adjusted by varying the distance to or position relative to the patient's skin.

[0386] The internal rotating structure may comprise an internal spherical cap, and the magnet or magnetic material of the internal rotating structure may be The outer rotating structure may be positioned outside the inner spherical cap. the magnet or magnetic material of the outer rotating structure is located inside the outer spherical cap. The rotational force may be determined by a magnetic coupling between the inner and outer spherical caps. The beam can be transmitted radially.

[0387] According to one embodiment, the inner spherical cap has a centrally located magnet and the outer spherical cap The cap has a magnet located in the center, and the magnets in the inner and outer spherical caps exhibit a repulsive force to each other. whereby the internal magnet and / or magnetic material is adapted to be coupled with the external magnet and / or The axial force created by the magnetic coupling between the magnetic material is reduced, thereby The squeezing effect on the skin is reduced.

[0388] The medical system may further include a gear system connected to the internal rotating structure. and receiving mechanical work of a given force and velocity and supplying mechanical work with a different force and velocity. It may be adapted as follows.

[0389] The gear system includes: an operable element; a first gear having a first number of teeth on its exterior; and a first The operable element may comprise a second gear having a greater number of teeth thereon than the gear. the element may be adapted to press an outer side of the first gear against an inner side of the second gear, This allows the teeth of the first gear to be spaced apart by at least two positions where the teeth are not interengaged. The gear teeth are interengaged with the teeth of the second gear in one position, and operation of the operable element causes the gear teeth to interengage with the teeth of the second gear in one position. The advancement causes relative rotation between the first gear and the second gear.

[0390] According to one embodiment, the steerable implant comprises a steering device and a body engaging portion. The operating device may comprise a hydraulic operating device. The body engaging portion may be hydraulically operated. The operable implant may be a hydraulic pump, a hydraulic fluid The system may further comprise a reservoir adapted to hold a fluid, the reservoir being connected to a hydraulic pump. The hydraulic pump may be adapted to transport hydraulic fluid from the reservoir to the body engaging portion. stomach.

[0391] The hydraulic pump may comprise a movable wall portion of the reservoir, the hydraulic pump moving the movable wall portion. By moving the valve to change the volume of the reservoir, hydraulic fluid is released from the reservoir to a hydraulically operated body. It may be adapted for delivery to a body engaging portion.

[0392] According to one embodiment, the operating device comprises a stationary part having a plurality of coils and a plurality of magnets. an electric motor having a moving part which can move the coils in sequence, The stone is magnetically propelled, which propels the moving part. The operating device tightly connects the coil of the stationary part. The stationary portion may further comprise an enclosure adapted to enclose the stationary portion in a closed state. A seal is formed between the coil and the propelled moving part, which contains the magnet. The tube is sealed from body fluids when implanted.

[0393] The medical system may further comprise an implantable generator, the implantable generator comprising: an operable At least one generating magnet is provided, which is connected to the magnet or magnetic material of the implant, The movement of the magnet or magnetic material causes the moving generator part to move, and at least and at least one coil magnetically coupled to the power generating magnet, thereby Movement of the moving generating part relative to the coil induces a current in the coil.

[0394] According to one embodiment, the movable generating part is adapted to undergo a rotational movement.

[0395] The implantable generator may be an implantable rotary generator, the movable generator portion performing a rotary motion. The at least one coil may be adapted to be magnetically coupled to the at least one magnet. Preferably, whereby the rotational movement of the movable generating part induces a current in at least one coil. .

[0396] The movable generating portion may be adapted to undergo reciprocating motion.

[0397] The implantable generator may be an implantable linear generator, and the movable generator part may be a reciprocating wherein the at least one coil is magnetically coupled to the at least one magnet. whereby reciprocating motion of the movable generating portion induces a current in at least one coil. do.

[0398] According to one embodiment, the steerable implant comprises a plurality of coils arranged in a circular pattern. , whereby a rotating magnetic field generated by an external driving unit sequentially supplies current to multiple coils. To guide.

[0399] The medical system includes at least one battery or energy storage device connected to at least one coil. The device may further include an electric storage device, whereby the electric current induced in the at least one coil is The current can be stored as electrical energy in a battery.

[0400] The medical system includes an enclosure adapted to hermetically surround a steerable implant. The implant may further comprise a seal, which seals the operable implant from the patient's bodily fluids. The medical system according to any one of the above embodiments further comprises a wireless communication unit. the wireless communication unit receives a wireless communication signal from an external unit; and and transmitting a wireless communication signal to an external unit.

[0401] The steerable implant in any of the embodiments is adapted to be implanted subcutaneously. That's fine.

[0402] According to one embodiment, the steerable implant comprises a steering device and a body engaging portion. The operating device comprises a movable part that is directly or indirectly connected to a body engaging part, The moving part is connected to at least one magnet, magnetizable material or magnetic material. The moving part may be adapted to be magnetically coupled to a moving magnetic field outside the patient's body, whereby the moving part The operating device further comprises an implantable generator, the implantable generator being adapted to move along the moving magnetic field. A suitable generator is connected to the moving part and adapted to convert the motion into an electric current, thereby generating a current for the moving part. The movement of the actuator operates the body engaging portion to generate an electrical current.

[0403] At least one magnet, magnetizable material or magnetic material may be connected to the rotating structure, and the patient The rotating structure is adapted to be magnetically coupled to a rotating magnetic field outside the skin of a subject, whereby the rotating structure It rotates along the magnetic field.

[0404] At least one magnet, magnetizable material, or magnetic material is attached to a structure adapted for reciprocating motion. The device may be adapted to magnetically couple to a reciprocating magnetic field outside the patient's skin, thereby The reciprocating structure moves along the reciprocating magnetic field.

[0405] The implantable generator may further comprise at least one magnet and at least one coil. The motion of the at least one magnet relative to the at least one coil is At least one magnet of the moving part may be located outside the patient's body. At least one magnet in an implantable generator may be adapted to be magnetically coupled to a moving magnetic field. It also functions as a

[0406] According to one embodiment, a battery or energy storage device adapted to be charged by an implantable generator is provided. The battery or energy storage means is adapted to power the body engaging portion. It may be adapted as follows.

[0407] The steerable implant is a device that allows the user to select at least one parameter of the steerable implant. The device may further comprise a control unit for controlling the controller.

[0408] The control unit is connected to a battery or energy storage means, whereby the battery is connected to the control unit. Powers the vehicle.

[0409] The operating device may comprise a hydraulic operating device.

[0410] According to one embodiment, the body engaging portion may be a hydraulically operable body engaging portion. The operable implant comprises a hydraulic pump and a reservoir adapted to hold a hydraulic fluid. The hydraulic pump may further include a reservoir connected to the hydraulic pump. It may be adapted for delivery from the reservoir to the body engaging portion.

[0411] The hydraulic pump may comprise a movable wall portion of the reservoir, the hydraulic pump moving the movable wall portion. A body engagement part that can hydraulically operate hydraulic fluid from the reservoir by moving the valve to change the volume of the reservoir. The device may be adapted to deliver the fluid in minutes.

[0412] According to one embodiment, the hydraulic pumps include: peristaltic pumps, diaphragm pumps, gear pumps, and velocimetry pumps. The pump may be a hydraulic pump selected from the group consisting of a hydraulic pump, ...

[0413] The manipulation device in any of the above embodiments inputs mechanical work of a first force and velocity. Gear system adapted to receive as force and output mechanical work with different forces and speeds may be provided.

[0414] The gear system of the operating device includes: an operable element; a center gear having a first number of teeth on its outer circumference; a hollow cylindrical first gear; and a hollow cylinder having more teeth on its inner surface than the first gear. The manipulable element may comprise a second gear having a shape similar to that of the first gear. the outer side of the first gear may be pressed against the inner side of the second gear; This allows the teeth of the first gear to be spaced apart by at least two positions where the teeth are not interengaged. In one position, the operable element interengages with the teeth of the second gear. By advancing the gear, relative rotation between the first gear and the second gear is generated.

[0415] According to one embodiment, the operable element is connected to the moving part, thereby controlling the movement of the moving part. The movement operates the gear system.

[0416] According to one embodiment, the steerable implant is configured to surround the steerable implant. The device further comprises an enclosure adapted for

[0417] In any of the above embodiments, the moving parts of the gear system are adapted to be placed subcutaneously. good.

[0418] The manipulation device may be configured to manipulate at least one of fascia, fibrous tissue, skin, muscle layer, or abdominal wall or It may be adapted to be anchored to any subcutaneous tissue within the abdomen.

[0419] The operating device may be provided with a distance measuring device adapted to provide a distance between the operating device and the moving part. You can further prepare the ingredients.

[0420] The distance element is designed to control the position of the moving part, preventing the body from rejecting the moving part. May be adapted.

[0421] According to one embodiment of the steerable implant, the steerable implant comprises an external unit. The device further comprises a wireless communication unit adapted to wirelessly communicate with the device.

[0422] According to one embodiment, the system includes a drive mechanism for providing a driving force to the steerable implant. An external unit is further provided which comprises an external drive unit.

[0423] The external drive unit may comprise a moving magnet adapted to generate a moving magnetic field, or The coils may comprise coils, the sequential energization of which creates a moving magnetic field.

[0424] According to one embodiment, the external drive unit is adapted to communicate wirelessly with the steerable implant. The wireless communication unit may further include a wireless communication unit adapted for transmitting the wireless communication signal.

[0425] There is also provided an operable hydraulic implant, the operable hydraulic implant comprising: , a body engaging portion, and a powered operating device in fluid communication with the body engaging portion. The operating device: holds hydraulic fluid and is adapted to move to vary the volume of the reservoir. a reservoir having a movable wall portion, thereby transporting hydraulic fluid from the reservoir to the body engaging portion; and an operating member connected to the movable wall portion, the operation of which changes the volume of the reservoir. The movable wall portion has an operating member that can be changed by changing the outer dimensions and shape of the operating member. The movable wall portion includes a flexible enclosure adapted to surround the movable wall portion and the operating member. may be adapted to move inside the enclosure, whereby the volume of the reservoir is The outer dimensions of the hydraulic implant can be manipulated by the movement of the movable wall section inside the enclosure. can be changed by influencing

[0426] The reservoir comprises a manual portion adapted to be manually depressed from outside the patient's body, This allows fluid to flow from the reservoir to the body-engaging portion of the manually operable hydraulic implant. The manual portion is transported to the Allows for manual override and / or additional pressure to reservoir and / or emergency operation. You may.

[0427] The reservoir in any of the above embodiments may be substantially circular or oval.

[0428] According to one embodiment, the average thickness of the movable wall portion is less than the average thickness of the manual portion of the reservoir.

[0429] According to one embodiment of the operable hydraulic implant, the reservoir is made of Parylene ( Contains silicone coated with PEG-1000 (registered trademark).

[0430] In one embodiment, the manipulation device is adapted to convert a radial rotational force into an axial reciprocating force. The threaded member may be connected to a threaded member, which in turn may be connected to an operating member.

[0431] The operable hydraulic implant includes an electrical circuit and a control circuit for controlling the operable hydraulic implant. The device may further include a control unit for controlling the device.

[0432] An operable hydraulic implant is a device that pumps hydraulic fluid into a reservoir from outside the patient's body. The device may further include an injection port for the injection of the liquid.

[0433] At least a portion of the operable hydraulic implant may be adapted to be implanted subcutaneously. stomach.

[0434] The manipulable hydraulic implant is adapted to move at least one fascia within the body, at least One osteofascia, at least one cortical bone layer, at least one muscle layer, fibrous tissue, abdominal wall Any part of the subcutaneous space, any part of the subcutaneous space, and at least one of the surrounding areas and adapted to directly or indirectly fix at least a portion of the hydraulic implant operable by means of the hydraulic actuator. The device may further comprise at least one fixed member coupled thereto.

[0435] The manipulable hydraulic implant includes a second body engaging portion and a fluid The device may further include a second reservoir in communication with the device. The hydraulic fluid may be moved by a movable wall portion adapted to move to change the volume of the hydraulic fluid. The second reservoir is delivered to the second body engaging portion.

[0436] The movable walls of the first and second reservoirs are adapted to increase or decrease the size of the reservoirs. The first reservoir may be connected to the same operating member, and the volume of the first reservoir may change in the opposite direction to the volume of the second reservoir. The device may be adapted to

[0437] According to one embodiment, the operating device comprises an electric motor connected to the operating member. Motors include: alternating current (AC) electric motors; direct current electric motors; linear electric motors; Axial type electric motors; piezoelectric motors; motors with two or more phases; three-phase motors; bimetal motors and a shape memory metal motor.

[0438] According to one embodiment, operation of the electric motor causes the movable walls of both the first and second reservoirs to Make an impact.

[0439] The manipulation device receives mechanical work at a first force and velocity and applies a different second force and velocity to the mechanical work. The gear system may comprise an electric motor adapted to provide mechanical work. and a force output part directly or indirectly connected to the operating member. good.

[0440] The gear system comprises: an operable element; a first gear having a hollow cylindrical shape and a first number of teeth on its outer circumference; a first gear; and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear. The operable element includes a wheel adapted to engage the inside of the first gear, thereby The outer side of the first gear is pressed against the inner side of the second gear, thereby forcing the teeth of the first gear has a second tooth at at least one location separated by a location where the teeth do not interengage. The operation of the operable element interengages with the teeth of the wheel, and advances the position of the first This generates relative rotation between the first gear and the second gear.

