The invention relates generally to medical devices and procedures, and more particularly to apparatus and methods for removing an electronic implant from a body via a member disposed outside of the body.
Electronic implants, such as, for example, microstimulators, electrical stimulation leads and/or electrical sensing leads, are used in various medical procedures. For example, some known electronic implants can be implanted within a body to stimulate a response from a bodily organ or tissue, such as, for example, the heart, a nerve, a muscle group or the like. Other known electronic implants can be implanted within a patient's body to sense a response from a bodily organ or tissue. Accordingly, known electronic implants are often implanted into the patient's body at a predetermined location and/or orientation (e.g., such that a portion of the electronic implant is in contact with a nerve).
In certain instances, an electronic implant may need to be moved within and/or removed from the body after it has implanted. For example, in some instances, an electronic implant may not be disposed at the desired location and/or orientation within the body. Some known procedures for removing electronic implants include reopening the incision through which the electronic implant was inserted and/or forming a new incision adjacent the implant. Other known procedures for removing electronic implants include attaching a tether to the electronic implant via a coupling member, such as, for example, an eyelet. Such coupling members can be difficult to attach to the electronic implant, and can increase the size of and/or decrease the electronic performance of the electronic implant.
Thus, a need exists for improved apparatus and methods for moving an electronic implant within and/or removing an electronic implant from a body.
Apparatus and methods for moving an electronic implant within a body are described herein. In some embodiments, an apparatus includes an electronic stimulator configured to be implanted within a body, and a flexible member coupled to the electronic stimulator by an adhesive. In some embodiments, the flexible member is formulated to be soluble when exposed to a bodily tissue.
In some embodiments, an apparatus includes an electronic stimulator and a flexible member. The electronic stimulator, which can be, for example, a BION® microstimulator manufactured by Boston Scientific Neuromodulation, is configured to be implanted within a body. The flexible member is coupled to the electronic stimulator by an adhesive. In some embodiments, the flexible member can be coupled to an outer surface of the electronic stimulator. In some embodiments, the flexible member is formulated to be soluble when exposed to a bodily tissue. In some embodiments, the adhesive can be formulated to be soluble when exposed to the bodily tissue.
In some embodiments, a method includes inserting at least a distal end portion of an insertion tool within a body such that a stimulation portion of an electronic implant is disposed within the body and at least a proximal portion of the electronic implant is disposed outside the body. The proximal portion of the electronic implant is soluble in a bodily tissue, and is coupled to the stimulation portion by an adhesive. The insertion tool is removed from the body after being inserted such that the stimulation portion of the electronic implant is at a first location within the body. The proximal portion of the electronic implant is moved from a region outside the body such that the stimulation portion is moved to a second location within the body. The second location of the stimulation portion is different from the first location.
In some embodiments, an apparatus includes an enclosure and a flexible member. The enclosure is configured to be disposed about an electronic stimulator when the electronic stimulator is disposed within a body. The enclosure is constructed from at least one filament formulated to be soluble when exposed to a bodily tissue, such as, for example, a catgut suture, a suture constructed from polyglycolic acid, or the like. The flexible member is coupled to the enclosure, and has a length such that a proximal end portion of the flexible member is disposed outside of the body when the electronic stimulator is disposed within the body.
In some embodiments, a method includes disposing a coupling member about a portion of an electronic stimulator. The coupling member can be, for example, a cap having an eyelet to which a flexible member can be attached. The coupling member defines an opening having a size greater than a size of the portion of the electronic stimulator. The size of the opening of the coupling member is changed such that the size of the opening of the coupling member is less than the size of the portion of the electronic stimulator.
As used in this specification, the words “proximal” and “distal” can refer to the direction closer to and away from, respectively, an operator (e.g., surgeon, physician, nurse, technician, etc.) who would use a medical device or a therapeutic device during a procedure. For example, the end of a medical device first to contact the patient's body would be the distal end, while the opposite end of the medical device (e.g., the end of the medical device being operated by the operator) would be the proximal end of the medical device. Similarly, the end of a medical device implanted the furthest within the patient's body would be the distal end, while the opposite end of the medical device (e.g., the end of the medical device that is implanted the least amount within the body or the end of the medical device that is disposed outside of the body) would be the proximal end.
