Method Article

Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa

DOI:

10.3791/57268

⸱

September 27th, 2018

 , 
12nd Department of Internal Medicine, Third Faculty of Medicine, Charles University, Prague, Czech Republic, 22nd Department of Internal Medicine, University Hospital Královské Vinohrady, Prague, Czech Republic, 3Czech Technical University in Prague, Czech Republic

* These authors contributed equally

In This Article

Summary

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The application of high-frequency low-energetic stimulation can alleviate the symptoms of gastric dysmotility. In this research, a miniature, endoscopically implantable and wirelessly rechargeable device which is implanted into a submucosal pocket is presented. Successful both-way communication and stimulation control were achieved during an experiment on live pig.

Abstract

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Gastric dysmotility can be a sign of common diseases such as longstanding diabetes mellitus. It is known that the application of high-frequency low-energetic stimulation can help to effectively moderate and alleviate the symptoms of gastric dysmotility. The goal of the research was the development of a miniature, endoscopically implantable device to a submucosal pocket. The implantable device is a fully customized electronic package which was specifically designed for the purpose of experiments in the submucosa. The device is equipped with a lithium-ion battery which can be recharged wirelessly by receiving an incident magnetic field from the charging/transmitting coil. The uplink communication is achieved in a MedRadio band at 432 MHz. The device was endoscopically inserted into the submucosal pocket of a live domestic pig used as an in vivo model, specifically in the stomach antrum. The experiment confirmed that the designed device can be implanted into the submucosa and is capable of bidirectional communication. The device can perform bipolar stimulation of muscle tissue.

Introduction

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Gastric dysmotility can be a sign of several relatively common diseases such as gastroparesis, which is usually characterized by a chronic progression and imposes rather severe consequences on the social, work-related, and physical status of the patient. Most cases of gastroparesis are usually diabetic or idiopathic in origin and are often resistant to available medication1. Patients afflicted with this condition most commonly present with nausea and repeated vomiting. Based on previous research, it is known that the application of high-frequency low-energetic electrical stimulation can help to effectively moderate and alleviate the symptoms of....

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Protocol

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All endoscopic procedures including animal subjects have been approved at the Institute of Animal Physiology and Genetics, Academy of Science Czech Republic (Biomedical Center PIGMOD), Libechov, Czech Republic (project Experiments in implantation of battery-less and battery devices into submucosa of the esophagus and stomach — experimental study). All experiments are done in compliance with Czech law 246/1992 Sb. "On the protection of animals against maltreatment, as amended". Transmitter device is not required to be sterilized, because it is an external device that is not in direct contact with the animal.

1. Implantable D....

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Results

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Figure 17 shows that an endoscopic placement of the gastric neurostimulator into a pocket in submucosa as well as proper placement of the electrodes to the muscular layer was successful. The dimensions of the device (Figure 10) are 35 x 15 x 5 mm3 while the weight is 2.15 g. Figure 17 shows the circuit diagram of the device showing that the device comprises of 6 different modules whic.......

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Discussion

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The design of the implantable device should primarily focus on the overall size of the device, achievable stimulation profiles (maximum voltage, maximum deliverable current, length of pulses and pulse frequency). Main limitation from the hardware perspective is the size and availability of suitable components. To minimize the overall size, surface mount components are preferred because of their compact packaging. The best solution would be to integrate bare chip dies on the substrate. However, this is limited by both the.......

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Disclosures

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This work was supported by the Research Project PROGRES-Q28, and awarded by Charles University in Prague. The authors thank to Ass. Prof. Jan Martínek, Ph.D. and PIGMOD centre.

Acknowledgements

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The authors declare that they have no competing financial interests.

