Implantable medical device
The invention relates to a medical device comprising: —a sealed casing ( 1 ), suited to being implanted in the body of a human or animal patient, —an inflatable element ( 3 ), —a fluidic circuit comprising a fluid reservoir ( 5 ) having a variable fluid volume and arranged inside the casing with a tube ( 2 ) between the reservoir and the inflatable element, —an actuator arranged inside the casing to selectively vary the volume of fluid in the reservoir, —a control unit ( 100 ) configured to control the actuator, —at least one sensor suited to measuring an absolute gauge pressure of the fluid in the fluidic circuit, a force exerted on the reservoir, a gas pressure inside the casing, an atmospheric pressure or a value relating to an altitude of the patient, the control unit ( 100 ) being configured so as: —on the basis of a measurement from said sensor while the actuator is inactive, to detect a differential between a value relating to an altitude of the patient and a reference value, and —as a function of said differential, to determine the command to be issued to the actuator so as to control the pressure of fluid in the fluidic circuit.
1 . A medical device comprising:
a sealed casing, containing a gas, suitable for being implanted in a body of a human or animal patient,
an inflatable element, suitable for being implanted in the body of the patient, outside of the casing,
a fluid circuit comprising a fluid reservoir having a variable fluid volume and arranged inside the casing with a tube ensuring a fluid connection between said reservoir and said inflatable element,
an actuator arranged inside the casing and mechanically coupled to the fluid reservoir in a manner as to selectively vary the volume of fluid in said reservoir,
a control unit configured to control the actuator in a manner as to transfer the fluid between the reservoir and the inflatable element,
at least one sensor suitable for measuring at least one physical quantity linked to an altitude of the patient in which the medical device is implanted, the at least one physical quantity being among: an absolute pressure of the fluid in the fluid circuit, a force exerted on the reservoir, a gas pressure inside the casing, and an atmospheric pressure,
the control unit being further configured to:
on the basis of a measurement of the at least one physical quantity from said sensor while the actuator is inactive, determine a value relating to the altitude of the patient,
detect a differential between the value relating to the altitude of the patient and a reference value, and
as a function of said differential, determine a command to be issued to the actuator in a manner as to control the pressure of fluid in the fluid circuit.
2 . The device according to claim 1 , wherein the control unit is configured to, based on the value relating to the altitude of the patient being greater than a first reference value, control the actuator to reduce the volume of fluid in the inflatable element.
3 . The device according to claim 2 , wherein the control unit is further configured to maintain the volume of fluid in the inflatable element which has been reduced, as long as the value relating to the altitude of the patient is greater than the first reference value, or the value relating to the altitude of the patient is between the first reference value and a second reference value that is less than the first reference value.
4 . The device according to claim 3 , wherein the control unit is configured to, based on the value relating to the altitude of the patient being less than the second reference value, determine a command for the actuator in a manner as to increase the volume of fluid in the inflatable element.
5 . The device according to claim 2 , wherein the control unit is configured to trigger the control of the actuator after the expiry of a determined period during which the value relating to the altitude of the patient is greater than the first reference value.
6 . The device according to claim 1 , wherein the control unit is configured to, based on the patient being submerged and the value relating to the altitude of the patient being less than a third reference value, control the actuator to reduce the volume of fluid in the inflatable element.
7 . The device according to claim 6 , wherein the control unit is further configured to maintain the volume of fluid in the inflatable element which has been reduced, as long as the patient is submerged and the value relating to the altitude of the patient is less than the third reference value, or the value relating to the altitude of the patient is between the third reference value and a fourth reference value greater than the third reference value.
8 . The device according to claim 7 , wherein the control unit is configured to, based on the patient being submerged and the value relating to the altitude of the patient being greater than the fourth reference value, determine a command for the actuator in a manner as to increase the volume of fluid in the inflatable element.