As used in this specification the words “electronic stimulator” and “electronic implant” can refer to any object or device that can be used as a part of an electrical circuit or an electrical process associated with electronically stimulating a bodily tissue. For example, in some embodiments, an electronic stimulator and/or an electronic implant can include passive objects, such as conductive wires, passive switches, insulators, electrical connectors or the like. In other embodiments, an electronic stimulator and/or an electronic implant can include an electrical device that produces, processes, receives and/or otherwise manipulates an electrical signal. Such electrical devices can include, for example, signal processors, sensors, stimulators, or the like.
The electronic stimulator 100 has a distal end portion 102, a proximal end portion 104 and a central portion 106. The distal end portion 102 includes a distal end electrode 112 having an outer surface 113. The distal end electrode 112 can be either a positively-charged electrode (i.e., an anode) or a negatively-charged electrode (i.e., a cathode). The proximal end portion 104 includes a proximal end electrode 114 having an outer surface 115. The proximal end electrode 114 can be either a positively-charged electrode (i.e., an anode) or a negatively-charged electrode (i.e., a cathode). The central portion 106 is disposed between the distal end electrode 112 and the proximal end electrode 114 and in some embodiments, can electronically isolate the distal end electrode 112 and the proximal end electrode 114. The central portion 106 can include, for example, a glass or ceramic portion. In this manner, when the electronic stimulator 100 is disposed within the body B, an electronic current (not shown in
A flexible member 120 is coupled to the electronic stimulator 100 by an adhesive 126. More particularly, a distal end portion 122 of the flexible member 120 is coupled to the outer surface 115 of the proximal end electrode 114 of the electronic stimulator 100, which can be either the cathode electrode or the anode electrode, by the adhesive 126. As shown in
The flexible member 120 is constructed from a material formulated to be soluble when the flexible member 120 is exposed to a bodily tissue (e.g., a bodily fluid). Such bodily tissues can include, for example, blood, mucous, water, saliva, urine, fat, muscle tissue, or the like. Similarly stated, the flexible member 120 is configured to dissolve after a being disposed within the body B. Said another way, the flexible member 120 is configured to be broken down and/or metabolized by the body B after a being disposed within the body B. The flexible member 120 can be constructed from any suitable biocompatible material formulated to be soluble when exposed to a bodily tissue. In some embodiments, for example, the flexible member 120 can be constructed from a natural material, such as cutgut (e.g., sheep or bovine intestines), chromic catgut (i.e., twisted collagen strands), or the like. In other embodiments, the flexible member 120 can be constructed from a synthetic material, such as polyglycolic acid, polydioxanone, polylactic acid, caprolactone, or the like.
The adhesive 126 can be any suitable biocompatible adhesive. Although the adhesive 126 is shown and described below as being soluble when the adhesive 126 is exposed to a bodily tissue of the types described above, in other embodiments, the adhesive 126 can be non-soluble when exposed to a bodily tissue. In some embodiments, the adhesive 126 can be a soluble adhesive, such as, for example, a fibrin glue (which includes fibrinogen and thrombin), BioGlue surgical adhesive, produced by CryoLife Inc., or the like. In other embodiments, the adhesive can be a non-soluble adhesive, such as, for example, light-curing acrylics and light-curing cyanoacrylates, light-curing silicones, cyanoacrylate adhesives, epoxy adhesives, and polyurethane adhesives.
In some embodiments, the flexible member 120 and the adhesive 126 can be collectively configured to withstand a tensile force sufficient to move the electronic stimulator 100 within the body B and/or remove the electronic stimulator 100 from the body B. Similarly stated, in some embodiments, the flexible member 120 and the adhesive 126 can be collectively configured to remain intact and coupled to the electronic stimulator 100 when a force is applied to the proximal end portion 124 of the flexible member 120 sufficient to move the electronic stimulator 100 within the body B. In this manner, the user can pull the proximal end portion 124 of the flexible member 120 with sufficient force to move the electronic stimulator 100 within the body B and/or remove the electronic stimulator 100 from the body B. In some embodiments, for example, the flexible member 120 and the adhesive 126 can be collectively configured to withstand a tensile force of at least 1.8 N (0.4 lbf). In other embodiments, the flexible member 120 and the adhesive 126 can be collectively configured to withstand a tensile force of at least 3.6 N (0.8 lbf).
