The hearing aid in the ear is considered one of the first small medical devices. But between "small" and "micro" there is a big difference. The innovative approaches of micromedicine use the dwarf dimensions of high-performance sensors, valves or pumps. By continuously transferring the measured values to the treating physician and optimally adapting the therapy, the care of chronically ill patients can be significantly improved. This benefits above all cardiovascular patients.
Drug delivery systems - the finest dosage
New drug delivery systems, known as drug delivery systems, work with valves or pumps that can deliver medication directly to the point of treatment. Thus, for example, a continuous pain treatment is possible. Also in diabetes treatment, a dosing pump under the skin can be used.
The drug-delivery systems also include the discus-like containers that can be implanted directly under the skin. They deliver small amounts (microliter = millionths of a liter) of medication continuously or at certain intervals. Such components, so-called smart pills, are available in the smallest dimensions of 6 by 14 by 2 millimeters.
Gentle interventions in the organism
The treatment with microtherapy takes place among other things with disc damage, in the pain and tumor therapy as well as for the treatment of vascular illnesses. Micromedicine is used both medically 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, the development of which was accelerated from the mid-1980s, Prof. Grönemeyer himself developed a large number of his miniature instruments. These include, among others, mini-balloons, the spine elements upright again.
What was previously known only from cardiology, the widening of cardiac vessels with a balloon catheter, the spine specialists at the Grönemeyer Institute for MicroTherapy in Bochum also transferred to the spine. In balloon kyphoplasty, two balloons are placed in the vertebral body and gently inflated with fluid under pressure. This raises the broken vertebral end plate and creates a cavity which is then filled with special bone cement.
In the computer tomograph and with additional X-ray control, the process is precisely controlled to avoid complications.
The patient is wide awake, the treatment area only anesthetized locally. "A number of our patients have been in great pain for many weeks, and some are wheelchair-bound, so it's nice to see that many of them are able to move 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 the medical routine in a few years. These include, for example, ECG devices whose electrodes are incorporated in T-shirts or undershirts or also new systems for continuous blood pressure or blood glucose measurement. A radio chip, which is planted 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 approached with a reader. As privacy advocates storm this development, emergency medical professionals see a huge leap in the care of local casualties.
Telemetric microsystems - monitoring over long distances
The focus of research and product development is currently on so-called telemetric microsystems. So z. B. monitored over long periods and distances away patients and risk groups or drugs are dosed. 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 1500 light-sensitive cells will be glued to the retina in the next few months. Light that falls on the sensors triggers stimulation currents on the retina, which are guided by the optic nerve into the brain. Patients who are still working on the reassignment may then at least see contours again.
Also promising are research results in the field of intraocular pressure measurement and the development of a platform that allows the external telemetric monitoring of risk patients nationwide. Further information: Despite acknowledged technology and successes, the health insurance companies are having a hard time with micromedicine.
The Grönemeyer Institute for Microtherapy in Bochum is a privately owned company. Any reimbursement should be clarified in advance with the respective health insurance.