The invention relates to a method for the production of a medical implant, comprising a head section, which has at least one blind hole-type recess designed in the manner of an electrical plug-in contact socket, along which is arranged at least one electrically conductive contact element, and a supply section, which is fixedly connected to the head section, and comprises at least one electrical component, preferably in the form of at least one of a microcontroller, and an electrical energy source, which are electrically connected to the at least one electrically conductive contact element by way of at least one electrical conductor.
Implantable medical devices for the purpose of electrical stimulation of local intracorporeal regions, in short, implantable pulse generators (IPGs), for example for heart therapeutical defibrillation, pacemaker, and resynchronization, applications, for neurostimulation therapeutical measures, such as spinal cord stimulation, brain stimulation, or vagus nerve stimulation, to name but a few, generally speaking have a self-contained housing, in which are included components for electrical pulse generation, such as at least one electrical energy source, and an electrical circuit structure connected to the latter. In addition, a so-called head section is attached to the housing, in which head section is included an electrical contact arrangement, electrically connected to the energy source, or to the electrical circuit structure, into which can be introduced a connector arrangement that is connected in a manner impermeable to fluids to the head section, which connector arrangement is in established contact with electrical supply and return lines for purposes of the intracorporeal local application of the electrical stimulation signals, and, if necessary, the supply of intracorporeally locally tapped electrical signals to the electrical circuit structure that is located in the housing.
In EP 2 134 418 B1 there is described a generic head section of an implantable medical device, which comprises two head section housing-halves, which can be joined together along a joining seam, into which semi-cylindrical recesses are inserted in each case in a serial sequence, spaced apart by partition walls, into which recesses are inserted electrically conductive contact ring elements, and electrically insulating sealing rings, in each case in a serially alternating sequence. The head section assembled from the two head section housing halves thus comprises an arrangement of coaxially aligned and electrically insulated contact ring elements, for the establishment of electrical contact with which a lateral access is provided in the head section, through which access an electrical connector arrangement can be introduced, in a manner impermeable to fluids, into a cavity surrounded by all the annular contact ring elements.
DE 10 2012 010 901 A1 discloses a method for the positioning and holding of electrical contacts and seals within a head section for the establishment of electrical contact with a medical implantable device. A blind hole is introduced into one side of the head section housing, which is made of a biocompatible and electrically insulating material, into which housing electrically conductive contact rings and annular sealing elements are introduced in an alternating sequence, which together surround a cavity, into which a pin-form connector arrangement can be introduced. Each of the individual annular contact rings is connected within the head section by way of an electrical connection line to electrical components located within the housing of the medical implantable device.
DE 20 2013 012 073 U1 discloses a connector bore module, for the assembly of contact rings and sealing elements which are arranged in an alternating sequence along a pin-form assembly tool. By means of a clamping device, all contact rings and sealing elements seated along the assembly tool are clamped against each other by the application of an axial clamping force. For the purpose of preserving the clamping force, a sleeve element is used, which is seated in an axially fixed manner on the assembly tool by a grub screw, and which, together with an assembly tool head at the end, bounds the arrangement of contact rings and sealing elements axially on both sides. In this clamped state, the arrangement is encapsulated in a curable casting compound, which takes up the clamping force in the solidified state.
Methods for the production of a medical implant are of known art from the documents US published patent applications 2016/0 166 825 and 2008/0 033 500. In both cases, the supply section and the head element are encapsulated in a casting compound monobloc, in at least a final production step.
The US published patent application 2003/0 144 707 discloses an implantable medical device with a surface contact arrangement.
DE 10 2017 222 364 A1 describes a method for the production of a head section of an implantable medical device, with a plug-in contact socket, in which a serial sequence of contact ring elements and electrically insulating sealing rings are arranged. An assembly tool is used for the mechanical clamping together of the annular elements, which tool is removed after the completion of the medical device, wherein the clamping together of the annular elements by force is taken up by the solidified plastic matrix of the head section.