Although the flexible member 120 is shown and described above as being coupled to the proximal end portion 104 of the electronic stimulator 100, in other embodiments, a flexible member can be coupled to any suitable location of the electronic stimulator 100. For example, in some embodiments, the flexible member 120 can be coupled to the end surface of the proximal end portion 104. In this manner, the addition of the flexible member 120 does not increase the profile (i.e., the maximum size or the outer diameter) of the electronic stimulator 100. Thus, the electronic stimulator 100 can be inserted into the body B using the same insertion tools as used for inserting electronic stimulators that do not include a flexible member. In other embodiments, the flexible member 120 can be coupled to the circumferential surface of the electronic stimulator 100 (e.g., the flexible member 120 can be wrapped about the circumference of the electronic stimulator 100).
Although the electronic stimulator 100 is shown as including a distal end electrode 112 and a proximal end electrode 114, in some embodiments, an electronic stimulator can be any suitable electrical device configured to convey an electronic signal (e.g., a current) within the body to a target location. For example, in some embodiments, an electronic stimulator can include a terminal (or pick-up) portion, a stimulation portion (e.g., a cuff electrode, an exposed electrical conductor or the like), and a flexible conductor disposed therebetween. Such an electronic stimulator can be used in the stimulation systems shown and described in U.S. Patent Publication No. 2006/0184211, entitled “Method of Routing Electrical Current to Bodily Tissues Via Implanted Passive Conductors,” filed Jan. 23, 2006, which is incorporated herein by reference in its entirety.
For example,
The electronic implant 410 includes the stimulation portion 413, a terminal portion 415, a conductor 418, and a proximal portion 416. The conductor 418, which can be constructed of a substantially flexible material, is disposed between the stimulation portion 413 and the terminal portion 415. The proximal portion 416 of the electronic implant 410 is coupled to the stimulation portion 413. The proximal portion 416 of the electronic implant 410 is constructed of a material that is soluble when exposed to a bodily tissue. Such materials can be flexible or rigid, and can include, for example, polyglycolic acid (PGA), polylactic acid, collagen, polycaprolactone, hylauric acid, polyethylene glycol, polyvinylpyrrolidone, high molecular weight carbohydrates, hydroxypropylcellulose and/or any combination thereof. In some embodiments, the proximal portion 416 is configured to substantially dissolve within a predetermined time (e.g., approximately 7 days, approximately 14 days, approximately 21 days, or the like) of being in contact with a bodily tissue. The proximal portion 416 of the electronic implant 410 can be any length and can be used to move the electronic implant 410 within the body B, as described herein.
As shown in
Returning to the flow chart shown in
Returning to the flow chart shown in
In other embodiments, the flexible member 120 can be coupled to the central portion 106 of the electronic implant. For example,
A flexible member 220 is disposed about and coupled to the central portion 206 of the electronic stimulator 200. More particularly, the flexible member 220 is wrapped about the outer surface (e.g., the circumference) of the central portion 206 of the electronic implant 200. In this manner, the coupling between the flexible member 220 and the electronic stimulator 200 can be enhanced by the frictional force resulting from the wrapping of the flexible member 220 about the electronic stimulator 200. Although
The flexible member 220 is coupled to the electronic stimulator 200 by an adhesive 226. In some embodiments, the adhesive 226 can be placed about the surface of the electronic stimulator 200 in discrete locations, which are labeled as 226A and 226B for clarity. More particularly, the adhesive 226A can be disposed about the central portion 206 to couple the flexible member 220 to the central portion 206, and the adhesive 226B can be disposed about the proximal end portion 204 to provide a strain relief for the flexible member 220. Although shown and described as being placed about the surface of the electronic stimulator 200 in multiple discrete locations, in other embodiments, the adhesive 226 can be disposed on the electronic stimulator 200 as a continuous bead of material.
The flexible member 220 can be constructed from any suitable biocompatible material. In some embodiments, the flexible member 220 can be constructed from a material formulated to be soluble when exposed to a bodily tissue, such as the materials described above with reference to the flexible member 120. In other embodiments, the flexible member 220 can be constructed from a non-soluble material, such as silk. The adhesive 226 can be any suitable biocompatible adhesive of the types shown and described above with reference to the adhesive 126.