[0441] The gear system is connected to a threaded member adapted to convert a radial rotational force into an axial reciprocating force. The threaded member may be connected to an operating member.

[0442] According to one embodiment, the manipulation device is adapted to be positioned outside the patient's body. a magnetic coupler adapted to magnetically couple with an external portion of the magnetic coupler, thereby The inner portion of the magnetic coupler moves along the outer portion of the magnetic coupler to manipulate the movable wall portion.

[0443] The steerable hydraulic implant is connected to an external unit positioned outside the patient's body. It may further comprise a wireless communication unit for wireless communication.

[0444] The operable hydraulic implant is adapted to store electrical energy in the patient's body. The device may further include at least one battery.

[0445] A medical system comprising an operable implant adapted for placement inside a patient's body. The steerable implant further provides a movable structure adapted to reciprocate. The movable structure comprises at least one magnet or magnetic material, and the movable structure is a reciprocating The device may be adapted to magnetically couple to an external unit that generates a fluctuating magnetic or electromagnetic field, The movable structure is caused to reciprocate along a reciprocating magnetic or electromagnetic field.

[0446] According to one embodiment, the steerable implant is connected to the movable structure. and a generator adapted to convert the reciprocating motion of the rotor into electrical energy.

[0447] The generator comprises: a movable generating part having at least one magnet and connected to the movable structure; The at least one coil may be magnetically coupled to the at least one magnet. Movement of the moving generating part relative to the coil induces a current in the coil.

[0448] According to one embodiment, at least one magnet of the movable generating part is a magnet of the movable structure. is.

[0449] The steerable implant includes a power conversion member adapted to convert a reciprocating force into a rotational force. Further, the generator may be a rotary generator connected to a power conversion member.

[0450] The generator comprises: a movable structure having at least one magnet and adapted to undergo reciprocating motion; and a magnetic coupling with at least one magnet, thereby and at least one coil in which a current is induced by the reciprocating motion of the power generating portion. , may be a linear generator.

[0451] According to one embodiment, the movable structure is a spring loaded in one direction, Therefore, the magnetic force from the magnetic coupler connected to the external unit in one direction and the negative force in the opposite direction The reciprocating motion is caused by a moving part that is a loaded spring.

[0452] The operable implant comprises a battery or energy storage device connected to a generator unit. the battery being adapted to store electrical energy generated within the generator unit. It is okay to do so.

[0453] According to one embodiment, the steerable implant comprises a body engaging portion connected to a movable structure. whereby movement of the movable structure manipulates the body engaging portion.

[0454] The medical system in any of the above embodiments includes a steerable implant in a sealed state. The implantable emitter may further comprise an enclosure adapted to surround the emitter. The machine is sealed from the patient's body fluids.

[0455] A medical system according to any one of the above embodiments: and transmitting a wireless communication signal to an external unit. It may further comprise an adapted wireless communication unit.

[0456] The steerable implant in any of the above embodiments is adapted to be implanted subcutaneously. The implant may be placed in a subcutaneous location in the abdomen.

[0457] According to one embodiment, the steerable implant is a steerable implant. a magnetic field applied to the outside of the patient's skin and adapted to affect at least one magnet or magnetic material; an external unit comprising an external drive unit adapted to generate a kinetic magnetic field; This causes the magnet or magnetic material to reciprocate along the reciprocating magnetic field of the external unit.

[0458] The external drive unit is a reciprocating structure having at least one magnet, electromagnet, or magnetic material. The reciprocating movement of the reciprocating structure may be controlled by a magnet or a movable structure of the implantable generator. may affect the magnetic material causing it to move back and forth.

[0459] According to one embodiment, the external drive unit comprises at least one magnet, electromagnet or magnetic material. The implantable generator may include a rotatable structure comprising: a rotor; The magnet or magnetic material of the structure is affected to cause it to move back and forth.

[0460] The rotatable structure of the external drive unit comprises: a first magnet or electromagnet that generates a positive magnetic field; and A second magnet or electromagnet may be provided to create a negative magnetic field, thereby The magnet or magnetic material of the implant can be rotated to operate the first and second magnets or electromagnets. and causes it to move back and forth.

[0461] According to one embodiment, the external drive unit generates magnetic fields having alternating positive and negative polarities. The implantable generator includes an electromagnet for reciprocating the magnet or magnetic material of the implantable generator.

[0462] According to one embodiment, the steerable implant inputs mechanical work at a first force and rate. Gear system adapted to receive as force and output mechanical work with different forces and speeds The gear system further comprises: an operable element, a first number of teeth on an outer circumference, a center a hollow cylindrical first gear and a hollow cylindrical gear having more teeth on its inner surface than the first gear; a second gear having a shape similar to that of a first gear, and the operable element is adapted to engage the inside of the first gear. , whereby the outside of the first gear is pressed against the inside of the second gear, thereby The teeth of the first gear are positioned at least at one location separated by a location where the teeth do not interengage. and the second gear teeth interengage with the teeth of the second gear, and operation of the operable element advances the position. This generates relative rotation between the first gear and the second gear.

[0463] According to one embodiment, the steerable implant comprises a steering device and a body engaging portion. The operating device includes a stationary part having a plurality of coils and a movable part having a plurality of magnets. an electric motor, whereby sequential energization of the coils magnetically propels the magnet; The operating device is a hermetically sealed device that surrounds the coil of the stationary part. The magnet further includes an enclosure adapted to house the stationary portion and the magnet. The space between the propelled moving part and the stationary coil is sealed, making the coil tightly sealed from body fluids when implanted. It will be closed.

[0464] According to one embodiment, the external unit comprises: a receiver of a wireless communication signal from the operable implant; Faith, and transmitting a wireless communication signal to an operable implant. It further comprises an adapted wireless communication unit.

[0465] A medical system for forming a magnetic coupling between an external unit and an operable implant. The medical system includes at least one of: a magnet, a magnetic material, and a magnetizable material. and a magnet, a magnetic material and a steerable implant comprising the magnet, the magnetic material and the steerable implant. an external permanent magnet adapted to be magnetically coupled to at least one of the magnetizable materials; The external unit includes at least one of the external electromagnets. or adjustable, thereby allowing the squeeze force exerted on the patient's skin to be modified or adjusted. In this way, the medical system reduces the risk of damaging the patient's skin.

[0466] According to one embodiment, the external magnet comprises at least one permanent magnet, and the external unit comprises: The skin contact area and the distance between the skin contact area and the permanent magnet, or the position relative to the skin contact area An adjustment device for adjustment is further provided.

[0467] According to one embodiment, the steerable implant comprises: a first magnet; a first portion of magnetic material; and at least one of the portions of the first magnetizable material; and a second magnet, a second magnetic The external unit comprises at least one of a section of material and a second section of magnetizable material. The magnet comprises: at least one first magnet or first electromagnet, and at least one second magnet or The first magnet of the steerable implant comprises two electromagnets, a magnetic material and a magnetizable material. At least one of the portions is attracted to a first magnet or a first electromagnet of the external unit. a second magnet, a magnetic material and a magnetizable material of the implant adapted to be manipulated; At least one of the sections has an external pressure sensor to balance the squeezing force exerted on the patient's skin. It may be adapted to be repelled by a second magnet or a second electromagnet of the unit.

[0468] According to one embodiment, the external unit may perform the following at different locations or at different times at the same location: The implant is adapted to generate first and second magnetic fields having different polarities. The components are adapted to generate first and second magnetic fields at different positions and with different polarities. Preferably, the first magnetic field is coupled to the second magnetic field and the steerable implant and external unit. , thereby reducing the squeezing effect on the patient's skin. It will be reduced.

[0469] According to one embodiment, the external unit comprises at least one electromagnet, A control unit is provided for controlling the magnetic force of the electromagnet.

[0470] According to one embodiment, the medical system includes an interface operable from an external unit by magnetic coupling. The external unit is adapted to transmit motive power to the plant, and the external unit receives power from the external drive unit. Applying force to at least one of the magnet, magnetic material, and magnetizable material of the operable implant forming a moving magnetic field adapted to magnetically couple to a steerable implant for transmitting a signal; The device includes an external drive unit adapted to

[0471] According to one embodiment, the medical system is adapted to transmit rotational force through the patient's skin. and an external drive unit forms a rotating magnetic field adapted to be magnetically coupled to the internal rotating structure. At least one permanent magnet and at least one electromagnet are used to form the magnet. an outer rotating structure having one of the inner rotating structure and the outer rotating structure; The inner and outer rotating structures are magnet-induced, causing a squeeze to the patient's skin. The torque may be adjusted to allow for rotational force without applying excessive force to the patient's skin. becomes transmittable.

[0472] According to one embodiment, the outer rotating structure has a larger diameter than the inner rotating structure, The radial force that allows the magnets of the rotating structure to rotate along with the magnets of the outer rotating structure. The magnets are positioned so that the axial force is stronger than the force pressing the inner structure against the outer structure.

[0473] According to one embodiment, the external unit comprises a first and a second and adapted to generate a rotating magnetic field having both a magnetic field and a rotating magnetic field selected from the following options: It exists in at least one form.

[0474] 1. The first magnetic field rotates the external rotating structure according to at least embodiment 7. The first magnetic field is formed by angularly discontinuous magnetic fields, a central first magnetic field, and a peripheral substantially continuous magnetic field. a first magnetic field that is continuous with the first magnetic field and that allows rotation of the internal rotating structure; and forming at least a part of the air bonding force, and the rotational movement and rotation of the external rotating structure. The structure is involved in at least one of the rotational motions of the magnetic field generated by the structure, and the rotational motion of the magnetic field ... The squeezing force is reduced by the first magnetic field.

[0475] 2. The first magnetic field is formed by one or more negative-pole permanent magnets located on both the internal and external rotating structures. The first magnetic field is formed by the stone and is angularly discontinuous, the central first magnetic field, and the surrounding solid 8. The internal rotation of embodiment 7, having at least one qualitatively continuous first magnetic field. At least a portion of the magnetic coupling force that allows the structure to rotate is additionally formed, and the external circuit The rotational motion of the rotating structure and the rotational motion of the magnetic field formed by the stationary rotating structure and a first magnetic field reduces the squeezing force on the patient's skin. , the first magnetic field.

[0476] 3. The first magnetic field is formed by one or more negative-pole permanent magnets located on both the internal and external rotating structures. The magnets are formed by the stones, creating a repulsive magnetic force between the inner and outer rotating structures, and the permanent magnets are a periodically intermittent first magnetic field, a central first magnetic field, and a substantially continuous first magnetic field at the periphery; a first magnetic field adapted to form at least one of the magnetic fields;

[0477] 4. The first magnetic field is generated by one or more negative-pole permanent magnets disposed in the internal rotating structure. The permanent magnet generates an angularly intermittent second magnetic field, a central second magnetic field, and a substantially surrounding and an internal rotating structure adapted to generate at least one continuous second magnetic field. the magnetic field formed by the magnetic coupling element is adapted to form a magnetic coupling force toward the external unit. First magnetic field.

[0478] 5. The second magnetic field is formed by at least two or more coils and two or more positive polarity permanent magnets. and adapted to be formed by an external structure having one permanent magnet; and The outer rotating structure rotates to rotate the inner rotating structure by the rotating magnetic field according to embodiment 7. and forming a magnetic coupling force; and two or more coils are provided, and the external rotating structure is The magnetic field of the external rotating structure rotates as the coils are energized. The magnetic coupling force that rotates the internal rotating structure by rotating the internal rotating structure with the rotating magnetic field When forming at least a part of the The second magnetic field, at least one of the central second magnetic field and the surrounding substantially continuous second magnetic field. Forming at least one second magnetic field.

[0479] 6. The second and first magnetic fields are adapted to be formed at least in part in an external structure. , angularly intermittent second and first magnetic fields, a central second or first magnetic field, and a surrounding real magnetic field. 1. adapted to form at least one of a qualitatively continuous second or first magnetic field; At least one of one or more coils, one or more positive permanent magnets, and one or more negative permanent magnets and both the second and first magnetic fields are generated by one or more magnetic fields disposed within the internal rotating structure. The negative pole permanent magnet is formed, and the permanent magnet generates an angularly intermittent second magnetic field, a central second magnetic field and a substantially continuous second magnetic field around the The magnetic field formed by the internal rotating structure is adapted to the following options: two or more of the internal structure and two or more positive permanent magnets magnetically coupled to the negative permanent magnets of the external rotating structure. The rotating magnetic field rotates the internal rotating structure, and at least a portion of the magnetic coupling force is generated. In the case of forming: two or more negative poles magnetically coupled with two or more negative pole permanent magnets of the internal structure The external rotating structure is provided with a permanent magnet, and the external rotating structure rotates to generate the internal magnetic field by the rotating magnetic field according to embodiment 7. When the rotating structure is rotated to form at least a part of the magnetic coupling force; and an embodiment Two or more coils are magnetically coupled to two or more negative permanent magnets of the internal structure according to 7. The external rotating structure is stationary, and the magnetic field of the external rotating structure sequentially energizes the coil. The inner rotating structure is rotated by the rotating magnetic field of embodiment 7, and the inner rotating structure is rotated by the rotating magnetic field of embodiment 7. When forming at least a part of the magnetic coupling force that enables the rotation of the rolling structure, a second magnetic coupling element adapted to generate a magnetic coupling force toward the external unit in at least one situation; and the first magnetic field.

