The hearing aid in the ear is considered one of the first small medical devices. But there is a big difference between “small” and “micro.” The innovative approaches of micromedicine use the dwarf dimensions of high-performance sensors, valves or pumps. By continuously transmitting the measured values to the attending physician and optimally adapting the therapy, the care of chronically ill patients can be significantly improved. Cardiovascular patients in particular benefit from this.
Drug-delivery systems – fine-tuned dosing
New drug delivery systems, known as drug-delivery systems, work with valves or pumps that can deliver a drug directly to the point of treatment. This enables continuous pain management, for example. A dosing pump can also be used under the skin in diabetes treatment. Drug delivery systems also include discus-like containers that can be implanted directly under the skin. They deliver minute quantities (microliters = millionths of a liter) of drugs continuously or at specific intervals. Such components, known as smart pills, are available in tiny dimensions of 6 by 14 by 2 millimeters.
Gentle intervention in the organism
Treatment with microtherapy is used, among other things, for intervertebral disc damage, in pain and tumor therapy, and for the treatment of vascular diseases. Micromedicine is used both medicinally and surgically. The pioneer and undisputed “pope” of micromedicine is Prof. Dietrich Grönemeyer, who heads the first and so far only chair for micromedicine at the University of Witten/Herdecke. Based on radiological procedures and the innovative imaging techniques whose development has been rapidly advanced since the mid-1980s, Prof. Grönemeyer has developed a large number of his own miniature instruments. These include mini-balloons that straighten spinal elements. What was previously only known from cardiology, the widening of heart vessels with a balloon catheter, the spine specialists at the Grönemeyer Institute for MicroTherapy in Bochum are also transferring to the spine. In balloon kyphoplasty, two balloons are placed in the vertebral body and carefully inflated with fluid under pressure. This lifts the collapsed vertebral body endplate, creating a cavity that is then filled with special bone cement. In the computer tomograph and under additional X-ray control, the procedure is precisely controlled to avoid complications. The patient is wide awake during the procedure, and the treatment region is only locally anesthetized. “A number of our patients have already been in severe pain for many weeks, and some are in wheelchairs. It is good to see that many can move again without assistance a short time after treatment,” explains Prof. Dietrich Grönemeyer.
Medical everyday life in a few years
Other micromedical devices will be part of everyday medical life in a few years. These include ECG devices, for example, whose electrodes are incorporated into T-shirts or undershirts, or new systems for continuous blood pressure or blood glucose measurement. A radio chip implanted under the skin can be read out at lightning speed in an emergency, providing blood group information and relevant medical data, for example. The chip is activated only when it is approached with a reader. While data protectionists are up in arms against this development, emergency physicians see it as a major advance in on-site care for accident victims.
Telemetric microsystems – monitoring over long distances
The focus of research and product development is currently on so-called telemetric microsystems. For example, patients and risk groups can be monitored or drugs dosed even over long periods of time and distances. The most important technology trends are bio- and pressure sensors as well as microfluidic structures and electrodes. At the University of Tübingen, a chip with 1,500 light-sensitive cells will be glued to the retina of blind people in the next few months, so to speak. Light falling on the sensors triggers stimulation currents on the retina, which are conducted from the optic nerve to the brain. Patients in whom the stimulus conduction still functions could then at least recognize contours again.Research results in the area of intraocular pressure measurement are also promising, as is the development of a platform that allows external telemetric monitoring of high-risk patients nationwide. More information: Despite recognized technology and successes, health insurers are having a hard time with micromedicine. The Grönemeyer Institute for Microtherapy in Bochum is a privately run company. A possible assumption of costs should be clarified beforehand with the respective health insurance company.
