Intestine dysfunction treatment apparatus

• US 6,915,165 B2
• Filed: 06/29/2001
• Issued: 07/05/2005
• Est. Priority Date: 06/28/2001
• Status: Expired due to Term

• Current Assignee: Abdomica AG, Abdomnica AG
• Original Assignee: Obtech Medical AG (Johnson & Johnson)
• Inventors: Forsell, Peter
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): LANDREM, KAMRIN R
• Application Number:
  US09/893,510
• Publication Number:
  US 20030009221A1
• Time in Patent Office: 1,467 Days
• Field of Search: 623/14, 623/13, 623/24, 623/25, 623/23.65, 606/197, 600/30, 602/67, 607/39, 607/40, 607/41, 607/62
• US Class Current: 607/40
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/08 Arrangements or circuits for monitoring, protecting, controlling or indicating for external stimulators A61N1/3603; for implantable neurostimulators A61N1/36128; for heart stimulators A61N1/37; for defibrillators A61N1/3925
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

An intestine dysfunction treatment apparatus comprises an electric stimulation device (56) implanted in a patient, who suffers from intestine dysfunction. The stimulation device comprises electric conductors adapted to directly engage with a muscle that directly or indirectly affects the transportation of the content of the patient'"'"'s intestines, for example the anal sphincter (58) or a portion of the muscle that contracts the bowels, to electrically stimulate the muscle to increase the tonus thereof. A control device (62) is provided for controlling a source of energy (64), which may or may not be implanted, to release electric energy for use in connection with the power of the stimulation device. The apparatus can be used for treating patients suffering from anal incontinence or constipation.

Claims

1. An intestine dysfunction treatment apparatus, comprising:

an electric stimulation device implantable in a patient, who suffers from intestine dysfunction,

electric conductors of the electric stimulation device adapted to directly engage with a muscle that directly or indirectly affects the transportation of the content of the patient'"'"'s intestines, to electrically stimulate the muscle to increase the tonus thereof,

an internal electric source of energy implantable in the patient, and

a control device controllable from outside the patient'"'"'s body to control the internal electric source of energy to release electric energy for use in connection with the power of the stimulation device, when the stimulation device is implanted, the electric energy being in the form of an alternating current through the electric conductors, the intensity of the current through the electric conductors amounting to a predetermined value,

the control device automatically controlling the electric source of energy to release more electric energy to restore the predetermined value of current intensity when the current through the conductors decreases.

2. An apparatus according to claim 1, wherein the control device controls the stimulation device.

3. An apparatus according to claim 2, wherein the control device controls the stimulation device to vary the intensity of the electric stimulation of the muscle over time.

4. An apparatus according to claim 3, wherein the control device is controllable from outside the patient'"'"'s body to control the stimulation device to change the intensity of the electric stimulation of the muscle so that the muscle tonus is changed.

5. An apparatus according to claim 4, wherein the muscle comprises the anal sphincter, and the control device continuously supplies the stimulation device with electric energy from the electric source of energy to keep the anal sphincter closed, except when the patient wants to defecate.

6. An apparatus according to claim 5, wherein the control device is controllable by the patient to control the stimulation device to increase the intensity of the electric stimulation of the anal sphincter so that the tonus of the anal sphincter is increased, when the patient feels rectum contractions.

7. An apparatus according to claim 5, wherein the control device is controllable by the patient to control the stimulation device to cease supplying the stimulation device with electric energy when the patient wants to defecate.

8. An apparatus according to claim 5, wherein the control device is controllable by the patient to control the stimulation device to decrease the intensity of the electric stimulation of the anal sphincter so that the tonus of the anal sphincter is decreased, when the patient wants to release gas from the rectum.

9. An apparatus according to claim 2, wherein the muscle is capable of contracting the patient'"'"'s large bowel in a wave-like manner for transporting the feces therein, and the control device controls the electric source of energy to momentarily supply the stimulation device with electric energy to cause the muscle to momentarily contract the bowel in said wave-like manner.

10. An apparatus according to claim 9, wherein the control device is controllable by the patient to power the stimulation device to cause the muscle to contract the large bowel in said wave-like manner, in order to avoid constipation.

11. An apparatus according to claim 2, wherein the control device comprises an internal control unit implantable in the patient for controlling the stimulation device.