[0480] 7. The second and first magnetic fields are adapted to be rotated at least in part by the internal structure. The combined and angularly intermittent second and first magnetic fields, the central second or first magnetic field, and the peripheral adapted to form at least one of a substantially continuous second or first magnetic field at one or more coils, one or more positive permanent magnets, and one or more negative permanent magnets The second and first magnetic fields are provided at least one.

[0481] In one embodiment, the internal rotating structure comprises an internal spherical cap, and the magnetic The stone or magnetic material is disposed on the exterior of the inner spherical cap. a magnet of the outer rotating structure is disposed inside the outer spherical cap, The rotational force is transmitted radially by the magnetic coupling between the inner and outer spherical caps. This becomes possible.

[0482] According to one embodiment, the medical system further comprises an implantable generator, is at least one of a magnet, a magnetic material, and a magnetizable material of the steerable implant at least one power generating magnet adapted to be magnetically coupled to the magnet, the movement of at least one of the magnetic material and the magnetizable material causes a moving generating portion to move, or or a power generating part, and at least one movable power generating part, The magnet is magnetically coupled to the coil, so that the movement of the movable generating part relative to the coil generates electricity. It comprises at least one coil in which a current is induced.

[0483] According to one embodiment, the movable generating part is adapted to undergo a rotational movement.

[0484] According to one embodiment, the implantable generator is an implantable rotary generator, having a movable generating portion. is disposed on an internal rotating structure and adapted to undergo rotational motion, and at least one coil The rotating motion of the moving generating part is magnetically coupled to at least one magnet. Induce a current in one coil.

[0485] According to one embodiment, the movable generating part is adapted to undergo a reciprocating motion.

[0486] According to one embodiment, the implantable generator is an implantable linear generator, and the mobile generator is The at least one coil is adapted to move in a reciprocating manner relative to the at least one magnet. and adapted to be magnetically coupled to at least one of the movable generating parts, Induce a current in the coil.

[0487] According to one embodiment, the external unit is adapted to generate a rotating magnetic field and is operable to The implant is adapted to be magnetically coupled to a rotating magnetic field and includes a plurality of coils arranged in a circular arrangement. This causes the rotating magnetic field to sequentially induce currents in the multiple coils.

[0488] In one embodiment, the external unit comprises a wireless energy transmitter and is operable to operate the implant. The device further comprises a wireless energy receiver, by which wireless energy is transmitted from the external unit to the internal unit. The wireless energy transmitter may include a wireless energy transmission coil; The wireless energy receiver may comprise a wireless energy receiving coil.

[0489] The medical system further comprises at least one battery adapted to store electrical energy. You can prepare.

[0490] According to one embodiment, the external unit comprises a wireless communication unit, and the medical system a communication unit by which the external unit and the operable implant can communicate wirelessly It becomes Noh.

[0491] The medical system includes an enclosure adapted to hermetically surround a steerable implant. The implant may further comprise a seal, which seals the operable implant from the patient's bodily fluids. will be done.

[0492] According to one embodiment, the steerable implant may be adapted for subcutaneous implantation.

[0493] There is further provided a steerable implant, which: and adapted to convert the force and velocity into mechanical work and to output mechanical work at a first force and velocity. and receiving mechanical work of a first force and velocity from the electric motor as an input. and a gear system adapted to output mechanical work having a second different force and speed. The medical system includes: outputting mechanical work from an electric motor having a first force and a first velocity. a first force output adapted to receive a second force and a second speed output from the gear system; It further comprises a second force output adapted to output mechanical work.

[0494] According to one embodiment, the steerable implant further comprises an implantable generator, The first power output connects to an implantable generator to generate an electrical current inside the body.

[0495] According to one embodiment, the steerable implant comprises a second force output portion of the steering device. It further comprises an operable body engaging portion connected to and operable thereby.

[0496] The actuatable body engaging portion may be a hydraulically actuatable body engaging portion, The device includes a hydraulic pump for delivering hydraulic fluid to a hydraulically operable body engaging portion. The device may further include a

[0497] The hydraulic pump of the operable implant includes a reservoir adapted to contain a hydraulic fluid. the reservoir may comprise a movable wall portion for varying the volume of the reservoir; The wall portion may be connected to a manipulation device, whereby the manipulation device can manipulate the movable wall portion. do.

[0498] The hydraulic pumps include: at least one valveless pump; at least one valve pump; at least one peristaltic pump; at least one membrane pump; at least one gear pump; and The pump may be a hydraulic pump selected from at least one bellows pump.

[0499] According to one embodiment, at least one of the first and second force outputs is adapted for radial rotation. The reservoir is connected to a threaded member adapted to convert the force into an axial reciprocating force. To change the thickness of the reservoir, the threaded member may be connected directly or indirectly to a movable wall portion of the reservoir. stomach.

[0500] The threaded member may be directly or indirectly mechanically connected to the body engaging portion, thereby The body engaging portion is actuated via a threaded member.

[0501] According to one embodiment, the gear system of the operable implant is connected to: a first force output; a first gear having a hollow cylindrical shape with a first number of teeth on its outer circumference; and and a second gear having a hollow cylindrical shape and having more teeth on its inner surface than the first gear, The movable element is adapted to engage the inside of the first gear, thereby engaging the outside of the first gear. The first gear is pressed against the inside of the second gear, causing the teeth of the first gear to interengage. and interengaging with the teeth of the second gear at at least one position separated by a non-interengaging position. and the operation of the operable element is to advance the position to move the first gear and the second gear. The first gear generates mechanical work with a force and velocity that produces relative rotation between the gears. connected to a second force output for outputting a force.

[0502] According to one embodiment, the operating device further comprises a second gear system, the second gear system being and receiving mechanical work of a second force and speed from the gear system of the second gear as an input, and The actuator is adapted to output mechanical work having a degree of freedom.

[0503] According to one embodiment, the manipulation device is a gear from a second gear system having a third force and velocity. It further comprises a third force output adapted to output mechanical work.

[0504] The second gear system includes: an operable element connected to the second output; and an outer gear having a first number of teeth. a hollow cylindrical first gear having a circumference of the first gear and a second gear having a larger number of teeth on the inner surface than the first gear; and a second gear having a hollow cylindrical shape, the operable element being located inside the first gear. whereby the outer side of the first gear is adapted to engage with the inner side of the second gear. The teeth of the first gear are pressed together, so that the teeth of the first gear are spaced apart by a point where they do not interengage. and interengaging the teeth of the second gear at at least one location, and operating the operable element by: By advancing the position, relative rotation between the first gear and the second gear is generated. and the first gear is connected to a third force output shaft for outputting mechanical work having a third force and velocity. It is connected to the power section.

[0505] According to one embodiment, the steerable implant is adapted to surround the steering device. The device further includes an enclosure.

[0506] The enclosure may include first and second penetrations, the first penetration providing a first force output. The first penetrating portion may be adapted to a second force output portion, and the second penetrating portion may be adapted to a second force output portion.

[0507] According to one embodiment, the enclosure comprises first, second and third through-hole outputs. .

[0508] According to one embodiment, the enclosure comprises first, second and third penetrations. The penetration is adapted to a first force output, the second penetration is adapted to a second force output, and the third penetration is adapted to a second force output. The third penetration is adapted to a third force output. The first force output connects the first body engaging portion to the third force output. a second force output connected to a first hydraulic pump for operating the second body engaging element; It may be connected to a second hydraulic pump for operating the portion.

[0509] According to one embodiment, the first force output comprises a first rotatable shaft and the second force output comprises a The output includes a second rotatable shaft.

[0510] The enclosure is adapted to provide a seal between the enclosure and the first rotatable shaft. a first sealing member that is joined to the enclosure and a second rotatable shaft that seals between the enclosure and the second rotatable shaft; The first and second sealing members may be adapted to The two sealing members may rotate the rotatable shaft.

[0511] The first rotatable shaft is adapted to be positioned inside the second rotatable shaft. Alternatively, the second rotatable shaft may be positioned inside the first rotatable shaft. May be adapted.

[0512] According to one embodiment, the first force output comprises a first rotatable shaft and the second force output comprises a The output includes a second rotatable shaft and the third force output includes a third rotatable shaft. Prepare.

[0513] According to one embodiment, the enclosure comprises: an enclosure; a first rotatable shaft; and a first sealing member adapted to seal between the enclosure and the second rotatable shaft; a second sealing member adapted to seal between the enclosure and a third rotatable sleeve; and at least one third sealing member adapted to seal between the shaft and the The first and second sealing members rotate the rotatable shaft.

[0514] The first and second rotatable shafts are adapted to be positioned inside the third rotatable shaft. or the second and third rotatable shafts may be fitted inside the first rotatable shaft. The first and third rotatable shafts may be adapted to position the second rotatable shaft. The stent may be adapted to be positioned inside the shaft.

[0515] The steerable implant comprises at least one actuator adapted to energize an electric motor. It may include one implantable battery.

[0516] The steerable implant receives wireless energy transmitted from outside the patient's body. The receiving unit may further comprise a receiving unit adapted to charge a battery. It is okay to do so.

[0517] According to one embodiment, the electric motor may be: an alternating current (AC) electric motor, a direct current electric motor motor, linear electric motor, axial electric motor, radial motor, three-phase motor, 2 a motor selected from a multi-phase or higher motor, a piezoelectric motor, a bimetal motor, and a shape memory metal motor; It is an electric motor.

[0518] Enclosures may be made of: carbon material, boron material, a mixture of materials, Peek® material , material alloys, metal materials, titanium, aluminum, ceramic materials, polymer materials, poly urethane, and Parylene® coated silicone. That's fine.

[0519] Different aspects or any part of an aspect, or different embodiments or Any and all parts of an embodiment may be combined in any possible manner. The method, or any step of the method, may be combined with the apparatus description and any apparatus embodiment. and aspects or portions of the embodiments may be considered as method descriptions, all of which may be omitted to the extent that they are in minor detail. Any detailed description is provided in general terms. The present invention should be interpreted in the broadest sense as a general summary description, and should not be construed as limiting any embodiment or Parts of the embodiments and any methods or parts of methods may be combined in any manner.

[0520] The invention will now be described, by way of example only, with reference to the accompanying drawings, in which: [Brief explanation of the drawings]

