The present disclosure relates to methods and systems for predictably and reliably aligning an implantable antenna with an external reader thereby facilitating power coupling and/or data transfer therebetween.
Obesity is becoming a growing concern, particularly in the United States, as the number of obese people continues to increase, and more is learned about the negative health effects of obesity. Morbid obesity, in which a person is 100 pounds or more over ideal body weight, in particular poses significant risks for severe health problems. Accordingly, a great deal of attention is being focused on treating obese patients. One method of treating morbid obesity has been to place a restriction device, such as an elongated band, about the upper portion of the stomach. Gastric bands have typically comprised a fluid-filled elastomeric balloon with fixed endpoints that encircles the stomach just inferior to the esophageal-gastric junction to form a small gastric pouch above the band and a reduced stoma opening in the stomach. When fluid is infused into the balloon, the band expands against the stomach creating a food intake restriction or stoma in the stomach. To decrease this restriction, fluid is removed from the band. The effect of the band is to reduce the available stomach volume and thus the amount of food that can be consumed before becoming “full.”
Food restriction devices have also comprised mechanically adjusted bands that similarly encircle the upper portion of the stomach. These bands include any number of resilient materials or gearing devices, as well as drive members, for adjusting the bands. Additionally, gastric bands have been developed that include both hydraulic and mechanical drive elements. It is also known to restrict the available food volume in the stomach cavity by implanting an inflatable elastomeric balloon within the stomach cavity itself. The balloon is filled with a fluid to expand against the stomach walls and, thereby, decrease the available food volume within the stomach.
With each of the above-described food restriction devices, safe, effective treatment requires that the device be regularly monitored and adjusted to vary the degree of restriction applied to the stomach. Traditionally, adjusting a gastric band required a scheduled clinician visit during which a hypodermic needle and syringe were used to permeate the patient's skin and remove fluid from the balloon. More recently, implantable pumps have been developed which enable non-invasive adjustments of the band. An external programmer communicates with the implanted pump using telemetry to control the pump. During a scheduled visit, a physician places a hand-held portion of the programmer near the gastric implant and transmits command signals to the implant. The implant in turn adjusts the band and transmits a response command to the programmer.
Implants such as those described above include electronics which require a power source that is sufficient for the intended function, such as making adjustments to the gastric band. Such devices may be internally powered by a battery or capacitor while others may be powered by an externally coupled power source or passive telemetry system. When coupling externally, the efficiencies between the implant and external device diminish substantially as the distance between them increases. There can also be significant power losses through tissue. Additionally, it can be difficult and time-consuming to properly align an internal antenna with an external reader so as to power the implant and/or transmit data therebetween.
Thus, there remains a need for a system and method capable of facilitating power coupling and/or data transfer between an implantable antenna and an external device.
Various aspects of an implantable restriction system are provided herein. In one such aspect the system includes an implantable restriction device configured to form a restriction in a pathway. The system can also include an implantable housing (e.g., a sensor housing) and an implantable antenna movably coupled to the housing such that the antenna can align with an external device for communicating therewith. The antenna can be effective to communicate with the external device to transcutaneously deliver energy to power the device to the antenna. The antenna can also be effective communicate (e.g., transmit and/or receive) various types of data to/from an external device.
As described below, the antenna can be movable in response to variety of factors. For example, the antenna can be movable in response to at least one of manual manipulation, a magnetic force, an electromagnetic force, a gravitational force, and a buoyant force. To facilitate such movement, the system can include at least one magnetic element coupled to the antenna wherein the at least one magnetic element is configured to align with an external magnetic member. Also, the antenna can contain an element (e.g., a weight) effective to enable a gravitational force to align the antenna in a desired orientation. In such an example, the antenna can be substantially ring-shaped and the weight can be positioned below and substantially along a central axis of the antenna. Also, the housing can be at least a portion of a gimbal element such that the antenna is free to rotate about a first axis and the antenna is also free to rotate about a second axis wherein the first axis can be substantially orthogonal to the second axis.
