Evolution of Biotelemetry in Medical Devices: From Radio Pills to mm-Scale Implants

The advent of semiconductor technology in the mid-20th century created unprecedented opportunities to develop a new generation of small-scale wireless medical sensing devices that can support remote monitoring of patients' vital signs. The first radio pills were developed as early as the 1950's using only a few transistors. These swallowable capsules could sense and wirelessly transmit vital parameters from inside the human body. Since then we have witnessed the rapid progress of medical devices driven by the evolution of semiconductor technology, from single-transistor oscillators to complex mixed-signal multi-channel and multi-modal systems. This paper retraces the evolution of biotelemetry devices from their very early inception to the smart miniaturized systems of modern days, focusing on semiconductor-enabled sensing methods and circuits developed over the last six decades. The paper also includes the author's perspective on current and future trends in the development of CMOS-based biotelemeters, focusing on concepts of implant modularity, miniaturization and hybrid energy harvesting solutions.

Modeling and Experiments on a Legged Microrobot Locomoting in a Tubular, Compliant and Slippery Environment

This paper presents the concept and preliminary modeling of a legged microrobot locomoting in a tubular, compliant and slippery environment. The envisaged application field is related to capsular endoscopy, i.e., the development of a mobile swallowable capsule for navigation inside the gastrointestinal tract for diagnosis and therapy. After introducing and discussing the issue of autonomous locomotion of endoscopic devices, with reference to worldwide ongoing research in the field, the legged solution is proposed and peculiarities of this approach are described. The importance of simulation for developing a legged device is discussed and a locomotion model is presented. Experimental results are described for the definition of biomechanical parameters necessary in the model. Thanks to this work first simulations have been obtained, in which the microrobot’s body moves according to arbitrary gait patterns for the legs and to its interaction with tissue. The resulting tool will be used for the design synthesis, for defining the optimal number of legs and the best number of degrees of freedom for each leg. It will be also used for controlling the device, by identifying the gait pattern to be adopted in order to obtain different capsule movements.

Locomotion of a legged capsule in the gastrointestinal tract: theoretical study and preliminary technological results

This work illustrates the analysis of locomotion in the gastrointestinal tract obtainable by a legged capsule for diagnostic and therapeutic purposes. A preliminary simulation of the legged locomotion onto slippery and deformable substrates has been performed and -simultaneously- mechanisms for on board actuation of the legs have been developed and tested. Moreover, an engineering translation of medical needs in endoscopy is presented, with some ad hoc solutions for improving diagnostic capabilities.

An Implantable Telemetry Platform System for In Vivo Monitoring of Physiological Parameters

This paper describes a microcontroller-based multichannel telemetry system, suitable for in vivo monitoring of physiological parameters. The device can digitalize and transmit up to three analog signals coming from different sensors. The telemetry transmission is obtained by using a carrier frequency of 433.92 MHz and an amplitude-shift keying modulation. The signal data rate is 13 kb/s per channel. The digital microcontroller provides good flexibility and interesting performance, such as the threshold monitoring, the transmission error detection, and a low power consumption, thanks to the implementation of a sleep mode. The small overall size (less than 1 cm3), the power density compatible with current regulations for the design of implantable devices, and the dedicated packaging make the system suitable for in vivo monitoring in humans. The design, fabrication, operation, packaging, and performance of the system are described in this paper. An in vivo pressure monitoring case study is described as well.

Chronic measurement of epidural pressure with an induction-powered oscillator transducer

An induction-powered oscillator transducer (IPOT) was designed for the chronic measurement of epidural pressure. The transducer was completely implantable so all pressure measurements were made through the intact skin. The IPOT had a linear pressure range from -50 to +200 cm H2O, was sensitive to 1 mm H2O and had a zero drift of less than 1 mm H2O/day under full load. Zero drift was minimized by using a hermetically-sealed metal bellows transducing element which was chemically treated to prevent corrosion and creep. The correlation between epidural pressure and intraventricular pressure was determined during the first 24 hours after implantation in six dogs. Epidural pressure was found to be a linear function of intraventricular fluid pressure. Epidural pressure and intraventricular pressure were essential equal provided the epidural wedge pressure was minimized by proper insertion of the transducer. The correlation between epidural pressure and intraventricular pressure was determined after chronic implantation in five dogs. Epidural pressure was a linear function of intraventricular pressure in the chronically implanted dogs, but epidural pressure was not equal to intraventricular pressure. After chronic implantation, the epidural pressure transducer was not responsive to changes in intraventricular pressure because of mechanical changes in the dura. The dura became stiff and non-compliant. Maximum correlation between epidural pressure and intraventricular fluid pressure in chronic implantations will depend on judicious material selection and mechanical design at the transducer-dura interface.