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Materials

List of materials used in this article
NameCompanyCatalog NumberComments
EIA 0402 ceramic capacitor 1.8 pFAVX04025U1R8BAT2A1 pc
EIA 0402 ceramic capacitor 100 nFTDKCGA2B3X7R1H104K050BB7 pcs
EIA 0402 ceramic capacitor 100 pFMurata ElectronicsGRM1555C1H101JA01D1 pc
EIA 0402 thick film resistor 10 kΩVishayCRCW040210K7FKED1 pc
EIA 0402 ceramic capacitor 10 nFMurata ElectronicsGRM155R71C103KA01D3 pcs
EIA 0402 ceramic capacitor 10 pFMurata ElectronicsGJM1555C1H100JB01D3 pc
EIA 0402 ceramic capacitor 12 pFMurata ElectronicsGJM1555C1H120JB01D2 pcs
EIA 0402 ceramic capacitor 18 pFKEMETC0402C180J3GACAUTO2 pcs
EIA 0402 resistor 1 mΩVishayMCS04020C1004FE0002 pcs
EIA 0402 resistor 1 kΩYageoRC0402FR-071KL1 pc
EIA 0402 ceramic capacitor 1 nFMurata ElectronicsGRM1555C1H102JA01D3 pcs
EIA 0603 ceramic capacitor 2.2 uFMurata ElectronicsGCM188R70J225KE22D2 pcs
EIA 0402 resistor 220 kΩVishayCRCW0402220KJNED5 pcs
0805 22 uH inductorTDKMLZ2012N220LT0001 pc
EIA 0402 resistor 330 kΩVishayCRCW0402330KFKED1 pc
EIA 0603 ceramic capacitor 4.7 uFTDKC1608X6S1C475K080AC1 pc
EIA 0402 resistor 470 ΩVishayRCG0402470RJNED1 pc
EIA 0402 resistor 470 kΩVishayCRCW0402470KJNED1 pc
EIA 0603 inductor 470 nHMurata ElectronicsLQW18ANR47G00D1 pc
EIA 0402 resistor 47 kΩMurata ElectronicsCRCW040247K0JNED2 pcs
27.0000 MHz crystal 5032AVX / KyoceraKC5032A27.0000CMGE001 pc
EIA 0402 capacitor 6.8 pFMurata ElectronicsGJM1555C1H6R8CB01D1 pc
EIA 0402 inductor 82 nHEPCOS / TDKB82498F3471J1 pc
ABS05 32.768 kHz crystalABRACONABS05-32.768KHZ-T1 pc
CDBU00340-HF schottky diodeCOMCHIP technologyCDBU00340-HF2 pcs
CG-320S Li-Ion pinpoint batteryPanasonicCG-320S1 pc
HSMS282P schottky diode rectifierBroadcom / AvagoHSMS-282P-TR1G1 pc
MAX8570 step-up converterMaxim IntegratedMAX8570EUT+T1 pc
MICRF113 RF transmitterMicrochip TechnologyMICRF113YM6-TR1 pc
4.3 V Zener diodeON SemiconductorMM3Z4V3ST1G1 pc
OPA237 operational amplifierTexas InstrumentsOPA237N1 pc
PIC16LF1783 8-bit microcontrollerMicrochip TechnologyPIC16LF1783-I/ML1 pc
TPS70628 low-drop regulatorTexas InstrumentsTPS70628DBVT1 pc
EIA 1206 thick film resistor 0 ΩYageoRC1206JR-070RL2 pcs
EIA 0603 thick film resistor 0 ΩYageoRC0603JR-070RL1 pc
EIA 0402 thick film resistor 100 kΩYageoRC0402FR-07100KL1 pc
EIA 0603 thick film resistor 100 kΩYageoRC0603FR-07100KL1 pc
EIA 0805 ceramic capacitor 100 nFKEMETC0805C104K5RAC72102 pcs
EIA 0402 thick film resistor 10 kΩYageoRC0402JR-0710KL1 pc
EIA 1206 ceramic capacitor 10 nFSamsungCL31B103KHFSW6E2 pcs
EIA 0402 thick film resistor 1 kΩYageoRC0402JR-071KL2 pcs
EIA 0402 thick film resistor 220 ΩYageoRC0402JR-07220RL2 pcs
EIA 0402 ceramic capacitor 220 nFTDKC1005X5R1C224K050BB1 pc
EIA 1206 ceramic capacitor 22 nFTDKC3216X7R2J223K130AA2 pcs