The system can also include an implantable sensor configured to measure at least one of an operational value of a system parameter and a value of a physiological parameter. In use, the antenna can be effective to communicate the operational value or the physiological value to the external device. For example, the implantable sensor can be a pressure sensor.
The antenna can be disposed on or coupled to various forms of a housing. For example, the antenna can be disposed on a sensor housing that is movably mounted to a base housing that is configured to engage an anatomical location (e.g., the fascia). In such an example, the antenna can be statically mounted upon the sensor housing, and the housing can be movably mounted to the base housing (e.g., by way of a ball and socket joint).
In another aspect, an implantable restriction system is provided which includes an implantable gastric restriction device configured to form a restriction in a patient. The system can also include an implantable sensor configured to measure at least one of a value of a system parameter and a physiological parameter. Additionally, the system can include an implantable antenna in communication with the implantable sensor wherein the implantable antenna can be configured to communicate with an external device and can be capable of achieving an effective orientation to enable the antenna to communicate with the external device. In this aspect, the antenna can be movable to the effective orientation in response to at least one of manual manipulation, a magnetic force, an electromagnetic force, and a gravitational force.
The antenna can be configured to be movable to the effective orientation in various manners. For example, the antenna can be movably coupled to a housing. In such an example, the antenna can be statically mounted to a housing which in turn can be movably mated to a base housing. The implantable antenna can also be coupled to a housing wherein the housing is at least a portion of a gimbal element such that the antenna is free to rotate about a first axis and the antenna is also free to rotate about a second axis wherein the first axis being substantially orthogonal to the second axis.
Additionally, various methods for transcutaneously communicating with an implantable restriction system are provided. In one such aspect, the method includes implanting a restriction system within a patient wherein the system includes a device effective to form a restriction in a pathway and an antenna effective to communicate with an external device to receive and transmit at least one of energy and data. The method can also include enabling the antenna to be movable with respect to at least a portion of a housing such that the antenna can align with the external device for communicating therewith. For example, the antenna can align with the external device in a desired orientation in response to at least one of manual manipulation, a magnetic force, an electromagnetic force, and a gravitational force.
The present disclosure will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices, systems, and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present disclosure is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present disclosure.
Systems and methods for communicating with an implantable restriction system are provided herein. In general, the implantable restriction system includes some type of internal antenna which may be coupled to or in communication with an implantable sensor configured to measure one or more operational parameter (e.g., pressure) and/or one or more physiological parameter. In use, the antenna can be any type of antenna capable of coupling with an external antenna so as to allow the implantable system to be powered and/or capable of transferring and/or receiving data (e.g., pressure readings) therebetween.
To facilitate such coupling and/or communication, the system and antenna can be configured in various manners so that it is able to attain and maintain proper alignment. For example, the antenna can be coupled to a housing, or a portion of a housing such that the antenna can move relative to the housing or the portion of the housing. In one embodiment the antenna can be coupled to a gimbal element so as to allow the antenna to freely swivel, move, and/or rotate about at least a first axis and a second axis wherein the first axis and the second axis are orthogonal to one another. In other embodiments, the antenna can be coupled to and/or include a weight or a weighted portion. In such an embodiment, the alignment of the antenna position can be known and easily reproduced by placing the patient in a certain orientation (e.g., standing). In other embodiments, the antenna can be in communication with (e.g., coupled to) at least one magnetic element configured to align with an external magnet thereby aligning the antenna with an external antenna or reader. In yet another embodiment, the antenna can be disposed on an implantable housing which in turn can be movably mounted to a base housing (e.g., via a ball and socket mounting) such that the antenna is free to move relative to the base housing while the base housing can be secured to an anatomical location (e.g., sutured to tissue). Thus, the presently disclosed embodiments provide a reliable system and method for facilitating power coupling and/or data transfer between the implantable system and an external reader.