[0521] [Figure 1a] FIG. 1a is a schematic diagram of an embodiment of a steerable implant and external unit. [Figure 1b] FIG. 1b is a schematic diagram of an embodiment of a steerable implant and external unit. [Figure 2a] FIG. 2a is a schematic top view of an embodiment of a gear system. [Figure 2b] FIG. 2b is a schematic side view of an embodiment of a gear system. [Figure 2c] FIG. 2c is a schematic top view of an embodiment of a gear system. [Figure 3a] FIG. 3a is a top cross-sectional view of an embodiment of a gear system. [Figure 3b]FIG. 3b is a side cross-sectional view of an embodiment of a gear system. [Figure 3c] FIG. 3c is a schematic top view of an embodiment of a gear system. [Figure 3d] FIG. 3d is a schematic top view of an embodiment of a gear system. [Figure 4] FIG. 4 is a side cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 5] FIG. 5 is an elevated perspective view in section of an embodiment of an implantable hydraulic actuation device. [Figure 6] FIG. 6 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 7] FIG. 7 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 8] FIG. 8 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 9] FIG. 9 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 10a] FIG. 10a shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 10b] FIG. 10b is an exploded elevated perspective view of one embodiment of an implantable electric motor. [Figure 11a] FIG. 11a shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 11b] FIG. 11b is an exploded elevated perspective view of one embodiment of an implantable electric motor. [Figure 12] FIG. 12 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable manipulation device. [Figure 13a] FIG. 13a is a schematic diagram of an embodiment in which the gear system is made up of multiple gear systems. [Figure 13b] FIG. 13b is a schematic diagram of an embodiment in which the gear system is made up of multiple gear systems. [Figure 14a]FIG. 14a is a schematic diagram of an embodiment in which the gear system is made up of multiple gear systems. [Figure 14b] FIG. 14b is a schematic diagram of an embodiment in which the gear system is made up of multiple gear systems. [Figure 15] FIG. 15 is a side cross-sectional view of an embodiment of a hydraulic operating device with two gear systems. [Figure 16] FIG. 16 is a side cross-sectional view of the left portion of an embodiment of a gear system consisting of two gear systems. [Figure 17] FIG. 17 is an elevated perspective view of a section of an embodiment of a hydraulic operating device comprising two gear systems. [Figure 18a] FIG. 18a shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable hydraulic actuation device. [Figure 18b] FIG. 18b is an exploded side perspective view in cross section of an embodiment of an implantable manipulation device. [Figure 19] FIG. 19 is an elevated perspective view of an embodiment of an implantable manipulation device and an elevated perspective view of a cross section of the implantable manipulation device. [Figure 20] FIG. 20 shows a side cross-sectional view and a top cross-sectional view of an embodiment of an implantable manipulation device. [Figure 21] FIG. 21 is a side cross-sectional view of an embodiment of an implantable hydraulic actuation device with a magnetic coupler. [Figure 22] FIG. 22 is a side cross-sectional view of an embodiment of an implantable manipulation device including a magnetic coupler. [Figure 23] FIG. 23 is a top cross-sectional view of a peristaltic pump. [Figure 24a] FIG. 24a is an elevated perspective view of an implantable manipulation device including a peristaltic pump. [Figure 24b] FIG. 24b is a side cross-sectional view of an implantable manipulation device including a peristaltic pump. [Figure 25a] FIG. 25a is a side cross-sectional view of an implantable manipulation device including a peristaltic pump. [Figure 25b]FIG. 25b is a top cross-sectional view of an implantable manipulation device including a peristaltic pump. [Figure 26] FIG. 26 is an elevated perspective view in section of an embodiment of an implantable hydraulic actuation device. [Figure 27a] FIG. 27a is a side cross-sectional view of an implantable hydraulic operating device in a first state. [Figure 27b] FIG. 27b is a side cross-sectional view of the implantable hydraulic operating device in a second state. [Figure 28a] FIG. 28a is a side cross-sectional view of an implantable hydraulically actuated device. [Figure 28b] FIG. 28b is a top cross-sectional view of an implantable hydraulically actuated device. [Figure 28c] FIG. 28c is a diagram illustrating the reservoir of the implantable hydraulically operated device. [Figure 29] FIG. 29 is an elevated perspective view of a section of an implantable manipulation device. [Figure 30a] FIG. 30a is an elevated perspective view of the implantable manipulation device in a first condition. [Figure 30b] FIG. 30b is an elevated perspective view of the implantable manipulation device of FIG. 30a in a first condition. [Figure 31a] FIG. 31a is an exploded perspective view of an implantable manipulation device including an initiation resistance delay. [Figure 31b] FIG. 31b is an exploded perspective view of an implantable control device including an initiation resistance delay. [Figure 31c] FIG. 31c is an exploded perspective view of an implantable manipulation device including an initiation resistance delay. [Figure 31d] FIG. 31d is an exploded perspective view of an implantable manipulation device including an initiation resistance delay. [Figure 31e] FIG. 31e is an exploded perspective view of an implantable manipulation device with a coupler. [Figure 32] FIG. 32 is a side cross-sectional view of an implantable operating device positioned under a patient's skin and an external unit for powering the implantable operating device. [Figure 33] FIG. 33 is a side view of a wireless energy transmitter and an implantable wireless energy receiver. [Figure 34] FIG. 34 is a side view of a steerable implant and wireless energy transmitter. [Figure 35a] FIG. 35a shows a side cross-sectional view of a wireless energy transmitter and a side cross-sectional view of a wireless energy transmitter placed under the skin of a patient. [Figure 35b] FIG. 35b shows a side cross-sectional view of a wireless energy transmitter and a side cross-sectional view of a wireless energy transmitter placed under the skin of a patient. [Figure 35c] Figure 35c shows an alternative concept of wireless energy transmission. [Figure 36] FIG. 36 is a side view of a steerable implant and wireless energy transmitter. [Figure 37] FIG. 37 is a side view of a steerable implant and wireless energy transmitter. [Figure 38a] FIG. 38a is a schematic side view illustrating the principle for wireless energy transmission through the patient's skin. [Figure 38b] FIG. 38b is a schematic side view illustrating the principle for wireless energy transmission through the patient's skin. [Figure 38c] FIG. 38c is a schematic side view illustrating the principle for wireless energy transmission through the patient's skin. [Figure 39] FIG. 39 is a side view of a steerable implant and wireless energy transmitter. [Figure 40] FIG. 40 is a side view of a steerable implant and wireless energy transmitter. [Figure 41] FIG. 41 is a schematic side view of a steerable implant. [Figure 42] FIG. 42 is a schematic side view of a steerable implant. [Figure 43a] FIG. 43a is a side view of a steerable implant including fixation and distance-creating elements. [Figure 43b]FIG. 43b is a side view of a steerable implant including fixation and distance-creating elements. [Figure 43c] FIG. 43c shows a distance element that constitutes a kit of distance elements. [Figure 43d] FIG. 43d shows another distance element that forms part of a kit of distance elements. [Figure 43e] FIG. 43e shows another distance element that forms part of a kit of distance elements. [Figure 44] FIG. 44 illustrates an embodiment of a steerable implant in which the body engaging portion is an injection device. [Figure 45a] FIG. 45a shows an embodiment of a steerable implant in which the body engaging portion is a compression device. [Figure 45b] FIG. 45b shows an embodiment of a steerable implant in which the body engaging portions are two compression devices. [Figure 45c] FIG. 45c shows an embodiment of a maneuverable implant in which the body engaging portion is a mechanical body engaging portion.

[0522] [Detailed description of the drawings] In the following, a detailed description of embodiments of the present invention will be given with reference to the accompanying drawings, in which: It should be understood that this is for illustrative purposes only and does not limit the scope of the present invention in any way. Any references to direction, such as "up" or "down," are merely illustrative. The illustration only indicates the orientation shown. Features with the same reference numbers have the same function. Therefore, unless otherwise apparent, certain features in certain embodiments may be used interchangeably. It should be noted that features from other embodiments having the same reference number may be interchangeable. Therefore, the description of features having the same reference number will be used to explain the basic concept of the feature. They are complementary in their explanation and show these characteristic parts from multiple angles. It should be understood that

[0523] Steerable implants may be manipulated to perform functions with respect to a patient's body. It should be understood that any implant is operated. changing the size and / or shape of the part, delivery of active or inactive substances to the patient's body, electrical stimulation of a part of a patient's body; the physical parameters of an implant that can be manipulated; data or functional parameters, and / or physiological or physical parameters of the patient The device senses the meter, communicates with an external unit outside the patient's skin, and is controlled from the external unit. This includes receiving or transmitting energy with a steerable implant. The device may be, for example, a pacemaker unit, an external cardiac compression device, or a left ventricular assist device (LVAD). ) devices, devices that assist the pumping function of the heart, such as operable artificial heart valves, insulin or implantable drug delivery devices, such as implantable devices for delivering chemotherapeutic agents. For example: to shrink the bowel for the treatment of anal incontinence, to shrink the bowel for the treatment of a stoma to contract the urethra to treat urinary incontinence, to treat gallbladder dysfunction Constricts the bile ducts, constricts the fallopian tubes for fertility control, and constricts the ovaries for sexual function control. constricting the vas deferens to increase blood flow to the erectile tissue, or constricting blood vessels to increase blood flow to the erectile tissue, or hydraulic contraction implants, mechanical contraction implants for the compression or restraint of The steerable implants would also be electrocontraction implants that reduce stomach volume. operable volume filling device for restricting the passage of food; operable gastric band for restricting the passage of food - Patents.com or manipulative implants to stretch the stomach wall to create a feeling of fullness. The steerable implant may be a therapeutic steerable implant for treating gastroesophageal reflux. steerable devices for treating GERD, steerable breast implants, or manipulable cosmetic procedures such as implants to adjust or replace any bone part of the body. Furthermore, the implant may be a replacement for an organ or part of an organ. Other examples of implants are: , implants that treat impotence through implanted drug delivery, implants that affect blood flow implants, vascular procedures which may include thrombectomy, implants which affect fertility and / or infertility An implant is an implant adapted to move fluid inside the body. The above listed examples of possible implants are examples of possible applications of steerable implants. It should be seen as an example that does not limit the scope in any way.

[0524] The body engaging portion is connected directly or indirectly to the patient's body. It should be understood as any element or part of an implant that can be operated to perform a function. The function may be, for example, to push and / or pull on a part of the patient's body, delivering substances to the body, collecting specimens from the patient's body, electrolyzing a part of the patient's body, and / or filling or emptying an implantable volume-filling device with hydraulic fluid. The answer would be to do this.

[0525] The physical or functional parameters of the steerable implant may be, for example, voltage, flow, or electrical parameters such as impedance, pressure, flow rate, temperature, volume, weight, or These may be fluid-related parameters such as viscosity. The parameters are received by the steerable implant. The energy transmitted, delivered to the patient's body, and received by the steerable implant the fluid being delivered to the patient's body, the force being applied to the patient's body, or the force being applied to the patient's body. It may be related to the time that has passed since the procedure was performed relative to the body.

[0526] The physiological or physical parameters of the patient may include, for example, the patient's body pressure, blood flow, blood saturation, etc. parameters related to ischemia markers, patient temperature, muscle activity, The parameter may be a parameter related to the activity of the digestive system.

[0527] The enclosures referred to herein are, in most instances, operable from body fluids upon implantation. The enclosure is adapted to separate the components of the implant, provided that the enclosure does not allow fluid To contain or separate the operable implant from other components of the operable implant. The enclosure may be used to separate fluids used by the Materials based on graphite, silicon carbide, or carbon fiber materials, etc., boron materials, polymer materials (silica, etc.) Polyurethane, UHWPE, or PTFE, etc.) Metallic materials (titanium, stainless steel, tantalum, platinum, niobium, aluminum, etc.) , ceramic materials (zirconium dioxide, aluminum oxide, or tungsten carbide) or glass, or a combination thereof. In all cases, the enclosure must be made from a low-permeability material, As a result, fluid movement through the walls of the enclosure is impeded.

[0528] The operating device of the steerable implant converts electrical energy into mechanical work. The electric motor may include, for example, a variable frequency drive. Alternating current (AC) electric motors, such as three-phase electric motors (which may be controlled by Electric motors, linear electric motors, AC or DC axial electric motors, piezoelectric motors, It may be a bimetallic motor or a shape memory metal motor.

[0529] Generally, an operable implant includes an implantable body engaging portion and an implantable operating device. A medical system including a plant, as well as an operable implant component, is provided herein. The implantable operating device is described as being able to electrically, mechanically, or hydraulically operate the body engaging portion. and adapted to operate by means of wireless energy transmission from outside the patient's body. It operates using an implantable battery adapted to store electrical energy either in the body of the patient or within the body of the patient. The manipulation device converts electrical energy into mechanical work (force * distance). The electric motor may include an electric motor for controlling the speed and / or power / torque and / or may be connected to one or more gear systems for changing the direction of the applied force. The steerable implant may further comprise a portion of a steerable implant, another steerable implant, and / or a communication unit for communicating with an external unit. Communication with the external unit includes control signals for controlling the steerable implant. may include feedback signals from steerable implants. These may include, for example, physiological sensor parameters related to the patient's physical status or is a sensor parameter, such as a physical sensor parameter, or the status of an operable implant. It may be a physical or functional parameter related to the status.

[0530] 1a and 1b show an operative implant adapted to be implanted in a patient's body. 100, and a device for energizing and / or manipulating the operative implant 100. 1 shows an overview of a medical system including an external unit 200 for communicating with an implant 100. 1a and 1b show schematic diagrams of a steerable implant 100 and an external unit 110, respectively. 200, the components shown in the figure are examples of components that may be included in the system 200, and the components shown in the figure are examples of components that may be included in the system 200, ... Just as an embodiment is not considered essential to the implementation, it is not considered complete. You shouldn't.

[0531] FIG. 1a shows a steerable implant 100 that is implanted subcutaneously beneath the patient's skin S. The steerable implant 100 receives wireless energy from the external unit 200. or an operating device 110 including a receiving unit 120 adapted to receive information. The wireless energy is transmitted through the steerable implant 100 and the electrical conductors that are inductively coupled to each other. and an external unit that functions as a transformer-like circuit for transmitting alternating current electrical energy signals. The coil of the unit 200 can be used to operate the coil of the external unit 200 and the implant. Wireless energy may be in the form of an electromagnetic field transmitted between the coils of 100. In an embodiment, the movable structure of the implantable manipulation device 100 includes a magnet or magnetic material. This may take the form of a moving magnetic field coupled by a force, allowing for steerable implants. The movable structure of the device is an external unit (e.g., as further described with respect to Figures 32-39). The receiving unit 120 further moves along the moving magnetic field generated by the operating device. in the form of a moving magnetic field that affects the structure and manipulates components that consume electrical energy; or indirectly to components of the operable implant 100 that consume electrical energy. An implantable operating device for charging batteries (e.g., 190a, 190b) for powering the device. The operating device 110 receives wireless energy both as wireless energy that generates a current. It will be a combined unit adapted to

[0532] In the embodiment shown in FIG. 1a, the external unit 200 is a rotating An external electric motor 230 is used to rotate the external part of the electromagnetic coupling 220, which includes the structure. an external drive unit 210 for generating the rotating magnetic field described above, thereby The rotation of the rotatable structure by operation of the electric motor 230 (for example, as shown in FIGS. 35-36) The moving magnetic field is generated (as further disclosed in relation to the present invention).

[0533] The manipulation device 110 of the steerable implant 100 further comprises a configuration of the manipulation device 110. The first unit 110a of the operating device 110 includes the main components, and the receiving unit a distance is created between the second unit 110b of the operation device 110 including the set 120 and the The distance is determined by the distance element 110c adapted to allow the receiving unit 120 to detect the first unit. The structure may be substantially unaffected by the components of the unit 110a. The components are magnetic elements that transmit wireless energy between the transmitting unit 220 and the receiving unit 120. Components containing magnetic or magnetizable materials that can disrupt electric and / or electromagnetic fields I guess so.

