HK1085953B - Implantable pump for operation of hydraulic implant - Google Patents

Description

Implantable pump for operating a hydraulic implant

Technical Field

The present invention relates to an implantable pump for pumping hydraulic fluid into the human or animal body or out of a hydraulically operated surgical implant. The pump comprises a wall forming a chamber of the pump for hydraulic fluid, the wall comprising a first wall portion and a second wall portion, the second wall portion being movable relative to the first wall portion, changing the volume of the chamber of the pump, pumping hydraulic fluid between the chamber and the surgical implant.

Background

One such implantable pump is disclosed in U.S. patent No.4982731 and may be hydraulically connected to an inflatable ring that forms an endless belt around the penis of an impotence patient. This prior art pump comprises a relatively large reservoir which can be squeezed in the form of an elastic bladder for hydraulic fluid. The reservoir is implanted in the scrotum of the patient so that the patient can enhance erection by depressing the squeezable reservoir in a multi-directional motion so that the loop restricts venous drainage.

Disclosure of Invention

It is an object of the present invention to provide an implantable pump which is thinner and smaller than prior art pumps, and which is therefore easier to implant subcutaneously. It is another object of the present invention to provide an implantable pump that is more versatile than prior art pumps. It is another object of the present invention to provide an implantable pump that is easier to calibrate.

Thus, according to a first aspect of the present invention, there is provided a new implantable pump of the type set forth above, characterized in that the second wall portion comprises a movable membrane which can be penetrated by an injection needle for adding hydraulic fluid to or withdrawing hydraulic fluid from the chamber of the pump, wherein the membrane is self-sealing, sealing the hole created in the membrane by the penetrating injection needle. As a result, the amount of hydraulic fluid pumped by the pump can be easily calibrated even when the pump has been subcutaneously implanted in a patient. Thus, the injection needle of a syringe can easily penetrate the skin of the patient in front of the membrane and further penetrate the membrane of the pump, so that hydraulic fluid can be added to or removed from the chamber of the pump from outside the patient's body.

According to a simplest embodiment, the membrane is manually displaceable, i.e. it is displaceable by pushing the patient's skin with a finger in front of a subcutaneously implanted pump. According to an alternative, the membrane can be moved magnetically. Thus, the membrane may be made of a magnetic material, or the membrane may be provided with magnetic elements, and the membrane may be pushed or pulled using an external permanent magnet or solenoid. According to another alternative, the pump may comprise a motor that can be controlled in a remote manner for moving the membrane.

In particular, the membrane is movable relative to the first wall portion between a first position in which the chamber of the pump has a first volume and a second position in which the chamber of the pump has a second volume that is larger than the first volume. The membrane is preferably flexible and has a hemispherical shape when in the first position. Thus, when the membrane is moved to its second position, the chamber of the pump is substantially empty and the membrane is in a tensioned state.

The implantable pump further comprises a locking device adapted to releasably lock the membrane in the second position. The membrane may be moved from the first position to the second position by manually pressing the membrane downward. Furthermore, the locking means may be adapted to release the membrane from the second position by pushing the membrane, and the membrane is adapted to resume its hemispherical shape in the first position when the membrane is released from the second position.

According to a preferred embodiment of the implantable pump, the membrane comprises a first layer and a second layer attached to each other, the first layer having a higher strength than the second layer, and the second layer having a better sealing property than the first layer. As a result, the thickness of the film can be very thin, i.e. about 3 mm. Thus, the pump of the present invention can be designed to be rather thin, which makes it easy to implant the pump subcutaneously.

The membrane layer may be made of silicone, wherein the first silicone layer is harder than the second silicone layer. The hardness of the second silicone layer is suitably less than 20 Shore. Generally, the second layer is located between the first layer and the chamber of the pump of the injection port. Alternatively, the membrane may comprise a third layer which is harder than the second layer, wherein the third layer is located between the second layer and the chamber of the pump. The silicone membrane is mounted in tension which allows a special type of hypodermic needle to be injected into the liquid chamber of the pump without leakage through the membrane after the needle has been removed from the membrane. This type of hypodermic needle has a transverse opening and does not cut any remaining holes in the silicone film. The needle will only move the silicone material sideways.

According to a second aspect of the present invention there is provided apparatus for treating a disease comprising a hydraulically operated surgical implant and an implantable pump of the present invention for pumping hydraulic fluid to or from the surgical implant.

Generally, the surgical implant comprises a hydraulic constriction device (a) for constricting a passage of an organ of a human or animal. The constriction device may be used to constrict the stomach of a patient who is obese, to restrict the entry of food to the patient, and may also be used to constrict the esophagus of a patient with reflux (or vomiting) disease, or to constrict the blood vessels of the penis of an impotent patient. Alternatively, the constriction device may be used as an artificial sphincter in patients with faecal or urinary incontinence.