The invention is a further development of a method for the production of a medical implant, comprising a head section, which has at least one blind hole-type recess providing an electrical plug-in contact socket, along which is arranged at least one electrically conductive contact element, and a supply section, which is fixedly connected to the head section, and comprises at least one electrical component, which preferably is at least one of a microcontroller, and an electrical energy source. These components are electrically connected to the at least one electrically conductive contact element by way of at least one electrical conductor structure, such that a procedural, time and cost saving providing effort for the production of both individually assembled implants, and also implants produced in large numbers, is significantly reduced. It is also of particular interest that the production quality, together with the fluid impermeability and the associated service life of the implants, should meet the highest demands. Since up to the present time it has been necessary to manufacture the head section and the supply section in separate building processes for technical reasons, special attention is paid to the joining of the head section and the supply section so as to be able to implement a durable joint that is impermeable to fluids, in accordance with the above-mentioned production requirements.
Of central importance in the production of generic medical implants is the design of the joint between the head section and the supply section, which in accordance with the invention is a material bond, that is, monolithical and ensures a durable joint between the head section and the supply section that is impermeable to fluids. Irrespective of the particular technical design of the head section and the supply section, both of which are encapsulated in a biocompatible casting compound by way of a casting process, both the head section and the supply section are joined by material bonding to two opposing faces of a connecting plate, which is referred to herein as a fixing plate, and is constructed as a curable casting material, in which material both the head section and the supply section are encapsulated.
For purposes of electrically connecting the at least one electrically conductive contact element included in the head section to the microcontroller and the electrical energy source preferably contained in the supply section, it is necessary to guide the at least one electrical conductor structure through the fixing plate that connects the head section to the supply section.
The method in accordance with the invention first provides for the production of the fixing plate, which has an upper face and a lower face, and is manufactured as a semi-finished product by a casting process using a curable casting compound. During the casting process, at least one electrical conductor structure, preferably in the form of a wire section, is oriented and arranged orthogonally with respect to the forming upper and lower faces of the fixing plate, so that the conductor structure is fixedly connected to the fixing plate after the curing of the casting compound, and projects beyond it, on both sides of the upper and lower faces of the plate.
Depending on the number of electrically conductive contact elements present within the head section, a corresponding number of electrical conductor structures, protruding through the fixing plate, must be provided. For this purpose, the electrical conductor structures protruding through the fixing plate, orthogonally with respect to the upper and lower faces of the plate, are distributed in the fixing plate in accordance with the spatial arrangement of the electrically conductive contact elements within the head section. As an alternative to the embedding of the electrical conductor structures in the course of the casting process, it is also possible to produce the fixing plate separately from the electrical conductor structures by way of the casting process. In this case, the electrical conductor structures are subsequently inserted into fine holes protruding through the fixing plate, and are wetted with an adhesive, for example with a drop of epoxy, which fixes the conductor structures in position as its cures, and is the same material as the head section.
For the production of the supply section, a casting mold is used in a manner known per se, which determines the outer shape and form of the supply section. In the preparation for the casting process, the at least one electrical component, which preferably in the form of at least one of a microcontroller and an electrical energy source, is positioned inside the casting mold and connected to the at least one electrical conductor structure. In accordance with the invention, the casting mold is designed with the fixing plate being prepared as a semi-finished product to be integrated into the casting mold. The lower face forms part of the surface bounding of the casting mold. Subsequently, the at least one electrical conductor structure projecting beyond the lower face of the plate, together with the at least one electrical component, are encapsulated in the curable casting compound.
In the course of the casting process, the casting compound fills the prepared casting mold and encloses the components arranged therein, wherein the flowable casting compound wets the lower face of the fixing plate serving as part of the casting mold surface, with the formation of a monolithic material bond.
After the casting compound has cured, the supply section is removed from the casting mold together with the fixing plate which is fixedly attached to the supply section which is fixedly connected to it.
For the production of the head section, the at least one electrically conductive contact element must first be provided, and connected to the at least one electrically conductive structure projecting beyond the upper face of the fixing structure.
Usually, the head section provides a multiplicity of electrically conductive contact elements, which are designed in the form of contact ring elements, and in the alternate as in a coaxial, and in an axial serial, sequence with electrically insulating, elastically deformable sealing rings which are force-fitted against each other under an axial clamping force. A preferred design of such a prestressed stacking arrangement of contact ring elements, which is integrated in a head section, is explained in more detail with reference to the following figures.