[0534] The distance element 110c connecting the first and second units 110a, 110b is , transmitting energy and / or information from the second unit 110b to the first unit 110a and / or electrical leads for connecting the second unit 110b to the first unit 110 The mechanical power transmission member may be adapted to transmit mechanical power to a The force transmission member may be, for example, a rotating shaft for transmitting a rotational force, a a flexible member, such as a Bowden cable, a wire, a belt, a rod, a worm gear, or Adapted to change the direction of rotational force received by a roughly 90-degree receiving unit such as a bevel gear The flexible member for transmitting the opening force may be at least one of a gear or the like. The operating device of FIG. 1 is further optionally adapted to convert electrical energy into mechanical work. The electric motor 130 is directly connected to the external unit 200. The transmitted electrical energy may be received from a receiving unit or may be stored in an implantable battery 190. The electric motor 130 may receive electrical energy that is stored. The moving force transmitted directly from the driving unit 210 is received by the receiving unit 120. In some embodiments, the electric motor 130 may be an alternating current (AC) electric motor. motors, direct current (DC) electric motors, linear electric motors, axial electric motors, piezoelectric Choose from motors, multi-phase motors such as 3-phase motors, bimetal motors, and shape memory metal motors. The electric motor 130 of choice will be

[0535] According to the schematic diagram shown in FIG. 1a, the power output of the electric motor 130 is connected to the power of the gear train 140. The gear system 140 is connected to an input of a mechanical workpiece having a first force and a first speed. and adapted to output mechanical work having a different second force and a different second velocity. , thereby providing high speed movement provided by the electric motor 130 and / or the receiving unit The direct connection with 120 is transmitted to slow motion as the force increases.

[0536] The gear system 140 may be any of the gear systems disclosed in the present specification, such as those disclosed with respect to FIGS. 2-16. In an alternative embodiment, the gear system 14 may include a gear system having any of the following configurations: 0 is a conventional gear system, worm gear system, or belt transmission system, etc. It is contemplated that the transmission system may include any other configuration. In the illustrated embodiment, the gear system 140 is configured to operate the operating device 11 to operate the body engaging portion. 1a is connected to a connecting member 182 that connects gear system 140 of 100 to body engaging portion 180. In the embodiment shown in FIG. 1, the connection between the gear system 140 and the body engaging portion 180 is Rotating shafts, rods, or Browden cables for transmitting rotational force. The mechanical connection portion 181 includes a flexible member or the like for connecting the mechanical connection portion 181 to the shaft.

[0537] The operating device further includes a control circuit (further described with respect to FIGS. 36-4) for generating an electrical circuit. The steerable implant 100 configuration may include a generator 170 for generating the power. is disposed between the receiving unit 120 and the gear unit 140, so that The generator 170 receives the force at high speed. In an alternative embodiment where there is no direct mechanical connection, gear system 140 may be omitted entirely.

[0538] Steerable implants can be used to operate or control the steerable implant. The device may include at least one implantable battery 190a, 190b. 0a, 190b can be used in combination with direct drive from an external drive unit 210. As an example, a patient may use a direct drive to operate a home-operated implant. The batteries 190a and 190b can be used for charging the battery when out and about or in emergency situations. , may be adapted to power the operation of the steerable implant 100; and / or Or it could be adapted to power the control unit and / or the communication unit. 190a, 190b are receiving units for receiving wireless energy or implantable The battery may be adapted to be charged either by a generator 170 or by a power source such as a The capacitor could be replaced by any form of energy storage device, such as a capacitor.

[0539] Referring again to FIG. 1a, the steerable implant 100 further comprises at least one implantable The implantable battery includes separate batteries 190a, 190b, such as battery 190a. The battery 190b may be located in the operating device 110 or may be located in the operating device 110 itself. The steerable implant 100 may receive wireless energy from the receiving unit 120. The batteries 190a and 190b are arranged so that the power can be stored in the batteries 190a and 190b. The lead 122 connected to the receiving unit 120 or the generator 170 is connected to the power supply. The generator 70 is connected to batteries 190a, 190b so that the electricity can be stored in the batteries 190a, 190b. At least one battery 190a, 190b may include a lead 172 connecting the battery 190a, 190b. b is a control system for controlling the steerable implant 100 and the electric motor 130. The first lead 1 may be adapted to provide power to at least one of the power supplies 195. 92 connects the batteries 190a, 190b to the control system 195, and the second lead 132 An electric motor 130 is connected to the batteries 190a, 190b.

[0540] The control unit 195 may, for example, regulate the frequency of the alternating current supplied to the electric motor. or by adjusting the voltage supplied to the electric motor 130. for controlling the steerable implant 100, which may include controlling the controller 130. The control unit 195 may include one or more of the steerable implants 100. The sensor may be adapted to receive sensor inputs from a number of sensors, which may be operable inputs. adapted to monitor a physical parameter of the plant 100 or a physiological parameter of the patient. In some embodiments, the control unit 195 may be a valve or relay. Adapted to control a hydraulically operated device by controlling the actuation of a movable wall portion of the reservoir. The control unit 195 may include a communication unit for communicating with the external unit 2000. In that case, the receiving unit 120 may further include a unit for transmitting information. This may allow for the physical parameters of the steerable implant and / or the patient's body to be adjusted. The physiological parameters of interest are determined by the relationship between the steerable implant 100 and the external unit 200. If necessary, the control unit may communicate the alternating current received by the receiving unit. to a direct current suitable for powering the elements of the steerable implant 100. At least one battery 190a, 190b of the implant 100 for or operable May include a rectifier circuit for charging. For processing communications, information, and / or data. Alternatively, the control unit 195 may further include a demodulator and a microprocessor. , demodulates the signal transmitted from the external unit 200, and the microprocessor The receiving unit 120 of the operable implant and the external The transmitting unit 220 of the external unit 200 can transmit, for example, a radio signal, an IR (infrared) signal, an ultrasonic signal, or the like. It may be adapted to communicate using wave, magnetic, inductive, or capacitive signals.

[0541] The steerable implant 100 or a part of the steerable implant is steerable at the time of implantation. The implant 100 may be enclosed by an enclosure to separate the components from bodily fluids. However, the enclosure may be used, for example, to contain a fluid in a reservoir. or from other components of the operable implant 100, such as lubricating fluid for the gear system. may be used to separate fluids used by the steerable implant 100 The enclosure may be configured to separate the electromagnetic waves between the external unit 200 and the steerable implant 100. It may be made from non-metallic and non-magnetic materials so as not to affect energy transmission. The material is a carbon-based material (e.g., graphite, silicon carbide, or carbon fiber material). , boron materials (e.g., silicone, Peek®, polyurethane, UHWP E or PTFE), polymeric materials (e.g., titanium, stainless steel, metallic materials (e.g., titanium, platinum, niobium, or aluminum), ceramic materials such as zirconium, aluminum oxide, and tungsten carbide; or glass. In any example, the enclosure may be made from one or a combination of , made from a low permeability material so that migration of fluids through the enclosure walls is prevented It should be.

[0542] Referring now to the external unit 200, the external unit 200 is an operable implant adapted to control and / or communicate with the operable implant 100. The external unit 200 receives the magnetic field of the receiving unit 120 of the steerable implant 100. The external device may be adapted to generate a moving magnetic field that is adapted to magnetically couple with a stone or magnetic material. The patient may include a driving unit 210, which allows the generation of a moving magnetic field outside the patient's body. , a magnetic coupling between the external drive unit 210 and the movable structure of the steerable implant 100 The movable magnetic field may be an electromagnet or a permanent magnet. 2. The electric motor 230 may be connected to a movable structure including at least one magnet. In an alternative embodiment, the moving magnetic field may be generated by, for example, changing the current to an electromagnet. It is generated by changing the magnetic field, such as by The applied force flows in an alternating current, thus causing a reciprocating motion of the magnetic or magnetizable material. The generation of a moving magnetic field is further explained with respect to Figures 32 to 39.

[0543] The external unit 200 is powered directly by connection to a power outlet of the power grid. or a drive unit for powering the electric motor 230 and / or electromagnets. At least one rechargeable battery or power supply may be connected using a conduit 292 to the power outlet 210. The external unit 200 may also include a disposable battery 290. It may also include an external control / communication unit for communicating with the control / communication unit 195 of 100. The external control / communication unit receives and transmits control signals from the operable implant. The external unit 200 may be adapted to adjust control of the external unit 200 in response to the received control signal.

[0544] FIG. 1b is an operational embodiment that should be seen as an alternative to the embodiment shown in FIG. 1a. 1b shows an embodiment of an implant 100. The difference is that the embodiment of FIG. 1b has an operating device 110 to the hydraulically operable body engaging portion 180'. The connector 182 is adapted to be connected to the operating device 110 using a connecting portion 182 that includes at least one conduit. A specific hydraulically actuable body engaging portion 180' is adapted to operate the hydraulically actuable body engaging portion 180'. The hydraulic embodiment is

[0545] The operating device 110 of the embodiment shown in FIG. 1b includes a reservoir for holding hydraulic fluid. The reservoir 160 includes a hydraulic pump 150 connected to a reservoir 160 (e.g., as shown in FIG. 4 or FIG. 5). The hydraulic pump 150 may be configured with a small number of movable walls (such as those disclosed herein) that are operable. In an alternative embodiment, the hydraulic pump 150 may include at least one movable wall portion 163. , for example: valveless pumps, pumps containing at least one valve, peristaltic pumps, membrane pumps The hydraulic pump 150 may be an implantable electric motor. either a controller 130 or a movable structure adapted to be operated from outside the patient's body. The hydraulic pump 150 is operated by connecting the electric motor 130 or the movable structure. The connection between the teeth is adapted to convert high speed, low force motion into low speed, high force motion. It operates via vehicle system 140.

[0546] The hydraulic body engaging portion 180' may be, for example, a hydraulic contraction or restraint device, or a volume filling device. This will include a vice.

[0547] FIG. 2a illustrates one implementation of an implantable gear system 140 for operation in the operating device 110. The gear system 140 is subjected to a mechanical action having a first force and a first speed, and a second The gears are adapted to output mechanical action having a first different force and a second different speed. The system 140 is a hollow cylinder including a first number of teeth 144t, for example 160, on its outer circumference. and on its inner surface, first teeth, e.g., 162. The second gear 145 has the shape of a hollow cylinder and includes a greater number of teeth 145t than the first gear. The input 142 is connected to an operable element 143' adapted to The element 143' is adapted to engage the inner side 144a of the first gear 144, so that , the teeth 144t of the first gear 144 are in a position where the teeth are not engaged with each other (for example, position P2). The teeth 145t of the second gear 145 are interengaged with each other at a mutually spaced position P1. As shown, the outer side 144b of the first gear 144 is pressed against the inner side 145a of the second gear 145. The movement of the operable element 143' advances the position P1, thereby pressing the first tooth Relative rotation is generated between the wheel 144 and the second gear 145. The embodiment shown in Figure 2a In the example, the second gear 145 includes two more teeth 145t than the first gear 144, giving a 2 / 16 0 or 1 / 80 of a revolution for each revolution that the operable element 143' performs. This results in a first gear 144 which is connected to the output (Fig. 2b 149) provides a force with 80 times the speed and 80 times the force, thus , increasing the force that can be exerted by, for example, an electric motor. The operable element slides radially against the inner surface of the first gear 144. To reduce the risk of The surface on which the fabricable implant 143' slides is made of Graphalloy, Nyliol It is further contemplated that the lubricating material may include a self-lubricating material such as PTFE or PTFE.

[0548] FIG. 2b shows gear system 140 in cross-sectional side view, and in this embodiment, gear system 140 includes A third gear 144 has an inner side 146a including the same number of teeth 146t as the outer side 144b of the first gear 144. The third gear 146, together with the inter-engaged position (P1 in FIG. 2a), The teeth 146t of the third gear 146 are aligned with the teeth 146t of the first gear 145 so as to rotate relative to the second gear 145. The third gear 146 is adapted to interengage with the teeth of the wheel 144. The teeth are connected by a radially extending connecting structure 147 for transmitting force from the teeth to the output 149. It is connected to output 149 of vehicle system 140.

[0549] FIG. 2c shows an alternative embodiment of the medical device, in which the operable element 143″ is The first gear 144 is adapted to engage the inner side 144a of the first gear 144 in two diametrically opposed positions. The operable element 143'' deflects the first gear 144 in the axial cross section, and The operable element 143'' maintains the deflected first gear 144'. The first gear 144 is adapted to rotate in a direction perpendicular to the rotation axis of the first gear 144 such that the teeth of the first gear 144 are angularly spaced apart. , interengaged with the teeth of the second gear 145 at two diametrically opposed positions P1' and P1''. The two positions P1' and P1'' are positions where the teeth are not interengaged, for example, the two positions P2' and P2″. In the embodiment of FIG. 2c, the first and second gears 1 When the teeth of the first gear 144 and the second gear 145 interengage in two positions, the first gear 144 deflects equally. The number of teeth between the first gear 144 and the second gear 145 is set to 1 / 2 so as to form an oval shape as follows: The difference between these two must be divisible by 2, so that the teeth of the first and second gears 144, 145 are In two areas between the first and second gears 144, 145 with positions where they do not inter-engage, Mathematically, this means that if the first gear has x teeth, then In this case, the second gear must have x+n*2 teeth. The transmission provided by the gear system 140 is calculated as follows: Transmission = x / (x+n*2). To provide uniform deflection of the first and second gears 144, the operable element The first gear 14 is arranged so that the first gears 44, 145 are interengaged in three, four or more positions. In an alternative embodiment (not shown) the actuator may be an operable element adapted to deflect the actuator 4. ), the difference in the number of teeth between the first gear 144 and the second gear 145 corresponds to the number of contact areas. In a more general formula, the relationship is that the second gear has x+n*m number of teeth. where n is a constant that is selected based on the desired transmission. where m is the number of positions where the teeth of the first and second gears interengage.