In an embodiment of the device according to the invention, the constriction means comprises an inflatable chamber which is in fluid communication with the chamber of the pump. The inflatable chamber is adapted to pinch the passageway when it is inflated and release the passageway when it is compressed.

According to another embodiment of the apparatus according to the invention, the constriction device comprises a relatively small first inflatable chamber and a relatively large second chamber in fluid communication with the chamber of the pump, the first chamber being capable of displacing the second chamber. The first chamber is adapted to displace the second chamber to constrict the passageway when the first chamber is inflated and to displace the second chamber to release the passageway when the first chamber is deflated. The second chamber may also be inflated with a fluid. In this case, the apparatus suitably comprises an injection port in fluid communication with the second chamber. As a result, the volume of the second chamber can be calibrated by adding or withdrawing fluid through the injection port.

Advantageously, the surgical implant is coupled to the pump to form an operable pump assembly that is easily implanted in the patient. An operation device may operate the pump assembly, and an implantable motor may drive the operation device. The motor and/or other energy consuming components of the pump assembly may be designed to be powered by wireless energy emitted from outside the patient's body.

The apparatus suitably comprises an energy transmission device for wirelessly transmitting energy from outside the patient's body into the patient's body for use in connection with the operation of the pump assembly. The energy transmission device transmits the energy of the first form, and the pump assembly is operable in response to the energy of the second form. The apparatus further comprises an energy transforming device implantable in the patient for transforming the energy of the first form wirelessly transmitted by the energy transmission device into energy of a second form different from the energy of the first form.

The energy transforming device may comprise at least one member having a positive region and a negative region, wherein the member is capable of creating an energy field between the positive and negative regions when exposed to the energy of the first form transmitted by the energy transmission device, and wherein the energy field creates the energy of the second form. For example, the element may comprise an electrical connection which is capable of generating an electric field between the positive and negative regions when exposed to the energy of the first form transmitted by the energy transmission device, thereby causing the energy of the second form to be electrical.

The energy transforming device may be adapted to transform the energy of the first form directly or indirectly into the energy of the second form, which powers the motor. The pump assembly may perform a reversible function and the motor may perform the opposite function. For example, the control device may be adapted to change the polarity of the energy of the second form so as to reverse the motor. Preferably, the energy transforming device is adapted to directly power the motor with the transformed energy, as the energy of the first form is being transformed into the energy of the second form.

The wireless energy of the first form may comprise sound waves and the energy of the second form may comprise electric energy.

According to one embodiment of the invention, the apparatus comprises an energy storage device implantable in the patient for storing the energy of the second form and for supplying energy in connection with the operation of the pump assembly. For example, the energy storage device may comprise an accumulating device, such as at least one capacitor, or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery.

According to another embodiment of the invention, the apparatus comprises a source of energy implantable in the patient for supplying energy for the operation of the pump assembly, and a switch operable by the energy of the second form supplied by the energy transforming device to switch from an off mode, in which the source of energy is not in use, to an on mode, in which the source of energy supplies energy for the operation of the pump assembly.

The apparatus may comprise an implantable stabilising device for stabilising the energy of the second form. Where the energy of the second form comprises electric current, the stabilising means comprises at least one capacitor.

The apparatus may comprise implantable electrical components, which may be at least one voltage level guard.

Preferably, the energy transmission device is adapted to transmit wireless energy for direct use in connection with the operation of the pump assembly when the wireless energy is being transmitted. The form of wireless energy may include a magnetic field or electromagnetic waves for directly powering the pump assembly. The energy transforming device may directly operate the pump assembly with the energy of the second form in a non-magnetic, non-thermal or non-mechanical manner.

The energy transforming device suitably comprises at least one component of the semiconductor type. The semiconductor component may comprise at least one element having a positive region and a negative region, the element being capable of generating an energy field between the positive and negative regions when exposed to the energy of the first form transmitted by the energy transmission device, and the energy field generating the energy of the second form.

The pump assembly is operable to perform a reversible function, and a reversing device is implantable in the patient for reversing the function performed by the pump assembly. The control device is adapted to control the reversing device to reverse the function performed by the pump assembly. The reversing device may comprise hydraulic means, including a device for changing the direction of flow of a fluid in the hydraulic means. Alternatively, the reversing device may comprise a mechanical reversing device, such as a switch.

Preferably, the energy transmission device transmits energy using at least one wireless wave signal, such as an electromagnetic wave signal, including one of an infrared light signal, a visible light signal, an ultraviolet light signal, a laser signal, a microwave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal. Alternatively, the wave signal may comprise a sonic or ultrasonic wave signal. Any of these signal types may include digital signals or analog signals, or a combination of digital and analog signals.

The energy of the first form transmitted by the energy transmission device may comprise an electric, electromagnetic or magnetic field, or a combination thereof, and the energy transmission device may transmit them in pulses or digital pulses or a combination of pulses and digital pulses. The energy transforming device is adapted to transform the energy of the first form into direct current or pulsating direct current, or a combination of direct and pulsating direct current. Alternatively, the energy transforming device may transform the energy of the first form into alternating current, or a combination of direct and alternating current.