Providing a movable antenna can facilitate coupling with an external device for various reasons. Given the relatively small size of the implant, any such antenna will typically exhibit low performance due to the physics of antenna coupling to the media (i.e. body tissues, air, etc.). Larger antennae, if designed correctly, will couple better than smaller antennae, and if the antenna cannot be a sizable fraction of the wavelength it will perform more like a probe than an antenna, exhibiting low gain and requiring higher power for transmit and more receiver gain in order to compensate. One skilled in the art would appreciate that antennae must occupy the space of at least about ¼ and more ideally about ½ of a wavelength to perform in an efficient manner. Since c=fλ where c=speed of electromagnetic propagation in a given media, f is frequency and λ is the wavelength, it can be seen that at frequencies other than microwave, associating an antenna design in an implant that is a sizable fraction of the wavelength is impractical. If, say, the communication frequency is in one of the industrial, scientific, and medical (“ISM”) radio bands that is conducive for transmission through tissue (approximately 13 MHz) a ¼ wavelength antenna element would be about 3.8 m long. Therefore certain compromises need to be made in order to provide efficient coupling of transmissions to and from the implant in a practical implant size. Thus, as described, the antenna can be constructed to be part of an entire implanted device (e.g., a restricting band, connecting tube, port, etc.) in order to increase its relative size and approach an ideal size. Additionally, polarization of the antenna system can also affect the coupling, with approximately 20 dB of attenuation occurring if the elements of the system are not properly aligned. Circularly polarized antennae can be used but are best exploited if the antenna system is of an optimal size. Therefore, it is an advantage to have a movable antenna in the implant in order to optimally couple the antenna system.
While the present disclosure can be used with a variety of restriction systems known in the art,
The internal portion 10a can also include a sensing or measuring device that is in fluid communication with the closed fluid circuit in the implantable portion 10a. In one embodiment, the sensing device is a pressure sensing device configured to measure the fluid pressure of the closed fluid circuit. While the pressure measuring device can have various configurations and can be positioned anywhere along the internal portion 10a, including within the injection port 30 and as described further below, in the illustrated embodiment the pressure measuring device is in the form of a pressure sensor that is disposed within a sensor housing 60 positioned adjacent to the injection port 30. The catheter 50 can include a first portion that is coupled between the gastric band 20 and the pressure sensor housing 60 and a second portion that is coupled between the pressure sensor housing 60 and the injection port 30. While it is understood that the sensing device can be configured to obtain data relating to one or more relevant parameters, generally it will be described herein in a context of a pressure sensing device.
As further shown in
A person skilled in the art will appreciate that the gastric band can have a variety of other configurations. Moreover, the various methods and devices disclosed herein have equal applicability to other types of implantable bands. For example, bands are used for the treatment of fecal incontinence, as described in U.S. Pat. No. 6,461,292 which is hereby incorporated by reference. Bands can also be used to treat urinary incontinence, as described in U.S. Publication No. 2003/0105385 which is hereby incorporated by reference. Bands can also be used to treat heartburn and/or acid reflux, as disclosed in U.S. Pat. No. 6,470,892 which is hereby incorporated by reference. Bands can also be used to treat impotence, as described in U.S. Publication No. 2003/0114729 which is hereby incorporated by reference.
The fluid injection port 30 can also have a variety of configurations. In the embodiment shown in
The reading device 70 can also have a variety of configurations, and one exemplary pressure reading device is disclosed in more detail in commonly-owned U.S. Publication No. 2006/0189888 and U.S. Publication No. 2006/0199997, which are hereby incorporated by reference. In general, the reading device 70 can non-invasively measure the pressure of the fluid within the implanted portion 10a even when the pressure sensing device is implanted beneath thick (at least over 10 cm) subcutaneous fat tissue. The physician can hold the reading device 70 against the patient's skin near the location of the sensor housing 60 and/or other pressure sensing device location(s), obtain sensed pressure data and possibly other information as discussed herein, and observe the pressure reading (and/or other data) on a display on the control box 90. The data reading device 70 can also be removably attached to the patient, as discussed further below, such as during a prolonged examination, using straps, adhesives, and other well-known methods. The data reading device 70 can operate through conventional cloth or paper surgical drapes, and can also include a disposal cover (not shown) that may be replaced for each patient.