The electrical conductor structures protruding above the upper face of the fixing plate are established in electrical contact with the respective electrical contact elements provided within the head section, preferably by way of a soldering, bonding, gap welding, or friction welding, process. Optionally, further electrical structures can be introduced into the head section, for example an antenna, which can be connected to corresponding electrical components within the supply section. Furthermore, the at least one contact element electrically connected to the electrical conductor structure is encapsulated in the curable casting compound such that a materially bonded connection to the upper face of the fixing plate is formed. The casting process for the production of the head section can be carried out before, during or after the manufacture of the supply section.
As in the case of the casting process for the production of the supply section, a monolithic material bond that is impermeable to fluids is also formed between the upper face of the fixing plate and the curable casting compound on the head section-side, so that all electrical components that are cast around the head section, the fixing plate and the supply section by use of the curable casting compound are completely surrounded by the casting compound in a manner impermeable to fluids, without any boundary surfaces.
Biocompatible plastics or epoxy resins are suitable as the casting compounds for the production of the head section, the fixing plate and the supply section.
Without any limitation of the general concept of the invention, the invention is described in an exemplary manner below by way of examples of embodiment, with reference to the drawings. Here:
The head section 2 has a blind hole-type recess 5 providing an electrical plug-in contact socket, along which are arranged electrical contact elements 6 in the form of contact ring elements in a serial sequence, in each case axially spaced apart by interposed electrically insulating sealing rings 7. The serial sequence of contact ring elements 6 and sealing rings 7 is subjected to an axial clamping force F, by means of which the contact ring elements 6 and the sealing rings 7 are clamped together in a manner impermeable to fluids. For the electrical signal and energy supply, the electrical contact ring elements 6 are connected by way of wire-type electrical conductor structures 8 to a microcontroller 9 introduced within the supply section 3, and to an electrical energy source 10 electrically connected to the microcontroller 9. The electrical energy source 10 can be designed as a battery, accumulator, biofuel cell, or in the form of an inductive coupling loop for a contactless inductive transfer of energy. Needless to say, alternative or further electrical components can be included in the supply section 1.
All components of the medical implant 1 are in each case encapsulated in a biocompatible casting compound monobloc, which preferably is a plastic or resin compound, and most preferably is an epoxy resin compound.
For the production of the medical implant 1 illustrated in
The fixing plate 4, which is designed as a separate semi-finished product, with the wire-form electrical conductor structures 8 attached therein, serves furthermore as part of the surface of a casting mold 12 for the production and design of the supply section 3. First of all, it is necessary to electrically connect the electrical conductor structures 8, which protrude beyond the plate lower face 4″, to the microcontroller 9 shown, as well as to the electrical energy source 10. The electrical connections can be made before or after the insertion of the fixing plate 4 into the casting mold for forming a boundary for the latter.
Following the casting process, electrical contacts are established between the electrical conductor structures 8 projecting beyond the upper side 4′ of the fixing plate 4 and the contact ring elements 6, as shown in
The axial stacking arrangement 14 illustrated in
In order to apply the clamping force, oriented axially to the rod-shaped assembly tool 13, which clamps the alternating sequence of contact ring elements 6 and sealing rings 7 in a force-fit with, or against, each other, it is necessary to rotate the assembly tool 13 relative to the fastening means 15, for example by completely screwing the assembly tool-side external thread into the internal thread of the fastening means 15, as a result of which a defined clamping force acting along the contact ring elements 6 and sealing rings 7 seated on the assembly tool 13 is established.
The axial stacking arrangement 14 shown in
After the head section-side casting compound has solidified, the medical implant 1 can be removed from the casting mold 17, and the assembly tool 13 can be separated from the fastening means 15 by rotation. The clamping force prevailing axially between the contact ring elements 6 and the sealing rings 7 is supported and conserved by the head section-side solidified casting compound. As an alternative to the procedure as explained above, it is also possible to carry out the casting procedure shown in
Number | Date | Country | Kind |
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10 2019 203 273.7 | Mar 2019 | DE | national |
Reference is made to International Application No. PCT/EP2020/055465, filed Mar. 2, 2020, which claims priority to German Patent Application No. 10 2019 203 273.7, filed Mar. 11, 2019, the contents of which are incorporated herein by reference in their entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/EP2020/055465 | 3/2/2020 | WO | 00 |