One of the energy of the first form and the energy of the second form may comprise magnetic energy, kinetic energy, acoustic energy, chemical energy, radiant energy, electromagnetic energy, optical energy, nuclear energy, or thermal energy. Similarly, one of the energy of the first form and the energy of the second form may comprise non-magnetic energy, non-kinetic energy, non-chemical energy, non-sonic energy, non-nuclear energy, or non-thermal energy.

Alternatively, the function of the energy transmission device may be different from or similar to the function of the energy transforming device.

The energy transforming device may suitably be designed for implantation subcutaneously or in the abdominal, thoracic or head region of a patient. Alternatively, the energy transforming device may be designed to be implanted in an aperture in the patient's body and below the mucosa of the aperture or in a lumen outside the mucosa.

Advantageously, the apparatus of the present invention comprises a control means, such as a microprocessor, for controlling the pump assembly. Preferably, the control means comprises a remote control device, conveniently a wireless remote control device, for controlling the pump assembly from outside the patient's body. The wireless remote control may comprise at least one external signal transmitting device or transceiver and at least one internal signal receiver or transceiver implantable in the patient. The wireless remote control may be adapted to transmit at least one wireless control signal, which may be a frequency signal, an amplitude signal, or a frequency or amplitude modulated signal. The control signal may comprise an analog signal or a digital signal or a combination of a digital signal and a frequency signal, and the remote control device may transmit an electromagnetic carrier wave signal for carrying the digital or analog control signal.

The control signal may comprise a wave signal comprising one of a sound wave signal, an ultrasonic wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultraviolet light signal, a laser signal, a microwave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal. The wireless remote control may transmit a carry signal carrying the control signal. The carrier signal may comprise a digital signal, an analog signal or a combination of a digital signal and a frequency signal. Alternatively, the control signal may comprise an electric or magnetic field, or a combination of an electric and magnetic field.

The apparatus may comprise at least one sensor adapted to be implanted in the patient. The sensor may be adapted to sense at least one physical parameter of the patient and/or at least one performance parameter of the medical implant. Suitably: the control device may control the pump assembly in response to signals from the sensor. The control device may comprise an implantable internal control unit which directly controls the pump assembly, or the control device may comprise an external control unit outside the patient's body which controls the pump assembly in response to signals from the sensor.

The apparatus of the invention may comprise an external data communicator and an implantable internal data communicator communicating with the external data communicator, characterised in that the internal communicator feeds data relating to the pump assembly back to the external data communicator or the external data communicator feeds data to the internal data communicator.

The device of the present invention may be used in any application requiring a small pump inlet system. It can be used in different kinds of implantable hydraulic constriction devices, such as adjustable bands for treating reflux disease, obesity, urinary incontinence, fecal incontinence, and impotence. It may also be used with hydraulic penile implants, as well as with infusion pumps for drug administration.

The pump assembly may be used to dispense a liquid from one part of a human body to another.

The apparatus of the present invention may also be used in connection with hydraulically controlled implants that are used to distribute fluid within the hydraulic implant or to or from an implanted fluid reservoir of the implant. Examples of such hydraulically controlled implants are artificial sphincters for blocking body openings, for treating fecal incontinence, colostomy, ileostomy, jejunostomy, or hernia in the cardia region. Another example is a hydraulic constriction device for creating an opening in any part of the body, for example in the stomach or esophagus of an obese patient, in order to treat obesity.

For fecal incontinence, colostomy, ileostomy, or jejunostomy, the apparatus of the invention may be used to control a hydraulic implant, and in the case of a large pump assembly of the device may also be used to pump fecal matter which may be excreted through an open stoma or through the patient's normal anal canal.

The device of the present invention may also be used to treat the vascular system, such as to restrict or compress any portion of the vascular system.

According to a third aspect of the present invention, there is provided a method of manipulating a hydraulically manipulatable surgical implant implanted in a human or animal body, the method comprising: subcutaneously implanting a pump in a human or animal body, the pump having an infusion membrane which is movable to vary the volume of a hydraulic fluid chamber in the pump; hydraulically connecting the hydraulic fluid chamber to a hydraulically operable surgical implant through a conduit to form a closed hydraulic fluid distribution system comprising the fluid chamber, the conduit and the surgical implant; calibrating the amount of hydraulic fluid in the fluid distribution system by penetrating the skin of the patient and the membrane of the implanted pump with an injection needle and adding hydraulic fluid to or withdrawing hydraulic fluid from the fluid chamber; and, the surgical implant is manipulated from time to time by moving an infusion membrane of a subcutaneously implanted pump, thereby distributing hydraulic fluid between a fluid chamber of the pump and the surgical implant.