As indicated above, the system 10 can also include one or more sensors for monitoring the operation of the gastric restriction system 10. The sensor(s) can be configured to measure various operational parameters of the system 10 including, but not limited to, a pressure within the system, a temperature within the system, a peristaltic pulse event or frequency, the peristaltic pulse width, the peristaltic pulse duration, and the peristaltic pulse amplitude. In one exemplary embodiment, the system can include a sensor in the form of a pressure measuring device that is in communication with the closed fluid circuit and that is configured to measure the fluid pressure within the system, which corresponds to the amount of restriction applied by the adjustable gastric band to the patient's stomach. In use, measuring the fluid pressure, or any other control parameter of the system, can enable a physician to evaluate the performance of the restriction system. In the illustrated embodiment, shown in
Various pressure sensors known in the art can be used as the pressure sensor 62, such as a wireless pressure sensor provided by CardioMEMS, Inc. of Atlanta, Ga., though a suitable Micro-Electro-Mechanical Systems (“MEMS”) pressure sensor may be obtained from any other source, including but not limited to Integrated Sensing Systems, Inc. (ISSYS) of Ypsilanti, Mich. and Remon Medical Technologies, Inc. of Waltham, Mass. One exemplary MEMS pressure sensor is described in U.S. Pat. No. 6,855,115, the disclosure of which is incorporated by reference herein for illustrative purposes only. It will also be appreciated by a person skilled in the art that suitable pressure sensors can include, but are not limited to, capacitive, piezoresistive, silicon strain gauge, or ultrasonic (acoustic) pressure sensors, as well as various other devices capable of measuring pressure.
One embodiment of a configuration of the sensor housing 60 having the sensor 62 disposed within it is shown in
In use, fluid can enter the sensor housing 60 through an opening 66 located anywhere on the housing's surface (here, the bottom surface) and come into contact with a pressure sensing surface 68 of the sensor 62. The sensor 62 is typically hermetically sealed to the motherboard such that fluid entering the opening 66 cannot infiltrate and affect operation of the sensor 62 except at the pressure sensing surface 68. The sensor 62 can measure the pressure of fluid coming into contact with the pressure sensing surface 68 as fluid flows in and out of the opening 66. For example, the pressure sensing surface 68 can include a diaphragm having a deformable surface such that when fluid flows through the opening 66, the fluid impacts the surface of the diaphragm, causing the surface to mechanically displace. The mechanical displacement of the diaphragm can be converted to an electrical signal by a variable resistance circuit including a pair of variable resistance, silicon strain gauges. One strain gauge can be attached to a center portion of diaphragm to measure the displacement of the diaphragm, while the second, matched strain gauge can be attached near the outer edge of diaphragm. The strain gauges can be attached to the diaphragm with adhesives or can be diffused into the diaphragm structure. As fluid pressure within band 20 fluctuates, the surface of the diaphragm can deform up or down, thereby producing a resistance change in the center strain gauge.