[0550] FIG. 3a shows an input 142 connected to first and second planetary gears 143'''a and 143'''b. The operable element includes a planetary gear including a central gear connected to the first gear 144, and the teeth of the first gear 144 are The teeth of the second gear 145 are interengaged at the first and second positions P1', P1''. The first and second planetary gears 143'''a, 143'''b also deflect the first gear 144. 2c shows an embodiment in which the first gear 1 The first gear 144 and the second gear 44 are arranged so that they are equally deflected to form an elliptical shape. The difference in the number of teeth between 145 and 146 must be divisible by 2, so that the first and second gears Between the first and second gears 144, 145 with the teeth of 144, 145 not interengaging The number of teeth may be evenly distributed between the two areas.

[0551] The planetary gear mechanism in FIG. 3a is composed of a central gear 142 and planetary gear mechanisms 143'''a and 143' The transmission of the gear system is further increased by the difference in the number of teeth between That is, the total transmission of gear system 140 is the transmission provided by the planetary gear mechanism plus the first gear. This is equal to the transmission provided by the difference in the number of teeth between 144 and the second gear 145.

[0552] Figure 3b shows gear system 140 in cross-sectional side view. In the embodiment shown in Figure 3b, gear system 140 also includes a third gear 146 similar to the third gear described with reference to FIG. 2b. As a result, the third gear 146 is in the inter-engaged position P1'', P1 The third gear 146 transmits power from the third gear 146 to the output 149. The output 149 of the gear system 140 is connected to the output 149 by a radially extending connecting structure 147 for connecting the Connected.

[0553] FIG. 3c shows the planetary gear mechanism with one planetary gear 143''' connected to the central gear 142. 2a shows an alternative embodiment of the planetary gear mechanism, which only includes a 1. This embodiment functions similarly to the embodiment described with reference to the present invention, with the difference being that the additional transmission is performed by a planetary gear mechanism. This is what is provided.

[0554] FIG. 3d shows a planetary gear mechanism with three planetary gears 143'''a, 143'''b, and 143' 14 shows an embodiment including a planet gear 144′, where each planet gear deflects the first gear 144′, resulting in The first gears 144 are angularly spaced (substantially 120 degrees between each other) Also, the second gear 145 is pressed against the second gear 145 at three contact positions P1', P1'', and P1'''. Similar to the other embodiments described, the first gear 144 and the second gear 145 The difference in the number of teeth must correspond to the number of contact areas, i.e. the embodiment shown in FIG. 3d. In this state, the difference must be divisible by 3 so that the first gear 144 is deflected evenly.

[0555] In an alternative embodiment, in any of the embodiments described with reference to Figures 2a to 3d The gears of the planetary gear mechanism in this case are toothless gears and therefore do not have friction due to their inter-engagement with each other. Therefore, the central gear is connected to the planetary gears by a friction-based connection. It is connected to the mechanism and drives the planetary gear mechanism.

[0556] The gear system 140 in any of the embodiments of Figures 2a-3d may be made of, for example, a metallic material, plastic, or the like. In one embodiment, the gear system may be made of a non-metallic, plastic, or ceramic material. The gear system is made of metallic and / or non-magnetic materials, so that the gear system can be implanted with an implantable energy receiver. The gear system is lubricated with biocompatible lubricants such as hyaluronic acid. The hydraulic fluid may be lubricated by a reservoir adapted to hold the hydraulic fluid. The gear system may be arranged on the side of the gears, with hydraulic fluid acting as a lubricant as well. systems, and / or to human tissue ingrowth in gear systems, and / or to hydraulic fluids and / or or enclosed by an enclosure to prevent leakage of lubricating fluid The enclosure may be a non-metallic and / or non-magnetic enclosure, As a result, the enclosure material may interfere with the wireless energy receiver of the steerable implant. The gear system may be separately enclosed or Enclosed with the electric motor of the operating device or with additional components of the operating device Good too.

[0557] FIG. 4 illustrates an operative implant including a gear system 140 as further described with respect to FIG. 3a. 100 shows an embodiment of an implantable operating device 110. The gear system 140 is, for example, a motor for converting electrical energy into mechanical work (such as any of the electric motors described in this specification) The power input 142 may be connected to an electric motor adapted for this purpose. similarly operates first gear 144 of gear system 140 (further described with respect to FIG. 4). The force output 149 is connected to the planetary gears 143'''a and 143'''b. 40 to the gear system 140 via a third gear 146 and a radially extending connecting structure 147. The force output 149 is connected to the threaded member 44 in the embodiment illustrated in FIG. a hollow shaft having an internal thread (not shown) adapted to engage the external thread of , whereby the interaction between the hollow shaft 149 and the threaded member 441 acts as a gear The radial rotational force generated by the operation of the system 140 is converted into a linear axial reciprocating force. The threaded member 441, in the embodiment shown in FIG. 4, is a reservoir adapted to contain hydraulic fluid. 4. The axially extending engagement member 444 is adapted to engage the spring 160. In the embodiment shown, reservoir 160 is a donus-shaped reservoir adapted to be compressed. This reduces the volume within the reservoir 160 and allows the fluid to flow out of the reservoir 160 into the fluid conduit. 162, further comprising a hydraulically actuable body engaging portion 162 of the actuable implant 100. Press the hydraulic fluid to 80.

[0558] The manipulation device 110 acts as an anvil in relation to the compression of the reservoir 160 and simultaneously a seat portion that also functions as an enclosure that at least partially surrounds the gear system 140; The seat portion 445 further includes a force output portion 149 and a threaded member 441. 442, which is adapted to enclose the threaded The force output 149 and threaded portion 441 are sealed from body fluids. The connection between the part of the enclosure 442 enclosing the material 441 and the seat part 445 is 5 and output 149, facilitating operation of gear system 140 and reducing the need for a seal between gears 5 and output 149. The force output 149 and the threaded member 44 allow for a hermetically sealed enclosure of the wheel system 140. The portion of the enclosure 442 surrounding 1 has a pleated section that acts as a bellows. The pleated section 443 includes the folds, which are affected by the mobility of the pleated section 443. The reservoir 160 is adapted to allow fibrous tissue ingrowth without being blocked. , preferably made from a resilient and / or elastic material, such as silicone, and Parylen e® coating to resist stress induced by compression of reservoir 160. The force input 142 may be inserted into the bottom of the enclosure. The electrical motor may be enclosed in a sealed environment, or alternatively, the operating device, such as an electric motor, may be located in the same sealed environment. This eliminates the need for a seal between the force input 142 and the enclosure.

[0559] FIG. 5 shows a gear system located inside the reservoir 160', which allows the reservoir 160' to 5 shows an embodiment of an operating device 110 at least partially enclosing a gear system 140. The embodiment shown further includes an electric motor 130 connected to the force input of the gear system 140. The power transmission between the electric motor 130 and the gear system 140 includes a gear train surrounding the electric motor 130. The first enclosure includes a reservoir 160', which is connected to a second enclosure surrounding the gear system 140. The enclosure may include a shaft that enters the enclosure, in which case both enclosures It must be rotatably passed through by a shaft, creating friction at the seal. In the embodiment, an enclosure surrounding the electric motor 130 and an enclosure surrounding the gear system 140 are provided. An enclosure is connected to enclose both the gear system 140 and the electric motor 130. A single enclosed space is created, in which case the shaft transmitting the force does not need to be sealed. The enclosure 445' thus surrounds the electric motor 130. The force output 149 that connects with the threaded member 441 is shown in FIG. It functions similarly to that described, the difference being that the volume of the reservoir 160' is 1, and a threaded member 441 is inserted into the reservoir 16 to move the movable wall portion. The reservoir 160' is connected directly to the movable wall portion of the fluid conduit 162'. 160' is connected to the reservoir 160' so that fluid in the reservoir 160' flows through the fluid conduit 162' to the reservoir 160'. 0' to a hydraulically operable body-engaging portion of the operable implant; Compression of reservoir 160' thereby exerts an indirect force on a portion of the patient's body.

[0560] In the embodiment shown in FIG. 5, the manipulable elements 143'''a, 143'''b are friction , and the first gear is connected by the force input. '''a, 143'''b does not contain teeth.

[0561] In some embodiments, the reservoir is rotated by placing a gear system inside the reservoir. The hydraulic fluid contained in 160 allows the gear system 140 to be lubricated. The lubricating fluid may be a biocompatible lubricating fluid such as phosphate, isotonic solution, or glycerol-based fluid. stomach.

[0562] The basic principles of the gear system 140 described above are applicable to any of the steerable implants herein. The advantages of the gear system 140 are: low friction, compact design High transmission, good precision, low noise, gear system 140 without lubrication It may function as

[0563] FIG. 6 illustrates an embodiment of an implantable manipulation device 100 for manipulating a steerable implant. 1 shows an embodiment of the operating device 110. The operating device 110 is an implantable device including a coil 132 and a magnet 133. The coil 132 is energized by a coil winding 132' and a coil core. A magnetic field is generated by the current in 132'' and magnetically couples with magnet 133. are fixed to a rotatable structure 135, which sequentially energizes the coils 132. This propels the magnet 133 and causes the rotatable structure 135 to rotate. The magnetic coupling between the magnet 133 and the rotor must be such that the torque generated is as large as possible. The rotatable structure 135 is arranged around the operation device 110 so that the operation device 110 can be rotated. The force generated by the coil 132 and the magnet 133 around the vise 110 is and a gear system connected to the input portion 142 of the force transmission element 143'''a and 143'''b. The operable element includes a radially extending portion 147 that extends from the outer side of the first gear 144. The second gear 145 is pressed against the inside of the first gear 144, causing the teeth of the first gear 144 to interengage. Interengages with the teeth of the second gear 145 at two positions separated by a non-engaging position. The second gear 145 engages and deflects the first gear 144 of the gear train 140 so that , has a greater number of gears on its inner surface than the first gear 144, so that the operable element 1 The operation of 43'''a and 143'''b is by advancing the inter-engaged positions. , causing relative rotation between the first gear 144 and the second gear 145.

[0564] The gear system further includes a third gear 146 having the shape of a hollow cylinder. The inside includes the same amount of teeth as the outside of the first gear 144, and the third gear 146 has at least The third tooth is arranged to rotate relative to the second gear 145 with one interengaged position. The teeth of the wheel 146 are adapted to interengage the teeth of the first gear 144. 46 is a radial gear connecting the third gear 146 to the output 149 located in the center of the gear system. 147. The portion 147 extends from the

[0565] The first gear 144, the second gear 145, and the third gear 146 are all arranged such that the magnet 133 A portion of the fixed rotatable structure 135 has a smaller diameter than the portion of the fixed rotatable structure 135 and a portion of the fixed rotatable structure 135 that fixes the coil 133. The gear system has a smaller diameter than the portion of the enclosure 111c that contains the electric motor. The coil 132 and the magnet 133 are arranged inside the gear system in the axial direction. The electric motor and gear system, which are arranged in the same axial plane, drive the operating device 110. It is possible to enclose it in a thin enclosure 111, and to make it suitable for example for subcutaneous implantation. Create chair 110.

[0566] The embodiment of the operating device described with reference to FIG. 6 includes a first spiral groove in a first direction and a threaded member in the form of a worm shaft 441' having a second helical groove in a second direction; The worm shaft 441' includes a radius adapted to compress the reservoir 160. 444 is engaged by an operable portion 446 which in turn is connected to an engaging member 444 extending in the direction Rotation of the worm shaft 441' rotates the operable portion 446 which engages the first helical groove. from the worm shaft 441', the operable portion 44 engages the second spiral groove at the end portion of the worm shaft 441'. 6 causes the operable portion 446 to reciprocate in the spiral groove. The worm shaft 441' is driven by an electric motor that always rotates in the same direction. 60 to allow for compression and expansion for ease of control and to direct the motor in a specific rotational direction. This allows for optimization of the rotors, seals, and bearings.

[0567] In the operating device 110 of FIG. 6, the coil 132 is disposed in a sealed space and supplies power to the electric motor. an energy supply unit in the form of a battery 190 adapted to supply power to the to control the electric motor and / or additional operable elements of the operable implant. The battery 190 and / or the control system 195 may also be adapted. 5 is a wireless energy receiver, and / or a wireless communication unit, and / or an operating device The battery 190 and / or the additional battery 190 for providing additional energy The electric motor is connected to a lead 192 that connects to a control system 195. In an alternative embodiment where the battery 190 is powered directly from the electrical receiver, the control It is only adapted to provide power to the system 195 .

[0568] FIG. 7 shows a control unit 20 and an operating device 110 similar to those shown with reference to FIG. 7 shows the control unit 20 and the operation device 110, with the difference that in the operation device of FIG. Magnets 133 are attached to the rotatable structure 135 from the periphery to the rotatable structure below the electric motor and gear system. a radially extending portion 147 adapted to transmit forces to the center of the structure 135; The radially extending portion 147 is fixed to a rotatable structure 135 including the transmits force to the gear input 142, which in turn transmits force to the operable elements 143'''a, 143 Engage b.

[0569] In the embodiment of FIG. 7, the coils 132 are disposed and arranged within individual coil enclosures 131. and sealed so that the coil 132 is protected from the patient's body fluids and / or from the gear system used. and / or hydraulically operated from a lubricating fluid in the reservoir 160 through a fluid conduit 162. The hydraulic fluid is further isolated from the hydraulic fluid adapted to transmit force to the body engaging portion.