The method may further comprise manipulating the surgical implant manually or magnetically, or alternatively by moving the injection membrane with the aid of a motor.

The present invention also provides a surgical method for treating a patient having a disease, the method comprising the steps of: insufflating the abdomen of the patient with gas; providing at least two laparoscopic trocars in a patient's body; inserting at least one sectioning tool through a trocar and sectioning a region of a patient; implanting a hydraulic surgical implant through the trocar using the surgical instrument in the segmented region, the implant being designed to treat reflux disease, urinary incontinence, impotence, fecal incontinence, or obesity; subcutaneously implanting a pump in a patient, the pump having an infusion membrane that is movable to vary the volume of a hydraulic fluid chamber in the pump; hydraulically connecting a fluid chamber of a pump to a hydraulically manipulatable surgical implant; calibrating the amount of fluid in the chamber of the pump by penetrating the skin of the patient and the membrane of the pump with an injection needle and adding fluid to or withdrawing fluid from the fluid chamber; and, the surgical implant is manipulated from time to time by moving by hand the infusion membrane of a subcutaneously implanted pump, thereby distributing hydraulic fluid between the fluid chamber of the pump and the surgical implant.

The methods described above may also be used to treat reflux (or vomiting) disorders, urinary incontinence, impotence, fecal incontinence or obesity, or the like.

Drawings

Preferred embodiments of the present invention will now be described, by way of example, with reference to the accompanying drawings, in which:

FIG. 1 shows an implantable pump according to the present invention;

figures 2 and 3 show how the pump shown in figure 1 can be operated manually;

FIG. 4 illustrates one embodiment of an apparatus according to the present invention including the implantable pump shown in FIG. 1;

FIG. 5 shows another embodiment of the apparatus of the present invention;

FIGS. 6 and 7 show details of the embodiment shown in FIG. 5;

FIG. 8 shows an alternative design to the embodiment shown in FIG. 5; and

figure 9 shows another embodiment of the apparatus of the present invention having a motor driven pump.

Detailed Description

Referring to the drawings, like reference numbers indicate like or corresponding parts throughout the views.

Fig. 1 shows an implantable pump 1 according to the invention comprising walls 2 forming a chamber 3 for hydraulic fluid, typically an isotonic saline solution. A stub pipe 3A is provided for connection to a pipe (not shown) for distributing hydraulic fluid from the chamber 3. The wall 2 comprises a first wall portion in the form of a rigid base plate 4 and a second wall portion in the form of a relatively thin deformable injection membrane 5, which is in the shape of a hemisphere and is attached to the base plate 4. The injection membrane 5 makes it possible to calibrate the pumpable amount of hydraulic fluid by inserting a hypodermic needle through the membrane 5 and adding hydraulic fluid to the chamber 3 or withdrawing hydraulic fluid from the chamber 3.

The membrane 5 comprises three layers attached to each other: an outer first hard layer 6, preferably having a hardness greater than 20 Shore; an intermediate second soft layer 7, the hardness of which is preferably less than 20 Shore; and an inner third hard layer 8, the hardness of which is suitably greater than 20Shore, preferably about 60Shore or higher. The soft layer 7 has good sealing properties, which means that the soft layer 7 automatically seals the hole created by the injection needle when penetrating the membrane 5 from the injection needle, once the injection needle has been removed from the membrane 5. The strength properties of the hard layers 6 and 8 and the sealing properties of the soft layer 7 make it possible to design the membrane 5 particularly thin. The film layers 6, 7 and 8 are suitably made of plastic or silicone, preferably silicone. Suitable Silicone materials are, for example, those manufactured by "Applied Silicone, inc.

In most applications of the pump of the invention it is sufficient if the membrane 5 comprises only two layers, an outer hard layer 6 and a soft layer 7. Thus, the hard layer 6 has better strength properties than the soft layer 7, while the soft layer 7 has better sealing properties than the hard layer 6.

Figures 2 and 3 show how the pump 1 is operated manually. Since the intermediate layer 7 of the membrane 5 is very soft, i.e. the hardness of the elastic silicone material is less than 20Shore, it is possible to design a thin and elastic membrane 5, which allows pumping by hand and still does not cause leakage when a hypodermic needle penetrates the membrane 5. As shown in fig. 2, with the pump 1 subcutaneously implanted in a patient, a finger 10 may push (actuated with one push) the membrane 5 from above in a direction 11 through the patient's skin 9. The film 5 will then be substantially flattened so that the surface of the film facing the finger 10 will become a somewhat concave bowl-like shape 12, see fig. 3. When the membrane 5 has been moved to the lowermost position, the locking device 13 holds the membrane there until it is pressed again manually. When the membrane 5 is actuated again by a second push with the finger 10, the locking means 13 (which function similarly to a locking mechanism for a ballpoint pen or the like) releases the membrane 5, so that the membrane 5 can return to its normal concave-shaped state as shown in fig. 2.