12. An apparatus according to claim 11, wherein the internal control unit is programmable.

13. An apparatus according to claim 12, wherein the control device comprises an external control unit intended to be outside the patient'"'"'s body, the internal control unit being programmable by the external control unit.

14. An apparatus according to claim 13, wherein the external control unit loads the internal control unit with data in accordance with a loading mode only authorised for a doctor.

15. An apparatus according to claim 13, wherein the external control unit controls the internal control unit in accordance with a doctor mode only authorised for a doctor.

16. An apparatus according to claim 13, wherein the external control unit controls the internal control unit in accordance with a patient mode permitted for the patient.

17. An apparatus according to claim 12, wherein the internal control unit is programmable for controlling the stimulation device over time.

18. An apparatus according to claim 17, wherein the internal control unit controls the stimulation device over time in accordance with an activity schedule program.

19. An apparatus according to claim 17, wherein the internal control unit comprises a microprocessor.

20. An apparatus according to claim 2, wherein the muscle comprises the rectus abdominis of the patient who has iliostomy, jejunostomy, colostomy or rectostomy therethrough, and the control device is adapted to continuously supply the stimulation device with electric energy from the electric source of energy to stimulate the rectus abdominis to close the patient'"'"'s intestines, except when the patient wants to defecate.

21. An apparatus according to claim 2, wherein the muscle comprises the wall muscle of the intestines of the patient who has iliostomy, jejunostomy, colostomy or rectostomy, and the control device is adapted to continuously supply the stimulation device with electric energy from the electric source of energy to stimulate the wall muscle of the intestines to close the intestines, except when the patient wants to defecate.

22. An apparatus according to claim 1, further comprising at least one implantable sensor for sensing at least one physical parameter of the patient.

23. An apparatus according to claim 22, wherein the muscle comprises the anal sphincter and the sensor senses as the physical parameter the pressure against the anal sphincter exerted by the fecal passageway.

24. An apparatus according to claim 23, wherein the electric stimulation device increases the stimulation intensity on the anal sphincter in response to the sensor sensing an abrupt increase in pressure caused by rectum contraction.

25. An apparatus according to claim 22, wherein the muscle comprises the anal sphincter and the sensor senses as the physical parameter the patient'"'"'s orientation.

26. An apparatus according to claim 25, wherein the electric stimulation device decreases the stimulation intensity on the anal sphincter in response to the sensor sensing that the patient is lying down.

27. An apparatus according to claim 22, wherein the sensor comprises a pressure sensor for directly or indirectly sensing as the physical parameter the pressure in the fecal passageway of the patient.

28. An apparatus according to claim 22, wherein the control device is controls the stimulation device in response to signals from the sensor.

29. An apparatus according to claim 28, wherein the control device comprises an internal control unit implantable in the patient, the internal control unit controlling the stimulation device in response to signals from the sensor.

30. An apparatus according to claim 29, wherein the control device comprises an external control unit outside the patient'"'"'s body, the external control unit controlling the stimulation device in response to signals from the sensor.

31. An apparatus according to claim 30, wherein the external control unit stores information on the physical parameter sensed by the sensor and is manually operated to control the stimulation device based on the stored information.

32. An apparatus according to claim 22, further comprising at least one implantable sender for sending information on the physical parameter sensed by the sensor.

33. An apparatus according to claim 1, wherein the source of energy comprises an implantable internal electric source of energy comprising at least one accumulator, at least one capacitor or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery.

34. An apparatus according to claim 1, further comprising a switch implantable in the patient for directly or indirectly switching the power of the stimulation device.

35. An apparatus according to claim 34, wherein the switch directly or indirectly affects the supply of electric energy from the internal electric source of energy.

36. An apparatus according to claim 35, wherein the switch switches between an “

off”

mode, in which the internal electric source of energy is not in use, and an “

on”

mode, in which the internal electric source of energy supplies electric energy to the stimulation device.

37. An apparatus according to claim 35, further comprising an energy transforming device implantable in the patient for transforming the wireless energy into electric energy, which is stored by the internal electric source of energy.

38. An apparatus according to claim 37, wherein the switch switches from an “

off”

mode, in which the internal electric source of energy is not in use, to an “

on”

mode, in which the internal source of electric energy supplies energy to the stimulation device.