SMC B tantalum capacitor 22 uFAVXTPSB226K010T0700 1 pc
EIA 0402 thick film resistor 27 ΩYageoRC0402FR-0727RL2 pcs
EIA 1206 thick film resistor 3.3 ΩYageoRC1206JR-073K3L3 pcs
SOT23 3.3V zener diodeON SemiconductorBZX84C3V3LT1G1 pc
SMC A tantalum capacitor 4.7uFKEMETT491A475M016AT2 pcs
EIA 0603 thick film resistor 470 ΩYageoRC0603JR-07470RL2 pcs
EIA 1206 ceramic capacitor 470 nFKEMETC1206C471J5GACTU3 pcs
Electrolytic capacitor 470 uFPanasonicEEE-1CA471UP3 pcs
EIA 0402 ceramic capacitor 47 pFAVX04025A470JAT2A2 pcs
0603 GREEN LEDLite-On Inc.LTST-C191KGKT1 pc
0603 RED LEDLite-On Inc.LTST-C191KRKT1 pc
16 MHz CX3225 crystalEPSONFA-238 16.0000MB-C31 pc
0805 ferrite beadWurth Electronics Inc.7427920401 pc
IR2110SO FET driverInfineon TechnologiesIR2110SPBF1 pc
FT230XS USB to seriál converterFTDI Ltd.FT230XS-R1 pc
Mini USB connectorEDAC Inc.690-005-299-0431 pc
PIC16F1783 8-bit microcontrollerMicrochip TechnologyPIC16F1783-I/ML1 pc
REG1117 3.3 V regulator SOT223Texas InstrumentsREG1117-3.3/2K51 pc
Schottky SMB diode rectifierSTMicroelectronicsSTPS3H100UF1 pc
SMB package TVS diodeLittelfuse Inc.1KSMBJ6V81 pc
IRLZ44NPBF N-channel MOSFETInfineon TechnologiesIRLZ44NPBF2 pcs
RTL2832U receiver dongleEVOLVEOMars1 pc
PICkit 3Microchip TechnologyPICkit 31 pc
Mini USB to USB A cableOEMMini USB to USB-A1 pc
Printed circuit board, implantable device---Manufacture with the provided supplementary file1 pc
Printed circuit board, transmitter/receiver device---Manufacture with the provided supplementary file1 pc
Printed circuit board, implantable device---Manufacture with the provided supplementary file1 pc
AWG18 wireAlpha Wire3055 BK0012 m
AWG42 wireDaburn Electronics2420/42 BK-1001 m
Olympus GIFQ-160OlympusN/A (part is obsoleted)1 pc
Single-use electrosurgical knife with knob-shaped tip and integrated jet functionOlympusKD-655L1 pc
Single-use oval electrosurgical snareOlympusSD-210U-151 pc
15.5 mm lens hoodFujiFilmDH-28GR1 pc
Injection therapy needle catheterBoston Scientific25G1 pc
Alligator law grasping forcepsOlympusFG-6L-11 pc
Instant Mix 5 min epoxyLoctiteN/A1 pc
Heat shrinkable tubing, inside diameter 9.5 mmTE ConnectivityRNF-100-3/8-X-STK1 pc
ChipQuik solder pasteChip QuikSMD4300AX101 pc

References

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  1. Abell, T., et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology. 125 (2), 421-428 (2003).
  2. O'Grady, G., Egbuji, J., Du, P., Cheng, L. K., Pullan, A. J., Windsor, J. A. High-frequency gastric elec....

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Tags

Endoscopic ImplantationSubmucosal PocketWireless ChargingMedRadio BandBipolar StimulationPCB AssemblySolder Paste DispenserHot Airgun StationOvesco ClipHDSDR Software

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