Fig. 4 shows an embodiment of the apparatus of the invention comprising a surgical implant in the form of a hydraulic constriction device 14, the pump 1 of the invention, and a tube 15 hydraulically connecting the constriction device 14 to the pump 1. The constriction device 14 comprises an expandable chamber 16 which is in fluid communication with the chamber 3 of the pump 5 via a conduit 15. The apparatus thus has a closed hydraulic distribution system comprising the fluid chamber 3, the conduit 15 and the chamber 16.

Constriction device 14 is intended to restrict the passage of an organ of a human or animal. For example, it can be used as an artificial sphincter applied to the urethra of an incontinent patient. The incontinent patient can push the membrane 5 of the pump 1 to its locked position in order to expand the chamber 16, closing the urethra and, when necessary, push the membrane 5 to release it, so that the chamber 16 can be collapsed and the patient can urinate.

The amount of fluid in the fluid distribution system of the apparatus can be calibrated by penetrating the membrane 5 of the pump 1 with the needle 17 of one syringe 18 and adding hydraulic fluid to the chamber 3 of the pump 1 or withdrawing hydraulic fluid from the chamber 3.

The apparatus shown in fig. 4 may also be used to treat patients with heartburn and reflux disease (heartburn and reflux disease), obesity or fecal incontinence, or to temporarily restrict penile outlet blood flow in an impotent patient. Thus, in a broad sense, after the pump 1 has been subcutaneously implanted in a patient, hydraulic fluid is manually pumped between the fluid chamber 3 and the implanted constriction device 14 using the movable injection membrane 5. The total amount of hydraulic fluid in the fluid chamber 3, the conduit 15 and the chamber 16 is calibrated by penetrating the skin of the patient and the membrane 5 with the injection needle 17 of the injector 18, adding fluid to the chamber 5 or withdrawing fluid from the chamber 5. From time to time the constriction device 14 is operated by manually moving the membrane 5 to pump fluid into the chamber 3 of the pump 1 or to pump fluid out of the chamber 3.

Fig. 5 schematically shows another embodiment of the apparatus of the invention, which is similar to the embodiment shown in fig. 4, with the difference that: the design of the constriction device differs. The constriction device 19 of the apparatus according to fig. 5 therefore comprises a relatively small inflatable chamber 20 which is in fluid communication with the chamber 3 of the pump 1, and a relatively large chamber 21 which is movable by the small chamber 20. The small chamber 20 is adapted to move the large chamber 21 to constrict the passage when the small chamber 20 is inflated and to move the large chamber 21 to release the passage when the small chamber 20 is deflated. Thus, the addition of a relatively small amount of hydraulic fluid by the pump 1 to the small chamber 20 will produce a relatively large constriction in the passage of interest.

Large chamber 21 is formed by a large bladder 22 which is connected to an injection port 23 by a conduit 24. The volume of bladder 22 is calibrated by adding fluid to injection port 23 or withdrawing fluid from injection port 23 with the aid of injector 18. Small chamber 20 is formed by a small bladder 25 attached at one end to an annular frame 26 of constriction device 19 and attached at the opposite end to bladder 22.

Fig. 6 and 7 schematically illustrate the operation of constriction device 19. Referring to fig. 6, when small chamber 20 is deflated, bellows 25 pulls bladder 22 inward onto annular frame 26, thereby causing constriction device 19 to compress the passageway of interest. When small chamber 20 is inflated, bellows 25 pulls bladder 22 away from annular frame 26, causing constriction device 19 to release the passageway, see fig. 7.

Fig. 8 shows an alternative design of the device shown in fig. 5. Thus, in this alternative design, the injection port 23 is significantly smaller than the pump 1 and is attached to the stub 3A of the pump 1.

Fig. 9 shows an embodiment of the device of the invention, which differs from the embodiment described above in that: the pump 1 is driven by a motor. Thus, a motor 27 for moving the membrane 5 is arranged in the chamber 3, on the substrate 4. A wire 28 is connected between the top of the membrane 5 and a pulley 29 on the motor shaft of the motor 27. When the motor 27 is activated, it winds the wire 28 on the pulley 29, thereby pulling the film 5 towards the substrate 4. When the motor 27 is reversed, the membrane 5 resumes its hemispherical shape. The wirelessly transmitted energy transmitted by a control device 30 delivers energy from outside the patient's skin 9 to the motor 27. A wireless energy conversion device 31, electrically connected to the motor 27, converts the wireless energy into electrical energy. The control device 30 controls the motor 27.

While the invention has been described with reference to specific embodiments, there is no intent to limit it to those embodiments. Modifications within the spirit of the invention will be apparent to those skilled in the art. The scope of the invention is defined by the following claims.