The enclosure 530 is disposed about the electronic stimulator 500 when the electronic stimulator 500 is disposed within a body B. In this manner, movement of the enclosure 530 results in movement of the electronic stimulator 500 within the body B. Thus, this arrangement allows a user to change the position, orientation and/or location of the electronic stimulator 500 within the body B by moving the enclosure 530. The enclosure 530 is constructed from multiple longitudinal filaments 532 and multiple lateral filaments 534. More particularly, the longitudinal filaments 532 are spaced apart by a first distance d1, and the lateral filaments 534 are spaced apart by a second distance d2. Thus, the enclosure 530 defines a plurality of openings 535 defined between the longitudinal filaments 532 and the lateral filaments 534. Note that only one of the openings 535 is labeled in
The longitudinal filaments 532 and the lateral filaments 534 can be spaced apart by any suitable distance. In some embodiments, for example, the distance d1 can be substantially equal to the distance d2. In other embodiments, the distance d1 can be different from the distance d2. In some embodiments, the distance d1 and/or the distance d2 can be at least 0.5 millimeters. In other embodiments, the distance d1 and/or the distance d2 can be at between approximately 0.5 millimeters and 1.0 millimeters. In yet other embodiments, the longitudinal filaments 532 and the lateral filaments 534 can be spaced apart such that a ratio of the area of the openings 535 to the area of an outer surface (not identified in
A first end portion 522 of a flexible member 520 is coupled to the electronic stimulator 500 by an adhesive 526. The flexible member 520 includes a second end portion 524 disposed apart from the first end portion 522 (e.g., adjacent a skin incision, outside of the body B, or the like), such that a user can move the electronic stimulator 500 within the body B via the flexible member 520 and the enclosure 530. In some embodiments, for example, a user can remove the electronic stimulator 500 from the body B via the flexible member 520 and the enclosure 530.
At least one filament of the enclosure 530 (i.e., at least one of the longitudinal filaments 532 or at least one of the lateral filaments 534) is constructed from a material formulated to be soluble when exposed to a bodily tissue, as described above. Similarly stated, at least a portion of the enclosure 530 is configured to dissolve after a being disposed within the body B. Said another way, at least a portion of the enclosure 530 is configured to be broken down and/or metabolized by the body B after a being disposed within the body B. The at least one filament can be constructed from any suitable biocompatible material, of the types described herein.
The flexible member 520 can be constructed from any suitable biocompatible material. In some embodiments, the flexible member 520 can be constructed from a material formulated to be soluble when exposed to a bodily tissue, such as the materials described above with reference to the flexible member 120. In other embodiments, the flexible member 520 can be constructed from a non-soluble material, such as silk. The adhesive 526 can be any suitable biocompatible adhesive of the types shown and described above with reference to the adhesive 126.
Although the flexible member 120 is shown and described above as being coupled to the electronic stimulator 100 by the adhesive 126, in other embodiments, a flexible member can be coupled to an electronic stimulator by a coupling member that is coupled to the electronic stimulator. For example,
The coupling member 640 defines an opening 642 and includes an eyelet 644. The eyelet 644 is configured to be coupled to a flexible member 620. The flexible member 620 can be any suitable flexible member of the types shown and described herein. The flexible member 620 can be coupled to the eyelet 644 in any suitable manner, such as for example, by tying the flexible member 620 to the eyelet 644, by adhesively coupling the flexible member 620 within the opening defined by the eyelet 644, and/or the like.
The opening 642 has a size S2, which can be, for example a diameter of the opening 642. In other embodiments, however, the opening 642 can have a non-circular cross-section. The size S2 of the opening 642 is different than the size SI of the first end portion 602 of the electronic stimulator. As shown by the arrow CC in
Returning to the flow chart shown in
Although such “heat-shrink” materials are often formulated to irreversibly change size when exposed to heat, in some embodiments, the size of the coupling member can be reversibly changed. Referring to the flow chart shown in
The coupling member 640 can be constructed of any suitable material, and the opening 642 can have any suitable size S2 that results in a desired interference fit when the coupling member 640 is heated to a predetermined temperature, disposed about the first end portion 602, and subsequently cooled. For example, in some embodiments, the nominal size S1 of the first end portion 602 of the electronic stimulator 600 can be a diameter of approximately 3.1 millimeters. The nominal size S2 of the opening can be a diameter of approximately 3.21 millimeters, thereby resulting in an interference fit of approximately 0.11 millimeters. As described above, the coupling member 640 can be heated such that the size S2 of the opening increases to approximately 3.26 millimeters (i.e., an increase of approximately 0.16 millimeters), thereby resulting in a diametral clearance of approximately 0.05 millimeters. The coupling member 640 can then be disposed about the first end portion 602 of the electronic stimulator 600 and subsequently cooled such that the coupling member 640 is fixedly coupled to the electronic stimulator 600. In some embodiments, for example, the coupling member can be constructed of a polymer having a thermal expansion coefficient of approximately 9.5×10−5 mm/mm/° C. Such materials can include, for example, ABS (acrylonitrile, butadiene styrene). In such embodiments, the coupling member 640 can be heated such that the temperature of the coupling member 640 increases approximately 173 degrees Celsius to achieve the change in the size S2 as described above.
