Name: autonomous and rechargeable microneurostimulator endoscopically implantable into the submucosa
Uploaded: 2018-09-27T12:30:00
Description: Watch this Scientific Journal Video about Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa at JoVE.com

The authors declare that they have no competing financial interests.

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 &#8212; experimental study). All experiments are done in compliance with Czech law 246/1992 Sb. &#34;On the protection of animals against maltreatment, as amended&#34;.&#160;Transmitter device is not...

<ol>
	<li>Abell, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gastric+electrical+stimulation+for+medically+refractory+gastroparesis.">Gastric electrical stimulation for medically refractory gastroparesis.</a> Gastroenterology. 125 (2), 421-428 (2003).</li><li>O'Grady, G., Egbuji, J., Du, P., Cheng, L. K., Pullan, A. J., Windsor, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High-frequency+gastric+electrical+stimulation+for+the+treatment+of+gastroparesis:+a+meta-analysis.">High-frequency gastric electrical stimulation for the treatment of gastroparesis: a meta-analysis.</a> World J Surg. 33 (8), 1693-1701 (2009).</li><li>Chu, H., Lin, Y., Zhong, L., McCallum, R. W., Hou, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+high-frequency+gastric+electrical+stimulation+for+gastroparesis.">Treatment of high-frequency gastric electrical stimulation for gastroparesis.</a> J Gastroenterol Hepatol. 27 (6), 1017-1026 (2012).</li><li>Rodr&#237;guez, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrical+stimulation+therapy+of+the+lower+esophageal+sphincter+is+successful+in+treating+GERD:+final+results+of+open-label+prospective+trial.">Electrical stimulation therapy of the lower esophageal sphincter is successful in treating GERD: final results of open-label prospective trial.</a> Surg Endosc. 27 (4), 1083-1092 (2013).</li><li>Ellis, F., Berne, T. V., Settevig, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+prevention+of+experimentally+induced+reflux+by+electrical+stimulation+of+the+distal+esophagus.">The prevention of experimentally induced reflux by electrical stimulation of the distal esophagus.</a> Am J Surg. 115, 482-487 (1968).</li><li>Rinsma, N. F., Bouvy, N. D., Masclee, A. A. M., Conchillo, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrical+Stimulation+Therapy+for+Gastroesophageal+Reflux+Disease.">Electrical Stimulation Therapy for Gastroesophageal Reflux Disease.</a> J Neurogastroenterol. 20 (3), 287-293 (2014).</li><li>Medtronic Inc, . <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Enterra Therapy 3116 - Gastric Electrical Stimulation System. , (2016).</li><li>Rodriguez, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Two-year+results+of+intermittent+electrical+stimulation+of+the+lower+esophageal+sphincter+treatment+of+gastroesophageal+reflux+disease.">Two-year results of intermittent electrical stimulation of the lower esophageal sphincter treatment of gastroesophageal reflux disease.</a> Surgery. 157 (3), 556-567 (2015).</li><li>Hajer, J., Nov&#225;k, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+an+Autonomous+Endoscopically+Implantable+Submucosal+Microdevice+Capable+of+Neurostimulation+in+the+Gastrointestinal+Tract.">Development of an Autonomous Endoscopically Implantable Submucosal Microdevice Capable of Neurostimulation in the Gastrointestinal Tract.</a> Gastroent Res Pract. , 8098067 (2017).</li><li>Deb, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+innovative+techniques+for+the+endoscopic+implantation+and+securing+of+a+novel,+wireless,+miniature+gastrostimulator+(with+videos).">Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos).</a> Gastrointest. 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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...