Claims (110)

1. An implantable pump (1) for pumping hydraulic fluid into a human or animal body or out of a hydraulically operated surgical implant (14; 19), the pump comprises a wall (2) forming a chamber (3) for a pump of hydraulic fluid, the walls comprising a first wall part (4) and a second wall part, which is movable relative to the first wall part, to vary the volume of the chamber (3) of the pump, to pump hydraulic fluid between the chamber and the surgical implant, characterized in that the second wall portion comprises a movable membrane (5) which is penetrated by an injection needle (17), to add hydraulic fluid to the chamber (3) of the pump or to withdraw hydraulic fluid from the chamber (3) of the pump, and wherein the membrane is self-sealing to seal the hole in the membrane created by the penetrating needle.

2. Implantable pump according to claim 1, characterized in that the membrane (5) is manually movable.

3. Implantable pump according to claim 1, wherein the membrane (5) is movable relative to the first wall portion (4) between a first position, in which the chamber (3) of the pump has a first volume, and a second position, in which the chamber has a second volume larger than the first volume.

4. An implantable pump according to claim 3, wherein the membrane (5) is flexible and has a hemispherical shape when it is in the first position.

5. The implantable pump according to claim 4, further comprising a locking device (13) adapted to releasably lock the membrane (5) in the second position.

6. An implantable pump according to claim 5, wherein the locking means (13) is adapted to lock the membrane (5) in the second position when the membrane is manually pushed from the first position to the second position.

7. An implantable pump according to claim 6, wherein the locking means (13) is adapted to release the membrane (5) from the second position when the membrane is pushed, and wherein the membrane is adapted to resume its hemispherical shape in the first position when the membrane is released from the second position.

8. An implantable pump according to any of claims 4-7, wherein the chamber (3) of the pump is substantially emptied when the membrane (5) is in the second position.

9. An implantable pump according to any of claims 1-7, wherein the membrane (5) comprises a first layer (6) and a second layer (7) attached to each other, the first layer (6) having a higher strength than the second layer and the second layer (7) having a better sealing property than the first layer.

10. An implantable pump according to claim 9, wherein the first layer (6) is harder than the second layer (7).

11. An implantable pump according to claim 10, wherein the second layer (7) is located between the first layer (6) and the chamber (3) of the pump.

12. An implantable pump according to claim 11, wherein the membrane (5) comprises a third layer (8) which is harder than the second layer (7), the third layer (8) being located between the second layer (7) and the chamber (3) of the pump.

13. Implantable pump according to claim 12, wherein the second layer (7) is made of silicone with a hardness of less than 20 Shore.

14. An implantable pump according to any of claims 1-7, wherein the membrane (5) is movable in a magnetically acting manner.

15. The implantable pump according to claim 1, further comprising an operation device adapted to operate the membrane.

16. The implantable pump according to claim 15, further comprising a motor for driving the operation device.

17. An implantable pump according to claim 16, wherein the pump is adapted to be implanted in a human body and the motor is adapted to be controlled by a remote control unit outside the human body.

18. An implantable pump according to claim 17, wherein the pump is adapted for implantation in a human body and the motor is configured to be powered by wireless energy emitted outside the human body.

19. The implantable pump according to claim 15, wherein the pump is adapted for implantation in a human body, and further comprising a control device for controlling the operation device.

20. The implantable pump according to claim 15, wherein the control device comprises a remote control for controlling the operation device from outside the human body.

21. The implantable pump according to claim 15, further comprising a magnet for driving the operation device.

22. An implantable pump according to claim 21, wherein the pump is adapted for implantation in a human or animal body and the magnet is adapted to control the pump from outside the body.

23. An apparatus for treating a disease comprising a hydraulically operated surgical implant, an implantable pump (1) for pumping hydraulic fluid to a surgical implant (14; 19), or pumping fluid out of the implant, the pump comprising walls (2) forming a chamber (3) of a pump for hydraulic fluid, the walls comprising a first wall part (4) and a second wall part, the second wall part being movable relative to the first wall part, to vary the volume of a chamber (3) of the pump, pumping hydraulic fluid between the chamber and the surgical implant, characterized in that the second wall portion comprises a movable membrane (5) which is penetrable by an injection needle (17) for adding hydraulic fluid to or withdrawing hydraulic fluid from the pump chamber (3) of the pump (1).

24. An apparatus according to claim 23, characterized in that the surgical implant comprises hydraulic constriction means (14; 19) for constricting the passage of a human or animal organ.

25. An apparatus according to claim 24, wherein said constriction device (14) comprises an inflatable chamber (16) in fluid communication with the chamber (3) of said pump, said inflatable chamber being adapted to constrict the passageway when it is inflated and to release the passageway when it is compressed.

26. An apparatus according to claim 24, wherein said constriction device (19) comprises a relatively small first inflatable chamber (20) and a relatively large second chamber (21) in fluid communication with the chamber (3) of the pump (1), said first chamber being movable, and wherein said first chamber is adapted to move said second chamber to constrict the passageway when inflating said first chamber and to move said second chamber to release the passageway when deflating said first chamber.