[0570] FIG. 8 shows the control unit 20 and the operation device 110 shown with reference to FIGS. 6 and 7. Similar alternative embodiments of the control unit 20 and the operating device 110 are also shown. In the embodiment shown with reference to FIG. 1, the rotatable structure 135 including the magnet 133 is an enclosure having a circumference greater than the diameter of the rotatable structure 135 to which 33 is attached; The coil 132 is adapted to be propelled by a portion 111c of the rotor 111. Therefore, the coil 132 is disposed radially outside the magnet 133, and the coil end The closure 131 seals the device from the rest of the operating device 110 and from the patient's bodily fluids. The rotatable structure 135 is connected to an input 142 at the center of the rotatable structure. Force 142 also (as described in more detail in other embodiments herein) is a gear system 8. The manipulable elements 143'''a, 143'''b are adapted to engage the manipulable elements 143'''a, 143'''b. The embodiment shown includes a steering device 110 that further isolates the rotating components of the steering device 110. All rotating parts of the operation device 110 are arranged in the center of the The resulting noise passes through the enclosure 111 of the operating device 110 and the patient's body. This is difficult to spread.

[0571] FIG. 9 shows the control unit 20 and the operating device shown with reference to FIGS. 6, 7 and 8. 1 further shows an alternative embodiment of the control unit 20 and the operating device 110, similar to 110. In FIG. 9, the magnet 133 is connected to the manipulable element 143'''a, 143'''b of the manipulation device 110. The operable elements 143'''a, 143'''b are connected The coil is rotatably connected to the connecting structure 143c, and the magnetic attraction force generated by the coil can be operated. In succession, the magnet 133 which propels the teeth 143'''a, 143'''b is attracted to the teeth. Engage and deflect the first gear 144 of the wheel system. Portions 43'''a, 143'''b are operable to engage the first gear 144 of the gear system. the magnetically conductive elements 143'''a, 143'''b, and have a larger diameter than the magnetically conductive elements 143'''a, 143'''b. The stone 133 may be placed in close proximity to the coil 132. The distance may be, for example, 50 μm, 100 μm, 200 μm, 400 μm, 600 μm, 800 1 μm, 1 mm, 2 mm, 3 mm, or 5 mm, and the operating device 1 10 and the magnetic force exerted by coil 132.

[0572] 10a and 10b show an operating device similar to the embodiment shown in relation to FIGS. 6 to 9. The difference between the embodiment of FIG. 6 and the embodiment of FIG. 10a is that the embodiment of FIG. 10a has a tooth an axial electric motor 130' adapted to propel a power input 142 of the vehicle system; The axial type electric motor 130' rotates around the rotation axis of the electric motor 130'. A set of circularly distributed coils 132 and a set of radially extending magnets 133 overlapping the axial direction. The set of magnets 133 is connected to a rotatable structure 135 that rotates the carp. By sequentially energizing the coils 132, the magnets 133 are magnetically propelled axially, as shown in FIG. In the embodiment shown in FIG. 10a, the operable planetary gears are 143'''a and 143'''b. connected to the force input 142 of the gear system, which is connected to the elements 143'''a, 143'''b. The gear system and axial electric motor 130' rotates the rotatable structure 135. are positioned coaxially along the rotational axis of the electric motor 130'.

[0573] The operable elements 143'''a, 143'''b engage the first gear 144 of the gear system. , deflecting the first gear 144 so that the outside of the first gear 144 contacts the second gear 145 , which forces the teeth of the first gear 144 into a position where the teeth are not interengaged. Thus, the teeth of the second gear 145 interengage at two separate positions. has more gears on its inner surface than the first gear 144, so that the operable element The operation of 143'''a and 143'''b is performed by advancing the inter-engaged positions. This generates relative rotation between the first gear 144 and the second gear 145 .

[0574] The gear system force output 149 is similar to that described in more detail with respect to FIGS. 4 and 5. The embodiment of FIG. 10a further includes an axial spring that generates a reciprocating force that compresses the reservoir 160. a battery 190 adapted to power an axial-type electric motor 130'; The electric motor 130' and / or the additional operable elements of the operable implant may be controlled by a Below the axial electric motor 130', which houses a control unit 195 adapted to The battery 190 and / or the control unit 195 sequentially energize the coil 132. A battery 19 is used to provide energy to operate the axial electric motor 130'. 0 and / or the control unit 195 is connected to the lead wire 192 that connects the coil 132. do.

[0575] FIG. 10b shows a rotatable structure to which the magnet 133 and the force input 142 of the gear system are fixed. 133, and the rotatable structure 135 is a non-metallic disk, which allows the individual magnets 1 33 are not affected by their being fixed to the rotatable structure 135. 10b shows the coil winding 132' and the magnet 133 positioned in the coil 132. The core structures 132s are adapted to act as magnetic interconnects between the respective cores 132''. The coil 132 includes a coil core 132'' connected to it. The core structures 132s are circularly distributed around the axis of rotation of the device 110 and are connected to the core structures 132s. The helices of the core 132'' and winding 132' of each core 132 are connected to the electric motor and gear. It extends axially parallel to the axis of rotation of the system.

[0576] FIG. 11a shows an embodiment similar to that shown in FIG. 10a, with the difference being that A Schall-type electric motor 130' includes magnetizable cores 132'' each magnetically coupled to a core 132''. The coils 132 include two sets of circularly arranged coils 132 arranged about a flexible core structure 132s. The rotatable structure includes a magnet 133 and two sets of coils 132a and 132b. The structure 135 has both the first and second sets of coils 132a, 132b. The magnets are positioned coaxially so as to overlap the magnets of the rotatable structure 135, thereby A first set of coils 132a propels a magnet 133 on its first side, and a second set of coils 132b propels the magnet 133 on its second side. In an alternative embodiment, coil set 1 Two sets of rotatable structures / disks 135 between 32a and 132b, one on each side The magnets may include a first set of magnets and a second set of magnets, the first set of magnets and the second set of magnets being radially offset. This is thought to make it possible to reduce the delay of the electric motor. 90 and / or control unit 195 sequentially energize the coils, thereby controlling the axial To operate the coil-type electric motor 130', a first set of coils and a second set of coils are connected. It is connected to a lead 192 which connects a battery 190 and a control unit 195 .

[0577] FIG. 12 shows the coil 132 connected to the battery 190 and the control unit 195. The enclosure 111 is made of a casting material and is positioned inside the enclosure 111, which surrounds the enclosed space containing the The coil 132 is connected to a battery 190 and a control unit 110. 195 by a lead wire 192, thereby propelling the magnet 133. The coils 132 can be energized sequentially. The magnets 133 are guided by the guide recesses 451. The manipulable element 143'''' is secured to the guide shaft 450 adapted to The core 132'' of each coil 132 and the helix of the winding 132' are integrated into the The coil 132 extends axially parallel to the axis of rotation of the device 110. The particles are distributed circularly around the axis of rotation of 110.

[0578] The operable element 143'''' comprises a coil 132 and a magnet 133 within the enclosure 111. 3. The manipulable element 143'''' is adapted to be propelled by a magnetic coupling between the manipulable element 143'''' is a hollow cylindrical first tooth 144t having a first number of teeth 144t, e.g., 160, on its outer circumference. First gear 144 and a gear 145t having more teeth than first gear 144, such as 162, on its inner surface. The outer surface of the first gear 144 is engaged with a second gear 145 having a hollow cylindrical shape. The teeth 144t of the first gear 144 are pressed against the inside of the second gear 145, so that the teeth 144t of the first gear 144 are pressed against the teeth 14 4t, 144t are separated by a position where they are not interengaged (e.g., position P2) At P1, the gear 143' interengages with the teeth 145t of the second gear 145. The operation of the operable element 143' is By advancing the position P1, the relationship between the first gear 144 and the second gear 145 is The gear system of the operating device of FIG. 12 further includes a first gear 144 and a second gear 145. The third gear 146 has an inner surface including the same number of teeth. 3, the third gear 146 is rotated relative to the second gear 145 along the interengagement position P1. The third gear 146 is adapted to interengage with the teeth 144t of the first gear 144 as shown in FIG. a radially extending connecting structure for transmitting force from the third gear 146 to the force output 149; A structure 147 is used to connect to the force output 149 of the gear system 140 .

[0579] The implantable operating device 110 described with respect to FIG. 12 includes all electrical components, particularly The coil 132, battery 190, and control unit 195 are protected from the surrounding environment, i.e., at the time of implantation. To provide a complete seal both from body fluids and from additional components of the operating device Furthermore, the implantable manipulation device 110 has few moving parts and the magnet 133 is corrosion-resistant. and completely surrounded by an operable element 143'''' that protects the magnet 133 from wear. The surface of the enclosure 111 that engages the operable element 143'''' is preferably made of a wear-resistant material, such as a ceramic material, and is preferably made of e.g. A manipulable element 143 surrounding the magnet 133 made from a wear-resistant material such as a ceramic material The material of the enclosure placed between the coil 132 and the magnet 133 is , preferably made of a non-metallic and / or non-magnetic material, so that the coil 32 and the magnet 1 The effect of the magnetic coupling between the conductor 33 is minimal.

[0580] FIG. 13a shows two gear trains 140a, 140b, each of which is a transmission of the first gear train 140a. transmission equal to the transmission of the second gear system 140b multiplied by the The two gear systems 140a and 140b are arranged to function as a single gear system with the same rotational speed. The gear system 140a, 140b is, for example, It may be of the same type, for example a gear system of the type disclosed with reference to Figures 2a to 5. In addition, one of the gear systems 140a, 140b may be configured as described with respect to, for example, FIGS. The other gear system 140a, 140b may be a planetary gear system or a standard gear system. The first and second gears may be different types of gear systems, such as a general gear system. a, 140b may have the same transmission or different transmissions. may have

[0581] In the embodiment of FIG. 13a, the first gear system and the second gear system are configured as follows: axial force transmission to the second gear set 140b (see, for example, the gear set 140b further described with respect to FIG. 8). The force transmitted between the first gear system and the second gear system is Preferably, both gear systems are centered, both gear systems are circumferential, or the first gear system 140a is the rotational force that can be transmitted from the center of the second gear set 140b to the periphery of the second gear set 140b.

[0582] FIG. 13b shows the gears of the first and second gear systems 140a, 140b connected in series. 13b shows an alternative embodiment of a vehicle system. 6) the first gear set 140a is "inside" the second gear set 140b. In the illustrated alternative, a first gear system and a second gear system 140a, 140b are both gear systems of the type described with respect to FIGS. 2a-5, with the first tooth A first gear of the gear train is connected to an operable element of the second gear train, thereby The movement of the first gear of the first gear system relative to the second gear of the second gear system 140b is The first gear system drives the operable element according to any one of the embodiments herein. In embodiments where the operable element includes a planetary gear, the total transformer The transmission is a planetary gear transmission multiplied by the transmission of the first gear system 140a. The transmission may be a transmission of the second gear system 140b.

[0583] Figure 14a shows three gears stacked coaxially to further strengthen the transmission. are connected in series, thus presenting yet another alternative. 1st gear transmission times 2nd gear transmission times 3rd gear transmission Similarly, FIG. 14b shows a first gear system 140a, a second gear system 140b, and a third gear system 140c. The first gear set 140b and the third gear set 140c are arranged radially inside each other, and the first The gear system and the second gear system are connected in series, for example, in the same way as in Figures 13b and 16. The coupled system is shown.

[0584] FIG. 15 illustrates the operation of a steerable implant similar to the embodiment described with respect to FIG. 15 shows an embodiment of the device 110, with the difference being that the embodiment shown in FIG. 15 has a first gear The first gear system 140a and the second gear system 140b are positioned coaxially along the rotation axes of the first gear system 140a and the second gear system 140b, and are connected in series. The first gear system and the second gear system 140a, 140b are connected to each other. Both the first and second gear systems 140a, 140b are operable planetary gear systems. It includes force inputs 142a, 142b that propel elements 143''a, 143''b. Possible elements 143'''a, 143'''b similarly have a first number of teeth on the outer periphery. The first gear 144 is engaged with a hollow cylindrical first gear 144 which includes two operable adapted to be engaged and deflected by flexible elements 143'''a, 143'''b It has a deflectable wall, which causes the outside of the first gear 14 to press against the inside of the second gear 145. This causes the teeth of the first gear 144 to be separated by positions where the teeth are not interengaged. The second gear 145 interengages with the teeth of the second gear 145 at two positions. The operable element 143''' has a greater number of gears on its surface than the first gear 144. a, 143'''b, the operation of the first tooth by advancing the interengaged position This generates relative rotation between the wheel 144 and the second gear 145 .

[0585] The first gear system 140a and the second gear system 140b further include a hollow cylindrical third gear. The inner side 146a of the third gear 146 has the same number of teeth as the outer side of the first gear 144. The teeth of the third gear 146 are adapted to interengage with the teeth of the first gear 144, This allows the third gear 146 to have at least one inter-engaged rotation with the second gear 145. The third gear 146 of the first gear system 140a is arranged in the circumferential direction. a third gear 146 and a force output part 149a / second gear 149b arranged at the center of the first gear system; It is connected to a radially extending structure that connects the force input 142b of the wheel system 140b. The first gear system and the second gear system 140a, 140b are thus connected to each other. b by the third gear 146 of the first gear train 140a connected to the force input 142b They are connected in series.