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 gastric dysmotility1,2.
Based on previous studies, it is proven that high-frequency gastric electrical stimulation can significantly improve the symptoms and gastric emptying3. It has also been shown that lower esophageal sphincter neurostimulator therapy is safe and effective for the treatment of gastroesophageal reflux disease (GERD), reducing the acid exposure and eliminating daily proton-pump inhibitor (PPI) usage without stimulation related adverse effects4. Before human trials, first studies were performed in animal models (canine models5). Based on these studies, electrical stimulation of the lower esophageal sphincter (LES, 20 Hz, pulse width of 3 ms) caused a prolonged contraction of the LES5. Similar effects of high (20 Hz, pulse width of 200 &#956;s) and low (6 cycles/min, pulse width of 375 ms) frequency electrical stimulation on LES in GERD patients were investigated. Both high and low frequency stimulation were effective6. However, currently, there are only two neurostimulation devices for gastric or esophageal stimulation available on the market7,8. In those devices, the electrodes can be implanted surgically, laparoscopically or robotically. The device itself is implanted subcutaneously. This requires general anaesthesia and have a bulky device fitted, using intramuscular catheters which allow for the stimulation of the gastric or esophageal muscle tissue. So, the option of using a wirelessly communicating device implanted into the gastric submucosal layer would represent a definite advantage and improvement in patient comfort. As stated in the previous research9,10, it was proven that an implantation of a miniature neurostimulator into submucosa is possible. For the endoscopic submucosal implantation, we use a technique called endoscopic submucosal pocketing (ESP), based on endoscopic submucosal tunnel dissection10. The goal of this research is to further improve this concept of an implantable neurostimulator, primarily in the scope of power management (specifically the wireless recharging capability), conformity with respective laws and regulations for wireless communication links in medical implantable devices and possibility of bipolar neurostimulation. Next, the presented microneurostimulator is capable of bidirectional communication and the stimulation parameters can be changed in real-time, even while the device is implanted.
This technique is suitable for teams with a therapeutic endoscopist experienced in endoscopic pocketing or tunnel dissections. Next, a hardware and embedded software designer with experience in building hardware prototypes with microcontrollers and radio frequency circuits using surface mount technology is needed. For building the hardware prototypes, a lab equipped with a reflow soldering station and basic equipment for electrical measurements (at least a digital multimeter, an oscilloscope, a spectrum analyzer and PICkit3 programmer) is required.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
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			<td>AVX</td>
			<td>04025U1R8BAT2A</td>
			<td>1 pc</td>
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			<td>EIA 0402 ceramic capacitor 100 nF</td>
			<td>TDK</td>
			<td>CGA2B3X7R1H104K050BB</td>
			<td>7 pcs</td>
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			<td>EIA 0402 ceramic capacitor 100 pF</td>
			<td>Murata Electronics</td>
			<td>GRM1555C1H101JA01D</td>
			<td>1 pc</td>
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			<td>Vishay</td>
			<td>CRCW040210K7FKED</td>
			<td>1 pc</td>
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			<td>EIA 0402 ceramic capacitor 10 nF</td>
			<td>Murata Electronics</td>
			<td>GRM155R71C103KA01D</td>
			<td>3 pcs</td>
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			<td>EIA 0402 ceramic capacitor 10 pF</td>
			<td>Murata Electronics</td>
			<td>GJM1555C1H100JB01D</td>
			<td>3 pc</td>
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			<td>EIA 0402 ceramic capacitor 12 pF</td>
			<td>Murata Electronics</td>
			<td>GJM1555C1H120JB01D</td>
			<td>2 pcs</td>
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			<td>EIA 0402 ceramic capacitor 18 pF</td>
			<td>KEMET</td>
			<td>C0402C180J3GACAUTO</td>
			<td>2 pcs</td>
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			<td>EIA 0402 resistor 1 m&#937;</td>
			<td>Vishay</td>
			<td>MCS04020C1004FE000</td>
			<td>2 pcs</td>
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			<td>EIA 0402 resistor 1 k&#937;</td>
			<td>Yageo</td>
			<td>RC0402FR-071KL</td>
			<td>1 pc</td>
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			<td>EIA 0402 ceramic capacitor 1 nF</td>
			<td>Murata Electronics</td>
			<td>GRM1555C1H102JA01D</td>
			<td>3 pcs</td>
		</tr>
		<tr>
			<td>EIA 0603 ceramic capacitor 2.2 uF</td>
			<td>Murata Electronics</td>
			<td>GCM188R70J225KE22D</td>