27. The apparatus according to claim 26, wherein the second chamber (21) is inflatable by a fluid, and the second chamber (21) further comprises an injection port (23) in fluid communication with the second chamber, such that the volume of the second chamber can be calibrated by adding or withdrawing fluid through the injection port.

28. The apparatus according to claim 27, characterized in that the film (5) is manually movable.

29. An apparatus according to claim 28, characterized in that the membrane (5) is movable relative to the first wall part (4) between a first position, in which the pump chamber (3) has a first volume, and a second position, in which the pump chamber has a second volume smaller than the first volume.

30. An apparatus according to claim 29, wherein said membrane (5) is elastic and has a hemispherical shape when it is in said first position.

31. An apparatus according to claim 30, further comprising locking means (13) adapted to releasably lock said membrane (5) in said second position.

32. An apparatus according to claim 31, wherein said locking means (13) is adapted to lock said membrane (5) in said second position when said membrane is manually pushed from said first position to said second position.

33. An apparatus according to claim 32, wherein said locking means (13) is adapted to release said membrane (5) from said second position when said membrane is pushed, thereby causing said membrane to resume its hemispherical shape in said first position.

34. An apparatus according to claim 33, characterized in that the chamber (3) of the pump is substantially emptied when the membrane (5) is in the second position.

35. A device according to claim 34, wherein said membrane (5) comprises a first layer (6) and a second layer (7) attached to each other, said first layer (6) having a higher strength than said second layer, and said second layer (7) having a better sealing performance than said first layer.

36. A device according to claim 35, characterized in that said first layer (6) is harder than said second layer (7).

37. The device according to claim 36, characterized in that the second layer (7) is located between the first layer (6) and the chamber (3) of the pump.

38. The device according to claim 37, characterized in that said membrane (5) comprises a third layer (8) which is harder than said second layer (7), said third layer (8) being located between said second layer (7) and the chamber (3) of said pump.

39. Device according to claim 38, characterized in that said second layer (7) is made of silicone having a hardness of less than 20 Shore.

40. An apparatus according to any one of claims 23-27, 29-39, characterized in that the membrane (5) is movable in a magnetically acting manner.

41. The apparatus according to claim 23, wherein said surgical implant is connected to said pump to form a steerable pump assembly.

42. An apparatus according to claim 41, further comprising an implantable operation device adapted to operate the pump assembly.

43. An apparatus according to claim 42, further comprising an implantable motor for driving the operation device.

44. The apparatus according to claim 43, wherein said motor is designed to be powered by wireless energy emitted from outside the patient's body.

45. The apparatus according to claim 41, further comprising an energy transmission device for wirelessly transmitting energy from outside the patient's body into the patient's body, which energy is used in connection with the operation of said pump assembly.

46. An apparatus according to claim 45, wherein the energy transmission device transmits energy of a first form and the pump assembly is operable in response to energy of a second form, and the device further comprises an energy transforming device implantable in the patient for transforming the energy of the first form wirelessly transmitted by the energy transmission device into the energy of the second form.

47. An apparatus according to claim 46, wherein the energy of the second form is different from the energy of the first form.

48. An apparatus according to claim 46, wherein the energy transforming device comprises at least one member having a positive region and a negative region, the member being capable of generating an energy field between the positive and negative regions when exposed to the energy of the first form transmitted by the energy transmission device, and the energy field generating the energy of the second form.

49. An apparatus according to claim 48, wherein the member comprises an electrical connector and the electrical connector is capable of generating an electric field between a positive region and a negative region when exposed to the energy of the first form transmitted by the energy transmission device, whereby the energy of the second form comprises electrical energy.

50. An apparatus according to claim 46, wherein the energy transforming device is adapted to transform the energy of the first form directly or indirectly into the energy of the second form.

51. An apparatus according to claim 50, further comprising an implantable motor for operating the pump assembly, wherein the motor is powered by the energy of the second form.

52. The apparatus of claim 51, wherein the pump assembly is operable to perform a reversible function and the motor is operable to perform a reverse function.

53. An apparatus according to claim 51, further comprising control means adapted to change the polarity of the energy of the second form so as to reverse the motor.

54. An apparatus according to claim 51, wherein the energy transforming device is adapted to directly power the motor with the transformed energy, while being transformed from the energy of the first form to the energy of the second form.

55. An apparatus according to claim 50, wherein the wireless energy of the first form comprises acoustic energy and the energy of the second form comprises electric energy.

56. An apparatus according to claim 46, further comprising an energy storage device implantable in the patient for storing the energy of the second form and for supplying energy in connection with the operation of the pump assembly.

57. The apparatus of claim 56 wherein said energy storage device comprises an accumulator device.

58. An apparatus according to claim 57, wherein the accumulating means comprises at least one capacitor, or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery.