In some embodiments, the size S2 of the opening 642 can be less than the size S1 of the first end portion 602 before the coupling member 640 is disposed about the electronic stimulator 600 and can be changed during and/or after the coupling member 640 is disposed about the electronic stimulator 600. For example, in some embodiments, at least a portion of the coupling member 640 can be constructed from an elastic material. When the coupling member 640 is disposed about the first end portion 602, the portion of the coupling member 640 can be elastically deformed (i.e., stretched) such that the first end portion 602 can be received within the opening 642. In this manner, a coupling force can be produced by the elastic properties of the coupling member 650 to fixedly couple the coupling member 640 to the first end portion 602 of the electronic stimulator 600. Such elastic materials can include any suitable silicone elastomer, such as, for example, Silastic® produced by Dow Corning Corp.
Although the coupling member 640 is shown and described above as being fixedly coupled to the first end portion 602 of the electronic stimulator 600, in other embodiments, a coupling member can be coupled to any suitable portion of an electronic stimulator. For example, in some embodiments, a coupling member can be coupled to a central portion of an electronic stimulator.
While various embodiments of the invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where methods described above indicate certain events occurring in certain order, the ordering of certain events may be modified. Additionally, certain of the events may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. Thus, the breadth and scope of the invention should not be limited by any of the above-described embodiments. While the invention has been particularly shown and described with reference to specific embodiments thereof, it will be understood that various changes in form and details may be made.
For example, although the proximal end portion 124 of the flexible member 120 is shown as being disposed beneath the skin S, in other embodiments, the flexible member 120 can have length such that the proximal end portion 124 is disposed outside of the body B when the electronic stimulator 100 is disposed within the body B.
Although the flexible members are shown and described above as being constructed from a material that is soluble when exposed to a bodily tissue, in other embodiments, a flexible member can be constructed from more than multiple different materials. In some embodiments, for example, a flexible member can include an electrically conductive material. In other embodiments, a flexible member can include a radio-opaque material. In yet other embodiments, a flexible member can include a non-soluble material.
Although the flexible member 120 is shown and described above as being coupled to an outer surface of the electronic stimulator 100, in some embodiments, a flexible member can be coupled to any suitable portion of an electronic stimulator. For example, in some embodiments, a flexible member can be coupled within an interior portion of an electronic stimulator. Such an interior portion can include, for example, a lumen and/or a drilling within a casing of the electronic stimulator. In such embodiments, an adhesive can be disposed within the interior portion of the electronic stimulator to couple the flexible member to the electronic stimulator.
Although the enclosure 530 is shown and described above as being constructed from multiple filaments (i.e., longitudinal filaments 532 and lateral filaments 534), in some embodiments, an enclosure can be constructed from a single filament. For example, in some embodiments, a single filament can be wound and/or weaved to produce an enclosure.
Although flexible member 520 is shown and described above as being coupled to the enclosure 530 by the adhesive 526, in some embodiments, the flexible member 520 can be coupled to the enclosure 530 by any suitable method. Such methods can include, for example, tying, melt bonding, or the like. In some embodiments, the flexible member 520 and the enclosure 530 can be monolithically constructed. Similarly stated, in some embodiments, the flexible member 520 and at least a portion of the enclosure 530 can be constructed a single filament.
Although the enclosure 530 is shown and described above as being constructed from flexible filaments, in some embodiments, an enclosure can be constructed from elastic filaments. In this manner, the enclosure can be stretched to fit about the electronic stimulator.
Although various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having a combination of any features and/or components from any of embodiments where appropriate. For example, in some embodiments, the enclosure 530 and the flexible member 520 can be configured to withstand the tensile forces as described above with reference to the flexible member 120.
This application claims priority to U.S. Provisional Application Ser. No. 60/954,838, entitled “Assembly for Facilitating Removal of Miniature Implantable Device, and Related Method for Making It,” filed Aug. 9, 2007, which is incorporated herein by reference in its entirety.
Number | Date | Country | |
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60954838 | Aug 2007 | US |