			<td>2 pcs</td>
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		<tr>
			<td>EIA 0402 resistor 220 k&#937;</td>
			<td>Vishay</td>
			<td>CRCW0402220KJNED</td>
			<td>5 pcs</td>
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			<td>0805 22 uH inductor</td>
			<td>TDK</td>
			<td>MLZ2012N220LT000</td>
			<td>1 pc</td>
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			<td>EIA 0402 resistor 330 k&#937;</td>
			<td>Vishay</td>
			<td>CRCW0402330KFKED</td>
			<td>1 pc</td>
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		<tr>
			<td>EIA 0603 ceramic capacitor 4.7 uF</td>
			<td>TDK</td>
			<td>C1608X6S1C475K080AC</td>
			<td>1 pc</td>
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		<tr>
			<td>EIA 0402 resistor 470 &#937;</td>
			<td>Vishay</td>
			<td>RCG0402470RJNED</td>
			<td>1 pc</td>
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			<td>EIA 0402 resistor 470 k&#937;</td>
			<td>Vishay</td>
			<td>CRCW0402470KJNED</td>
			<td>1 pc</td>
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			<td>EIA 0603 inductor 470 nH</td>
			<td>Murata Electronics</td>
			<td>LQW18ANR47G00D</td>
			<td>1 pc</td>
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			<td>EIA 0402 resistor 47 k&#937;</td>
			<td>Murata Electronics</td>
			<td>CRCW040247K0JNED</td>
			<td>2 pcs</td>
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			<td>27.0000 MHz crystal 5032</td>
			<td>AVX / Kyocera</td>
			<td>KC5032A27.0000CMGE00</td>
			<td>1 pc</td>
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			<td>EIA 0402 capacitor 6.8 pF</td>
			<td>Murata Electronics</td>
			<td>GJM1555C1H6R8CB01D</td>
			<td>1 pc</td>
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			<td>EIA 0402 inductor 82 nH</td>
			<td>EPCOS / TDK</td>
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			<td>1 pc</td>
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			<td>ABRACON</td>
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			<td>1 pc</td>
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			<td>CDBU00340-HF schottky diode</td>
			<td>COMCHIP technology</td>
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			<td>2 pcs</td>
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			<td>Panasonic</td>
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			<td>Broadcom / Avago</td>
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			<td>Microchip Technology</td>
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			<td>1 pc</td>
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			<td>ON Semiconductor</td>
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			<td>1 pc</td>
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			<td>Texas Instruments</td>
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			<td>1 pc</td>
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			<td>PIC16LF1783 8-bit microcontroller</td>
			<td>Microchip Technology</td>
			<td>PIC16LF1783-I/ML</td>
			<td>1 pc</td>
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			<td>TPS70628 low-drop regulator</td>
			<td>Texas Instruments</td>
			<td>TPS70628DBVT</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 1206 thick film resistor 0 &#937;</td>
			<td>Yageo</td>
			<td>RC1206JR-070RL</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0603 thick film resistor 0 &#937;</td>
			<td>Yageo</td>
			<td>RC0603JR-070RL</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 0402 thick film resistor 100 k&#937;</td>
			<td>Yageo</td>
			<td>RC0402FR-07100KL</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 0603 thick film resistor 100 k&#937;</td>
			<td>Yageo</td>
			<td>RC0603FR-07100KL</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 0805 ceramic capacitor 100 nF</td>
			<td>KEMET</td>
			<td>C0805C104K5RAC7210</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0402 thick film resistor 10 k&#937;</td>
			<td>Yageo</td>
			<td>RC0402JR-0710KL</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 1206 ceramic capacitor 10 nF</td>
			<td>Samsung</td>
			<td>CL31B103KHFSW6E</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0402 thick film resistor 1 k&#937;</td>
			<td>Yageo</td>
			<td>RC0402JR-071KL</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0402 thick film resistor 220 &#937;</td>
			<td>Yageo</td>
			<td>RC0402JR-07220RL</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0402 ceramic capacitor 220 nF</td>
			<td>TDK</td>
			<td>C1005X5R1C224K050BB</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 1206 ceramic capacitor 22 nF</td>
			<td>TDK</td>
			<td>C3216X7R2J223K130AA</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>SMC B tantalum capacitor 22 uF</td>
			<td>AVX</td>
			<td>TPSB226K010T0700&#160;</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>EIA 0402 thick film resistor 27 &#937;</td>
			<td>Yageo</td>
			<td>RC0402FR-0727RL</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 1206 thick film resistor 3.3 &#937;</td>