[0586] In the embodiment shown in FIG. 15, the force output 149b of the second gear system 140b is similarly The hollow shaft connects to a threaded member 441 that operates the reservoir 16. The details of the operation of the member 441 are further explained with respect to FIG. 40a, 140b provide a volume for forcing hydraulic fluid into the hydraulically operable body engaging portion. It has been described with respect to a hydraulic embodiment having a reservoir 160 of varying donor shape. However, the first gear system and the second gear system 140a, 140b connected in series are not included in the present specification. Examples of alternative embodiments include: a threaded member 44 directly connected to a body engaging portion that may be directly connected to the body; 1, and a first gear system and a second gear system connected to a pump for pumping hydraulic fluid. 140a, 140b. The pump may be, for example, a peristaltic pump or a membrane pump.

[0587] The first gear system and the second gear system 140a, 140b are enclosed in the same sealed space. This allows the transmission of force between the first gear system and the second gear system 140a, 140b through the seal. In the embodiment shown in FIG. 8, the first gear The force input 142a of the system 140a penetrates the enclosure, but in an alternative embodiment, An operating device such as an air motor is rigidly attached to the gear system enclosure, or The first and / or second gear trains 140a, 140b are surrounded by the first and / or second gear trains 140a, 140b. No through seals are required between the first gear set and the second gear set 140a, 140b.

[0588] FIG. 16 includes an alternative embodiment of a gear system 140 similar to the embodiment shown in FIG. 16 shows the operation device 110. FIG. 16 shows the left half of the operation device 110 in cross section. The device may be made of rigid components, for example made of a stiff polymer material, a ceramic material, or a metal. A portion of the housing 111 is a coil enclosure 13 1, surrounding the coil 132, so that upon implantation the coil 132 is protected from body fluids and scar tissue. The tissue is sealed. The coil 132 is one element of the electric motor and is connected to the periphery of the operating device. a radially extending portion 147 adapted to transmit force from the periphery to the center of the operating device; The rotatable structure further includes a magnet 133 attached to the rotatable structure 135. The body 135 is mounted on the first bearing so that the rotatable structure can rotate relative to the housing 110. The rotatable structure 1 is rotatably attached to the housing 110 using a ring Ba. The central portion of the gear train 140a is connected to the first gear 140b by the operable element 143'''. 14a, and the teeth of the first gear 144a are engaged with the second gear of the first gear system 140a and 3 gears 145a, 146a to interengage the teeth of the operable element 143''' The first tooth forms a force input for a first gear system 140 adapted to propel the first tooth. The second gear 145a of the gear train 140a is rotated in a direction perpendicular to the first gear 144a of the first gear train 140a. having many teeth, and a first gear 144a and a second gear 145a (as further described above). The third gear 146a has the same number of teeth as the first gear 144a. The third gear 146a rotates along the contact position. and to a force input 140a for a second gear system 140b. The third gear is connected to a radially extending portion 147 adapted to The structure 147 and the structure including the force input 142b of the second gear system 140b are The force input 142a of the first gear system 140a is connected to the bearing Bb, and the bearing Bc is connected to the force input 142a of the first gear system 140a. The second gear train 140b is rotatably connected to the force output 149c using the second gear train 140b. The gear train 140b operates in the same manner as the first gear train 140a, and the third tooth of the second gear train 140b The wheel 146b, the radially extending portion 147, and the force output of the second gear train 149c The included structure is rotatably mounted on the housing 110 of the operating device 110 using a bearing Bd. Currently connected.

[0589] In the operating device shown in FIG. 16, the coils 132 are sequentially energized. The magnet 133 connected to the rotatable structure 135 is then propelled, and the rotatable structure 13 5 similarly drives the first gear train 140a. The first gear train 140a drives the operating device 110 can be used to power the body-engaging portion of the steerable implant. connected in series with a second gear train 140b which also provides a force output 149c that may The first gear system and the second gear system 140a, 140b are connected in series, The total transmission of the operating device 110 is the transmission of the first gear system 140a. Therefore, the force output is equal to the transmission of the second gear system 140b. 149c is the speed of the rotatable structure including the magnet 133 times the speed of the first gear system 140a The force is output at the speed of the transmission multiplied by the second gear train 140b. do.

[0590] FIG. 17 shows an implementation of a manipulation device 110 similar to the manipulation device described with respect to FIG. 17 shows an embodiment, and the difference is that the operation device of FIG. 17 is an enclosure of the operation device 110. 111 has a first force output 149a and a second force output 149 extending from , whereby the operating device 110 performs first and second types of mechanical work, i.e., a first form of mechanical work having a first force and a first velocity, and a second form of mechanical work having a second force and a second velocity. A second form of mechanical work can be supplied, which has velocity.

[0591] More specifically, a coil 132 surrounded by a coil enclosure 131 is This results in a rotatable gear connected to the force input 142a of the first gear system. The magnet 133 is fixed to the structure 135. The rotatable structure 135 also has a high The force output of the manipulation device 110 is adjusted so that a fast force output is provided from the manipulation device 110. The high-speed force output unit 149a is also connected to the power supply 149b. The first gear system may be coupled to a generator for generating a current. The first gear system may be coupled in series with the second gear system. Therefore, the first gear system finally uses the third gear 146a of the second gear system to A second gear system provides output, thus via a radially extending rotatable structure 147. The connection is used to propel the low speed force output 149c. For example, a maneuverable impactor that engages the patient's body and requires low velocity and high force mechanical work. It may be connected to a portion of the runt.

[0592] FIG. 18a shows a first gear set 140a positioned radially inward of a second gear set 140b. As a result, the second gear system 140b rotates in the axial direction (with respect to the rotation axis of the operating device 110). 16 and 17 show an embodiment of an operating device in which the first gear system 140a is overlapped in the axial direction. As in the steering device described with respect to FIG. 17, the steering device may include a coil winding 132' and a coil 132 including a coil core 132'', such as an iron core. The coil influences a magnet 133 fixed to a rotatable structure 135, 133. In an alternative embodiment, the magnet 133 is driven by the magnetic field generated by the coil 132. The rotatable structure 135 may be replaced by any magnetic material that may be attracted. Similarly, the force input 142a of the first gear system 140a is driven by the first tooth of the first gear system. The inner side of the wheel 144a is engaged with operable elements 143'''a, 143'''b which are similarly engaged. This biases the first gear 144a, which also contributes to the functionality of the gear system described above. The third gear 146a of the first gear system 140a operates the second gear. The radially extending structure 147 that constitutes the operable element 143:2 of the wheel system 140b is connected to the The operable element 143:2 of the second gear system 140b is connected to the second gear system 140b. and a second gear set 140 having teeth that interengage with the teeth of the third gear 146b of the first gear set 140 and functioning in a similar manner. The third gear 146b of the second gear system 140b engages the first gear 144b of the second gear system 140b. A radially engineered structure that transmits force from the periphery of the operating device to the center of the operating device 110. Similarly connected to the structure 147 is a force output 149c of the second gear train 140b. The electric motor and the first and second gear systems 140a, 140b are in the same plane. This allows for a very thin design suitable for subcutaneous implantation.

[0593] The force output 149c of the second gear system 140b is, as will be further explained with respect to FIG. A threaded member 4 that converts rotational force into a linear reciprocating force that operates the donut-shaped reservoir 160 It is connected to 41.

[0594] The housing of the operation device 111 is designed to prevent bodily fluids from affecting the operation device 110. The housing / enclosure 111 is made of, for example, titanium or titanium alloy. They may be made from biocompatible metallic materials such as titanium, and are used as fluid manipulation devices. 0. In an alternative embodiment, the enclosure 111 may be made of, for example, silicon carbide. Ceramic materials such as silicon or zirconium carbide, or UHWPE or PTFE In any example, the body fluid enclosure 1 may be made of a polymer material or glass. The enclosure is constructed from low-permeability materials so that transmission through the walls is prevented. It is necessary to

[0595] In the embodiment shown in FIG. 18a, the coil 132 is further enclosed within the coil enclosure 131. , which further enables the coil 132 to be connected to other components of the steering device 110 and / or or sealed from bodily fluids.

[0596] The operating device of FIG. 18a includes a battery 190 adapted to power an electric motor, a parallel and adapted to control electric motors and additional operable elements of operable implants. The battery 190 and / or the control unit 195 may be enclosed within a sealed space. The battery 190 and / or control unit 195 may be connected to a wireless energy receiver and / or or a wireless communication unit and / or an additional power supply for supplying additional energy to the operating device. The electric motor is connected to a lead wire 192 that connects to a battery. In an indirectly powered embodiment, the battery 190 powers only the control unit 195. In other embodiments, the wireless energy receiver may be adapted to receive the wireless energy from the operating device 11. 0. The optical fiber 110 may be integrated into and enclosed in the same enclosure 111 that encloses the optical fiber 110.

[0597] FIG. 18b shows the first and second gear systems and the operation device 110 of FIG. 11a. The electric motor is shown in an exploded view. The bottom section includes the second gear 145a of the first gear train, and 1B is a stationary part of the operating device 110 including the second gear 145b of the second gear system 145b. The bottom section includes a coil core 132'' and a coil winding 132'', forming an electric motor. the coil 132, and a coil enclosure adapted to hermetically enclose the coil 132. The coil 132 may further include a filter 131 so that the coil 132 is protected from body fluids and / or from the first and second and / or from a lubricant adapted to lubricate the second gear system, and / or (as defined herein) from the operating device 110 (which will be further described in connection with other embodiments described herein). hydraulic fluid for transmitting force to the hydraulically operable body-engaging portion of the operable implant; The stationary parts 132, 145a, and 145b are sealed from the rotatable structure 135. The rotatable structure 135 is adapted to be in magnetic communication with the coil 132. The coil 132 includes a magnet 133, so that sequential energization of the coils 132 energizes the magnet 133. , i.e., the magnet 133 propels the fixed rotatable structure 135. 145 also includes an input 142a to the first gear system 140a, the input of the first gear system being: The operable element 143 of the first gear set 140a is engaged by interengaging teeth or by friction. The first gear 144a is adapted to drive the planetary gear mechanism 143'''. The outer teeth 144t of the first gear train are connected to the inner teeth of the second gear 145a of the first gear train, which is part of the stationary part. The operable element 143''' is configured to interengage the teeth 145t of the first gear system 140. The first gear 144a of the first gear system is engaged and deflected. The first and second gears 144t include fewer teeth than the second gear 145b of the second gear train. The interengagement position between 144a and 145a is advanced and the third gear 146a of the first gear train , the third gear 146a is in the forward position because it includes the same amount of teeth 146t as the first gear 144a. The third gear 146a of the first gear system moves with the operable element of the second gear system. Element 143:2 is an integral part, and therefore the output 149b of the second gear system and the output 149b of the first gear system The third gear 146a of the system and the rotating operable element 143:2 2'.

[0598] The rotating operable element 143:2' of the operable element 143:2 of the second gear system is The first gear 144b of the second gear system is engaged and deflected, so that the second gear system Similar to the first gear system, the second gear system drives the third gear 146b of the second gear system. The third gear 146b is connected to the output of the second gear system (and the operating device). The s...

Claims

1. 1. A maneuverable implant for hydraulically contracting a patient's urethra to treat urinary incontinence, said maneuverable implant comprising: a hydraulic constriction device for constricting the urethra; a hydraulically operated device for operating the hydraulic contraction device, the hydraulically operated device having an enclosure adapted at least in part to sealingly enclose a piezoelectric motor; a connection portion connecting the hydraulically operated device to the hydraulically contracting device, the connection portion including at least one fluid conduit for transferring hydraulic fluid from the hydraulically operated device to the hydraulically contracting device, the hydraulically operated device including a reservoir for holding hydraulic fluid to be transferred to the hydraulically contracting device, the reservoir including a movable wall portion for pumping hydraulic fluid from the reservoir to the hydraulically contracting device; Equipped with At least a portion of the wall of the enclosure forms the movable wall portion constituting at least a portion of the wall of the reservoir, and at least a portion of this movable wall portion is disposed between the reservoir and the piezoelectric motor, thereby separating and sealing a space surrounding the piezoelectric motor from the reservoir. Operable implants.

2. 10. The steerable implant of claim 1, wherein the enclosure is further adapted to hermetically enclose a gear system connected to the piezoelectric motor and adapted to receive mechanical work of a first force and velocity as an input and to output mechanical work having a different force and velocity.

3. The gear system comprises: connected directly or indirectly to a threaded member adapted to convert a radially rotating force into an axially reciprocating force; 3. The steerable implant of claim 2, wherein the threaded member is directly or indirectly connected to the movable wall portion for varying the volume of the reservoir.

4. 4. The steerable implant of claim 2 or 3, wherein the gear system comprises a gear system.

5. The steerable implant of any one of claims 1 to 4, further comprising at least one battery sealed in the enclosure for powering the piezoelectric motor.

6. The steerable implant of any one of claims 1 to 5, wherein the piezoelectric motor is a linear electric motor.

7. The steerable implant of any one of claims 1 to 6, wherein the enclosure comprises titanium.

8. a portion of the enclosure including a pleated section that functions as a bellows; The steerable implant of any one of claims 1 to 7, wherein the threaded member is disposed inside the pleated section of the enclosure.

9. The steerable implant of any one of claims 1 to 8, wherein a portion of the wall of the reservoir comprises a bellows structure.

10. the reservoir is circular; The steerable implant of any one of claims 1 to 9, wherein the circular reservoir comprises a movable wall portion adapted to compress and expand the circular reservoir.

11. The steerable implant of any one of claims 1 to 10, wherein the reservoir is configured to surround at least a portion of the hydraulically operated device.

Images