One embodiment of a variable resistance circuit for the sensor 62 is shown in
The external portion 10b can also include a primary telemetry transceiver 142 for transmitting interrogation commands to and receiving response data, including sensed pressure data, from the implanted microcontroller 65. The primary transceiver 142 is electrically connected to the microprocessor 136 for inputting and receiving command and data signals. The primary transceiver 142 drives the telemetry coil 144 to resonate at a selected RF communication frequency. The resonating circuit can generate a downlink alternating magnetic field 146 that transmits command data to the microcontroller 65. Alternatively, the transceiver 142 can receive telemetry signals transmitted from a secondary TET/telemetry coil 156 (“the internal antenna”) in the internal portion 10a. The received data can be stored in the memory 138 associated with the microprocessor 136. A power supply 150 can supply energy to the control box 90 in order to power element(s) in the internal portion 10a. An ambient pressure sensor 152 is connected to microprocessor 136. The microprocessor 136 can use a signal from the ambient pressure sensor 152 to adjust the received pressure measurements for variations in atmospheric pressure due to, for example, variations in barometric conditions or altitude, in order to increase the accuracy of pressure measurements.
As indicated above, the presently disclosed system can be configured in various manners so as to allow the implantable system to be powered by and/or communicate with an external reader. In an exemplary embodiment, the system can include an implantable antenna 156 which is configured to readily and predictably align with some external reference point (e.g., the external reader 70) in response to some force. For example, the antenna 156 can be configured so as to align with an external reader 70 in response to a magnetic force or an electromagnetic force being applied to a magnetic member in communication with the antenna 156. Also, the antenna 156 can be configured to align with the external reader 70 in response to a gravitational force being applied to the antenna 156. For example, the antenna 156 can be configured so as to adopt a known orientation when the patient assumes a certain position (e.g., standing). In short, the presently disclosed system can include any mechanism and/or configuration for easily and reliably aligning an implantable antenna 156 with the external reader 70 or some other external reference point.
In the embodiment of
In other embodiments, the implantable antenna can be configured so as to adopt a known orientation in response to a gravitational force. For example, in such an embodiment the orientation of the antenna 156 can be predictably manipulated based on the orientation or posture of the patient (e.g., supine, upright, etc.). As will be appreciated by those skilled in the art, the antenna 156 can be configured in various manners so as to predictably align with an external reference point in response to such a gravitational force. For example, as shown in the exemplary embodiment of
In yet another embodiment, the antenna 156 can be disposed in a known orientation within or with respect to a housing 60 (i.e., statically mounted thereto) which can be pivotally mounted on a base housing configured to be secured to a desired anatomical location. Thus, following implantation, the housing 60 (and therefore the antenna 156) can be readily manipulated relative to the base housing so as to align the antenna 156 with a known external reference point (e.g. an external reader 70). Those skilled in the art will appreciate that the housing 60 can be mated to the base housing in various manners so as to provide such pivotable movement. For example, as shown in
In order to facilitate reorientation of the internal antenna, the distal surface 60D of the housing 60 and the proximal surface 220P of the base housing 220 can be configured to move relative to one another. In one exemplary embodiment, the distal surface 60D of the housing 60 and the proximal surface 220P of the base housing 220 are configured to move relative to one another, for example, using a ball and socket configuration. In one embodiment, shown in
In another embodiment, as shown in
Additionally, various embodiments of a method for transcutaneously communicating with an implantable restriction system are provided herein. In general, the presently disclosed embodiments allow a user to readily and predictably align an implantable antenna with an external device (e.g., an external antenna or reader). Once properly aligned, the implantable antenna can easily communicate with an external antenna thereby allowing the implantable system to be powered and/or various system and/or physiological parameters (e.g., pressure readings) to be transmitted/received from the implantable antenna to/from some external antenna or reader.
More specifically, in an exemplary embodiment, the method includes implanting a restriction system within a patient wherein the system includes a device effective to form a restriction in a pathway and an antenna effective to communicate with an external device to receive and transmit at least one of energy and data. The method also includes enabling the antenna to be movable with respect to at least a portion of a housing such that the antenna can align with the external device for communicating therewith. As described above, various manners or mechanisms can be utilized to move and/or manipulate the implantable antenna. For example, the antenna can align with the external device in a desired orientation in response to at least one of manual manipulation, a magnetic force, an electromagnetic force, and a gravitational force.
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
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