			<td>Yageo</td>
			<td>RC1206JR-073K3L</td>
			<td>3 pcs</td>
		</tr>
		<tr>
			<td>SOT23 3.3V zener diode</td>
			<td>ON Semiconductor</td>
			<td>BZX84C3V3LT1G</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>SMC A tantalum capacitor 4.7uF</td>
			<td>KEMET</td>
			<td>T491A475M016AT</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 0603 thick film resistor 470 &#937;</td>
			<td>Yageo</td>
			<td>RC0603JR-07470RL</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>EIA 1206 ceramic capacitor 470 nF</td>
			<td>KEMET</td>
			<td>C1206C471J5GACTU</td>
			<td>3 pcs</td>
		</tr>
		<tr>
			<td>Electrolytic capacitor 470 uF</td>
			<td>Panasonic</td>
			<td>EEE-1CA471UP</td>
			<td>3 pcs</td>
		</tr>
		<tr>
			<td>EIA 0402 ceramic capacitor 47 pF</td>
			<td>AVX</td>
			<td>04025A470JAT2A</td>
			<td>2 pcs</td>
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		<tr>
			<td>0603 GREEN LED</td>
			<td>Lite-On Inc.</td>
			<td>LTST-C191KGKT</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>0603 RED LED</td>
			<td>Lite-On Inc.</td>
			<td>LTST-C191KRKT</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>16 MHz CX3225 crystal</td>
			<td>EPSON</td>
			<td>FA-238 16.0000MB-C3</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>0805 ferrite bead</td>
			<td>Wurth Electronics Inc.</td>
			<td>742792040</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>IR2110SO FET driver</td>
			<td>Infineon Technologies</td>
			<td>IR2110SPBF</td>
			<td>1 pc</td>
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		<tr>
			<td>FT230XS USB to seri&#225;l converter</td>
			<td>FTDI Ltd.</td>
			<td>FT230XS-R</td>
			<td>1 pc</td>
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		<tr>
			<td>Mini USB connector</td>
			<td>EDAC Inc.</td>
			<td>690-005-299-043</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>PIC16F1783 8-bit microcontroller</td>
			<td>Microchip Technology</td>
			<td>PIC16F1783-I/ML</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>REG1117 3.3 V regulator SOT223</td>
			<td>Texas Instruments</td>
			<td>REG1117-3.3/2K5</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Schottky SMB diode rectifier</td>
			<td>STMicroelectronics</td>
			<td>STPS3H100UF</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>SMB package TVS diode</td>
			<td>Littelfuse Inc.</td>
			<td>1KSMBJ6V8</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>IRLZ44NPBF N-channel MOSFET</td>
			<td>Infineon Technologies</td>
			<td>IRLZ44NPBF</td>
			<td>2 pcs</td>
		</tr>
		<tr>
			<td>RTL2832U receiver dongle</td>
			<td>EVOLVEO</td>
			<td>Mars</td>
			<td>1 pc</td>
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		<tr>
			<td>PICkit 3</td>
			<td>Microchip Technology</td>
			<td>PICkit 3</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Mini USB to USB A cable</td>
			<td>OEM</td>
			<td>Mini USB to USB-A</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Printed circuit board, implantable device</td>
			<td>---</td>
			<td>Manufacture with the provided supplementary file</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Printed circuit board, transmitter/receiver device</td>
			<td>---</td>
			<td>Manufacture with the provided supplementary file</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Printed circuit board, implantable device</td>
			<td>---</td>
			<td>Manufacture with the provided supplementary file</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>AWG18 wire</td>
			<td>Alpha Wire</td>
			<td>3055 BK001</td>
			<td>2 m</td>
		</tr>
		<tr>
			<td>AWG42 wire</td>
			<td>Daburn Electronics</td>
			<td>2420/42 BK-100</td>
			<td>1 m</td>
		</tr>
		<tr>
			<td>Olympus GIFQ-160</td>
			<td>Olympus</td>
			<td>N/A (part is obsoleted)</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Single-use electrosurgical knife with knob-shaped tip and integrated jet function</td>
			<td>Olympus</td>
			<td>KD-655L</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Single-use oval electrosurgical snare</td>
			<td>Olympus</td>
			<td>SD-210U-15</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>15.5 mm lens hood</td>
			<td>FujiFilm</td>
			<td>DH-28GR</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Injection therapy needle catheter</td>
			<td>Boston Scientific</td>
			<td>25G</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Alligator law grasping forceps</td>
			<td>Olympus</td>
			<td>FG-6L-1</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Instant Mix 5 min epoxy</td>
			<td>Loctite</td>
			<td>N/A</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>Heat shrinkable tubing, inside diameter 9.5 mm</td>
			<td>TE Connectivity</td>
			<td>RNF-100-3/8-X-STK</td>
			<td>1 pc</td>
		</tr>
		<tr>
			<td>ChipQuik solder paste</td>
			<td>Chip Quik</td>
			<td>SMD4300AX10</td>
			<td>1 pc</td>
		</tr>
	</tbody>
</table>