39. An apparatus according to claim 38, wherein the control device controls the switch to switch between the “

on” and

“

off”

modes.

40. An apparatus according to claim 39, wherein the control device comprises a wireless remote control.

41. An apparatus according to claim 1, wherein the control device comprises a wireless remote control.

42. An apparatus according to claim 1, further comprising an external data communicator intended to be outside the patient'"'"'s body, and an internal data communicator implantable in the patient for communicating with the external communicator, wherein the internal data communicator feeds data related to the patient back to the external data communicator or the external data communicator feeds data to the internal data communicator.

43. An apparatus according to claim 42, wherein the internal data communicator feeds data related to the stimulation device.

44. An apparatus according to claim 42, wherein the internal data communicator feeds data related to at least one physical signal of the patient.

45. An apparatus according to claim 1, wherein the control device comprises a wireless remote control for transmitting at least one wireless control signal for controlling the stimulation device.

46. An apparatus according to claim 45, wherein the remote control is capable of obtaining information on the condition of the stimulation device when the stimulation device is implanted and to control the stimulation device in response to the information.

47. An apparatus according to claim 45, wherein the wireless remote control comprises at least one external signal transmitter or transceiver and at least one internal signal receiver or transceiver implantable in the patient.

48. An apparatus according to claim 45, wherein the wireless remote control comprises at least one external signal receiver or transceiver and at least one internal signal transmitter or transceiver implantable in the patient.

49. An apparatus according to claim 45, wherein the remote control transmits a carrier signal for carrying the control signal.

50. An apparatus according to claim 49, wherein the carrier signal is frequency, amplitude or frequency and amplitude modulated.

51. An apparatus according to claim 49, wherein the carrier signal is digital, analogue or digital and analogue.

52. An apparatus according to claim 49, wherein the control signal used with the carrier signal is frequency, amplitude or frequency and amplitude modulated.

53. An apparatus according to claim 45, wherein the control signal comprises a wave signal comprising one of a sound wave signal including an ultrasound wave signal, an electromagnetic wave signal including an infrared light signal, a visible light signal, an ultra violet light signal and a laser light signal, a micro wave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal.

54. An apparatus according to claim 45, wherein the control signal comprises an electric, magnetic or electric and magnetic field.

55. An apparatus according to claim 45, wherein the control signal is digital, analogue or digital and analogue.

56. An apparatus according to claim 55, wherein the remote control transmits an electromagnetic carrier wave signal for carrying the digital or analogue control signal.

57. An apparatus according to claim 45, wherein the control signal is transmitted in pulses by the wireless remote control.

58. An apparatus according to claim 1, wherein the stimulation device is embedded in a soft or gel-like material.

59. An apparatus according to claim 1, wherein the stimulation device is embedded in a silicone material having hardness less than 20 Shore.

60. An apparatus according to claim 1, wherein the muscle comprises the anal sphincter or extends around a portion of the bowels or rectus abdominis, the stimulation device comprises a band for application around the anal sphincter or the portion of the bowels or rectus abdominis, and the band is provided with the electric conductors for engaging the muscle.

61. An apparatus according to claim 1, wherein the electric conductors comprise hooks to secure the electric conductors on the muscle.

62. An apparatus according to claim 61, wherein the hooks are to be inserted into the muscle.

63. An intestine dysfunction treatment apparatus, comprising:

an electric stimulation device implantable in a patient, who suffers from intestine dysfunction,

electric conductors of the electric stimulation device adapted to directly engage with a muscle that is capable of contracting the patient'"'"'s large bowel in a wave-like manner for transporting the feces therein, to electrically stimulate the muscle to increase the tonus thereof,

an electric source of energy, and

a control device controllable from outside the patient'"'"'s body, wherein the control device is adapted to control the stimulation device and the electric source of energy to momentarily supply the stimulation device with electric energy to cause the muscle to momentarily contract the bowel in said wave-like manners,

the electric source of energy releasing the electric energy in the form of an alternating current through the electric conductors, the intensity of the current through the electric conductors amounting to a predetermined value.

the control device automatically controlling the electric source of energy to release more electric energy to restore the predetermined value of current intensity when the current through the electric conductors decreases.

64. An apparatus according to claim 63, wherein the control device is controllable by the patient to power the stimulation device to cause the muscle to contract the large bowel in said wave-like manner, in order to avoid constipation.