9 . The device according to claim 6 , wherein the control unit is configured to trigger the control of the actuator after the expiry of a determined period during which the value relating to the altitude of the patient is less than the third reference value.
10 . The device according to claim 1 , wherein the fluid reservoir comprises a stationary portion and a movable portion and the actuator is mechanically coupled to said movable portion in a manner as to linearly move said movable portion with respect to the stationary portion in a manner as to vary the volume of the reservoir.
11 . The device according to claim 10 , wherein said at least one sensor comprises a sensor arranged in the casing, mechanically connected to the actuator or to the movable portion of the reservoir, arranged in a manner as to measure at least one of a tensile force and a compressive force in a direction of movement of the movable portion of the reservoir, said measured force resulting at least from:
a force exerted by the movable portion of the reservoir linked to the pressure in the fluid circuit, and
a force exerted on the movable portion of the reservoir linked to the pressure of gas in the casing,
the control unit being configured to measure the fluid pressure in the fluid circuit on the basis of said measured force.
12 . The device according to claim 11 , further comprising at least one of (i) a force sensor in the casing, (ii) an altimeter in the casing, and (iii) an atmospheric pressure sensor in a control device outside the body of the patient, wherein the control unit is configured to detect the altitude differential on the basis of the measurement data of said force sensor, atmospheric pressure sensor or the altimeter.
13 . The device according to claim 12 , wherein the control unit is configured to detect the altitude differential on the basis of measurement data from one sensor chosen among said force sensor, pressure sensor and the altimeter and to confirm said detected altitude differential on the basis of measurement data from another sensor among said force sensor, pressure sensor and the altimeter.
14 . The device according to claim 1 , wherein said at least one sensor comprises a gas pressure sensor in the casing.
15 . The device according to claim 1 , wherein said at least one sensor comprises an altimeter arranged in the casing and configured to measure the value relating to the altitude of the patient.
16 . The device according to claim 1 , further comprising a control device outside the body of the patient and suitable for being carried by the patient, said control device comprising an atmospheric pressure sensor and being suitable for communicating, to the control unit, the pressure measured by said atmospheric pressure sensor in a manner as to determine the value relating to the altitude of the patient.
17 . The device according to claim 1 , wherein the control unit is configured to detect said altitude differential in a discontinuous manner.
18 . The device according to claim 17 , wherein the control unit is configured to detect the altitude differential at regular intervals of between 1 and 300 minutes.
19 . The device according to claim 1 , wherein the inflatable element is an occlusive cuff suitable for being arranged around an anatomical conduit in a manner as to selectively close said anatomical conduit.
20 . The device according to claim 19 , said device being configured to be implanted in the body of the human or animal patient in a manner as to selectively close by means of the cuff the anatomical conduit chosen among at least: a urethra, a gastric conduit, a colon and a rectum.
21 . A medical device comprising:
a sealed casing, containing a gas, suitable for being implanted in a body of a human or animal patient,
an inflatable element, suitable for being implanted in the body of the patient, outside of the casing,
a fluid circuit comprising a fluid reservoir having a variable fluid volume and arranged inside the casing with a tube ensuring a fluid connection between said reservoir and said inflatable element,
an actuator arranged inside the casing and mechanically coupled to the fluid reservoir in a manner as to selectively vary the volume of fluid in said reservoir,
a control unit configured to control the actuator in a manner as to transfer the fluid between the reservoir and the inflatable element, and
a control device arranged outside the body of the patient and suitable for being carried by the patient, the control device comprising an atmospheric pressure sensor and being suitable for communicating, to the control unit, an atmospheric pressure measured by the atmospheric pressure sensor;
the control unit being further configured to:
on the basis of a measurement of the atmospheric pressure from said atmospheric pressure sensor while the actuator is inactive, determine a value relating to the altitude of the patient,
detect a differential between the value relating to the altitude of the patient and a reference value, and
as a function of said differential, determine a command to be issued to the actuator in a manner as to control the pressure of fluid in the fluid circuit.