autonomous and rechargeable microneurostimulator endoscopically implantable into the submucosa

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.

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 wh...

Watch this Scientific Journal Video about Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa at JoVE.com

Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa

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.

Gastric dysmotility can be a sign of common diseases such as longstanding diabetes mellitus. It is known that the application of high-frequency ...

The main advantage of this technique is that it offers a significantly less invasive approach. Generally, individuals new to this method will struggle because the implantable device development is a discipline which requires experience both in hardware and software design. Visual demonstration of this method is critical as the endoscopic submucosal implantation is an experimental procedure currently not used in daily practice.To begin this procedure, place the PCBs on a flat surface. Use a solder paste dispenser with a 0.6 millimeter needle and 60 PSI pressure to manually dispense less than 15 microliters of the soldering paste onto every metallic pad on the PCB. Begin with the top side of the PCB.With a pair of anti-static tweezers, place all components on the top layer of the PCB. Assign the component positions and components to their numbers. After that, use a PCB hot airgun station at 260 degrees Celsius to solder all components.Wait until all the solder paste melts. Put away the hot airgun and allow the board to cool to room temperature. Connect the PCB to all other electrical components except for the battery.Solder the wireless charging communication coil to pads two and three, then connect the antenna to pad one and the PCB electrodes to pads number four and five. Following that, solder the CG-320 battery to pads six and seven. The negative terminal of the battery must be soldered on pad seven.Be careful while performing the next steps. The device is now powered and is sensitive to short circuits and contact with metallic objects. Next, shrink the tubing with a hot airgun heated to 150 degrees Celsius and then allow it to cool.After that, apply epoxy glue to the left end to seal one side of the tubing, then glue the electrode to the back of the PCB with tubing. Subsequently, seal the other end of the tubing. In this step, place the PCBs on a flat surface.Use a solder paste dispenser with 0.6 millimeter needle and 60 PSI pressure to manually dispense less than 50 microliters of the soldering paste onto every metallic pad on the PCB. With a pair of anti-static tweezers, place all components on the top layer of the PCB. Assign the component position and the components to their numbers.Use a PCB hot airgun station preset to 260 degrees Celsius to solder all components. Wait until all the solder paste melts. Put away the hot airgun and allow the board to cool to room temperature.Next, the 12-volt power supply is connected to the wall and the USB connector is inserted to the PC.After that, open the PuTTY software. Select Serial as the connection type, then enter COMX as a serial line where X is the number of the COM Port of the device. If no other COM Port device was installed, this number will be one.Enter 38, 400 as speed. Click Open. The charger transmitter device is now ready to be used.In order to perform the implantation and visualization, insert an animal model dedicated endoscope with the implantable device grasped into a snare into the stomach. When in the stomach, release the device. After that, extract the endoscope.Equip it with a dissection cap and then reinsert it to the stomach. In order to implant the device to submucosa, apply saline solution mixed with methylene blue into the submucosal layer using an injection therapy needle catheter. Make a horizontal incision to create an opening in the submucosa using an electrosurgical knife with a knob-shaped tip.Insert an affixed cap into the newly created space and with the use of an electrosurgical knife, continue disrupting, dilating, and dissecting the submucosal layer to create a large enough pocket to insert the stimulation device. Grasp the device which is lying freely inside the stomach with correctly oriented electrodes with a grasper and navigate it into the submucosal pocket. After that, use two hemostatic clips to secure the device in place inside of the submucosal pocket.Then pull out the endoscope. Put the Ovesco clip on the endoscope and reinsert it into the stomach. Orientate the endoscope towards the pocket, grasp both sides of the pocket and apply the Ovesco.After that, check the correct placement of the Ovesco. After successful implantation, place the charger transmitter coil in proximity of the implanted device, then plug in the RTL2832 dongle in the PC.Run the HDSDR software and set the center frequency to 432 megahertz. Subsequently, select the LO frequency to 431.95 megahertz, then select the Tune frequency to 432.00 megahertz.Select Bandwidth to 960, 000. Transmit a Manchester-coded sequence from the charger transmitter by pressing the R key in the PuTTY terminal and receive the OOK modulated reply from the implant shown in the main HDSDR window. Shown here is the top copper layer of the PCB.The component names are indicated on the top layer. And here is the bottom copper layer of the PCB. The component names are on the bottom layer.And this figure shows the composite picture of all PCB layers. Once mastered, this technique can be done in four hours for the implantable device manufacturing and one hour for device implantation and testing if performed properly. While attempting this procedure, it's important to verify all functions of the implantable device prior to implantation.Following this procedure, other methods like further development of algorithm and data processing can be performed in order to answer additional questions like the efficiency of the method. After its development, this technique paved the way for researchers in the field of gastroenterology to explore third space in gastrointestinal tract. After watching this video, you should have a good understanding of how to perform an endoscopy implantation of autonomous gastric micronuerostimulator in submucosa.Don't forget that working with soldering paste and electronics manufacturing including working with hot airgun can be hazardous and precautions such as gloves and safety glasses should always be worn while performing this procedure.

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