A spinal cord stimulation (SCS) system includes multiple electrodes, multiple, independently programmable, stimulation channels within an implantable pulse generator (IPG) which channels can provide concurrent, but unique stimulation fields, permitting virtual electrodes to be realized. The SCS system includes a replenishable power source (e.g., rechargeable battery), that may be recharged using transcutaneous power transmissions between antenna coil pairs. An external charger unit, having its own rechargeable battery can be used to charge the IPG replenishable power source. A real-time clock can provide an auto-run schedule for daily stimulation. An included bi-directional telemetry link in the system informs the patient or clinician the status of the system, including the state of charge of the IPG battery. Other processing circuitry in the IPG allows electrode impedance measurements to be made. Further circuitry in the external battery charger can provide alignment detection for the coil pairs.

Rechargeable spinal cord stimulator system

An electrosurgical generator has an output power control system that causes the impedance of tissue to rise and fall in a cyclic pattern until the tissue is desiccated. The advantage of the power control system is that thermal spread and charring are reduced. In addition, the power control system offers improved performance for electrosurgical vessel sealing and tissue welding. The output power is applied cyclically by a control system with tissue impedance feedback. The impedance of the tissue follows the cyclic pattern of the output power several times, depending on the state of the tissue, until the tissue becomes fully desiccated. High power is applied to cause the tissue to reach a high impedance, and then the power is reduced to allow the impedance to fall. Thermal energy is allowed to dissipate during the low power cycle. The control system is adaptive to tissue in the sense that output power is modulated in response to the impedance of the tissue.

Electrosurgical generator with adaptive power control

A closed-loop control system is disclosed for use with an electrosurgical generator that generates electrosurgical energy. The closed loop control system includes a user interface for allowing a user to select at least one pre-surgical parameter, such as the type of surgical instrument operatively connected to the generator, the type of tissue and the desired surgical effect. A sensor module is also included for continually sensing at least one of electrical and physical properties proximate a surgical site and generating at least one signal relating thereto. The system also includes a control module for continually receiving the at least one selected pre-surgical parameter from the user interface and each of the signals from the sensor module, and processing each of the signals in accordance with the at least one pre-surgical parameter using at least one of a microprocessor, computer algorithm and a mapping. The control module generates at least one corresponding control signal relating to each signal from the sensor module, and relays the control signal to the electrosurgical generator for controlling the same. A method is also disclosed for performing an electrosurgical procedure at a surgical site on a patient. The method includes the steps of: applying at least one electrical pulse to the surgical site; continually sensing electrical and physical properties proximate the surgical site; and varying pulse parameters of individual pulses of the at least one pulse in accordance with the continually-sensed properties.

Method and system for controlling output of RF medical generator

Apparatus and methods are described for treatment of morbid obesity using minimally invasive techniques. The apparatus includes a system of components that may be used separately or in combination for effectively reducing stomach volume, bypassing a portion of the stomach and/or small intestines, reducing nutrient absorption in the stomach and/or small intestines and/or depositing minimally or undigested food farther than normal into the intestines, thereby stimulating intestinal responses. The components described include an artificial stoma device, a gastric sleeve device, an intestinal sleeve device, a combined gastrointestinal sleeve device and permanent and detachable attachment systems. Also described are devices for delivering and deploying the components of the system.

Apparatus and methods for treatment of morbid obesity

A device, system and method for diagnosing and treating gastric disorders is provided. A functional device resides within the patient's stomach and is secured to the stomach wall by an attachment device. The functional device may be a sensor for sensing various parameters of the stomach or stomach environment, or may be a therapeutic delivery device. The functional device in one embodiment provides a device, system and method for gastric electrical stimulation where stimulating electrodes are secured to the wall of the stomach by the attachment device or otherwise. A preferred device includes: at least one stimulating electrode in electrical contact with the stomach wall; an electronics unit containing the electronic circuitry of the device; and an attachment mechanism for attaching the device to the stomach wall. The functional devices may be programmed to respond to sensed information or signals. An endoscopic delivery system delivers the functional device through the esophagus and into the stomach where it is attached the stomach wall. The endoscopic instruments attach or remove the attachment devices and functional devices from the stomach and may be used to assist in determining the optimal attachment location.

Gastric treatment and diagnosis device and method

Apparatus and techniques to address problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Techniques for positioning therapy delivery elements within a spinal cord or brain

https://www.gastrojournal.org/article/S0016-5085(03)00878-3/pdf

Gastric electrical stimulation for medically refractory gastroparesis

A GI tract stimulator and/or monitor IMD comprising a housing enclosing electrical stimulation and/or monitoring circuitry and a power source and an elongated flexible member extending from the housing to an active fixation mechanism adapted to be fixed into the GI tract wall is disclosed. After fixation is effected, the elongated flexible member bends into a preformed shape that presses the housing against the mucosa so that forces that would tend to dislodge the fixation mechanism are minimized. The IMD is fitted into an esophageal catheter lumen with the fixation mechanism aimed toward the catheter distal end opening whereby the bend in the flexible member is straightened. The catheter body is inserted through the esophagus into the GI tract cavity to direct the catheter distal end to the site of implantation and fix the fixation mechanism to the GI tract wall. The IMD is ejected from the lumen, and the flexible member assumes its bent configuration and lodges the hermetically sealed housing against the mucosa. A first stimulation/sense electrode is preferably an exposed conductive portion of the housing that is aligned with the bend of the flexible member so that it is pressed against the mucosa. A second stimulation/sense electrode is located at the fixation site.

Implantable medical device affixed internally within the gastrointestinal tract

Bifurcated, active fixation, gastrointestinal leads adapted to be implanted within the body at a site of the GI tract to conduct electrical stimulation and electrical signals of the GI tract between the gastrointestinal stimulator and the site are disclosed. The GI tract lead has a lead body comprising a common lead body trunk extending from a lead body trunk proximal end to a junction with a first plurality of lead body legs that extend from the junction to a like first plurality of lead body leg distal ends. An electrode head is formed at each lead body leg distal end having a plate and supporting at least one stimulation/sense electrode and an active fixation mechanism, whereby a plurality of active fixation attachment mechanisms are supported by a like plurality of electrode heads. The plurality of electrode heads can be affixed by the fixation mechanism at a plurality of spaced apart locations of the GI tract. The plurality of electrode heads can be affixed spaced apart an optimal distance for efficacious sensing and/or stimulation accommodating the physiology and any defects or surgical interventions of the physiology or other therapeutic equipment or IMDs that restrict full access to the GI tract.

Implantable bifurcated gastrointestinal lead with active fixation

A gastroelectric stimulator comprises a neurostimulator for producing a stimulation signal, at least one electrical lead, and at least two electrical contacts. The electrical lead has a proximal end and a distal end, the proximal end being connected to the neurostimulator and the distal end positionable in a lead position within the patient's abdomen. The electrodes are carried near the electrical lead distal end. The electrodes are electrically connected through the electrical lead to the neurostimulator to receive the stimulation signal and convey this signal to an electrode position within the patient's digestive system. The stimulation signal is adapted to influence pancreatic secretions.

Warren Starkebaum

Papers

Techniques for positioning therapy delivery elements within a spinal cord or brain

Gastric electrical stimulation for medically refractory gastroparesis

Implantable medical device affixed internally within the gastrointestinal tract

Implantable bifurcated gastrointestinal lead with active fixation

Gastroelectric stimulation for influencing pancreatic secretions