59. An apparatus according to claim 46, further comprising a source of energy implantable in the patient for supplying energy for the operation of the pump assembly, and further comprising a switch operable by the energy of the second form supplied by the energy transforming device to switch from an off mode, in which the source of energy is not in use, to an on mode, in which the source of energy supplies energy for the operation of the pump assembly.

60. An apparatus according to claim 46, further comprising implantable stabilising means for stabilising the energy of the second form.

61. An apparatus according to claim 60, wherein the energy of the second form comprises electric current and the stabilising means comprises at least one capacitor.

62. The apparatus according to claim 45, further comprising implantable electrical components, the implantable electrical components comprising at least one voltage level protection device.

63. An apparatus according to claim 45, wherein the energy transmission device is adapted to transmit wireless energy for direct use in connection with the operation of the pump assembly when the wireless energy is being transmitted.

64. An apparatus according to claim 45, wherein the energy transmission device is adapted to transmit wireless energy in the form of a magnetic field or electromagnetic waves for directly powering the pump assembly.

65. An apparatus according to claim 46, wherein the energy transforming device directly operates the pump assembly magnetically, thermally or mechanically with the energy of the second form.

66. An apparatus according to claim 46, wherein said energy transforming device comprises at least one component of a semiconductor type.

67. An apparatus according to claim 46, wherein said semiconductor component comprises at least one member having a positive region and a negative region, said member being capable of generating an energy field between the positive and negative regions when exposed to said energy of the first form transmitted by said energy transmission device, and said energy field generating said energy of the second form.

68. The apparatus of claim 41, wherein the pump assembly performs a reversible function.

69. The apparatus according to claim 68, further comprising a reversing device implantable in the patient for reversing the function performed by the pump assembly.

70. An apparatus according to claim 69, comprising a control device control which controls the reversing device to reverse the function performed by the pump assembly.

71. An apparatus according to claim 69, wherein the reversing device comprises hydraulic means including means for changing the direction of flow of a fluid in the hydraulic means.

72. An apparatus according to claim 69, wherein the reversing device comprises a mechanical reversing device.

73. An apparatus according to claim 69, wherein the reversing device comprises a switch.

74. An apparatus according to claim 45, wherein the energy transmission device transmits energy using at least one wireless signal.

75. The apparatus of claim 74 wherein said signal comprises a wave signal.

76. The apparatus of claim 75, wherein the wave signal comprises an electromagnetic wave signal comprising one of an infrared light signal, a visible light signal, an ultraviolet light signal, a laser light signal, a microwave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal.

77. The apparatus of claim 75, wherein the wave signal comprises a sonic or ultrasonic wave signal.

78. The apparatus of claim 74, wherein the signal comprises a digital signal or an analog signal, or a combination of a digital signal and an analog signal.

79. An apparatus according to claim 46, wherein the energy of the first form transmitted by the energy transmission device is an electric, electromagnetic or magnetic field, or a combination thereof.

80. An apparatus according to claim 79, wherein the energy transmission device transmits the electric, electromagnetic or magnetic field, or a combination thereof, in pulses.

81. An apparatus according to claim 46, wherein the energy transforming device transforms the energy of the first form into a direct current form.

82. An apparatus according to claim 46, wherein the energy transforming device transforms the energy of the first form into an alternating current form or a combination of a direct current and an alternating current form.

83. The apparatus according to claim 46, wherein one of the energy of the first form and the energy of the second form is magnetic energy, kinetic energy, sonic energy, chemical energy, radiant energy, electromagnetic energy, light energy, nuclear energy, or thermal energy.

84. The apparatus according to claim 46, wherein one of the energy of the first form and the energy of the second form is magnetic energy, kinetic energy, chemical energy, acoustic energy, nuclear energy, or thermal energy.

85. An apparatus according to claim 46, wherein the function of the energy transmission device is different from the function of the energy transforming device.

86. An apparatus according to claim 46, wherein the energy transmission device functions similarly to the energy transforming device.

87. An apparatus according to claim 46, wherein the energy transforming device is designed to be implanted subcutaneously.

88. An apparatus according to claim 46, wherein the energy transforming device is designed to be implanted in the abdominal, thoracic, or head region of the patient.

89. An apparatus according to claim 46, wherein the energy transforming device is designed to be implanted in an aperture in the patient's body and in a lumen below or outside the mucosa of the aperture.

90. The apparatus according to claim 23, further comprising at least one sensor adapted to be implanted in the patient.

91. An apparatus according to claim 90, wherein the sensor is adapted to sense at least one physical parameter of the patient.

92. An apparatus according to claim 90, wherein the sensor is adapted to sense at least one functional parameter of the surgical implant.

93. The apparatus according to claim 90, further comprising a control device for controlling said surgical implant and said pump in response to signals from said sensor.

94. An apparatus according to claim 93, wherein the control device comprises an implantable internal control unit that directly controls the surgical implant and the pump in response to signals from the sensor.

95. The apparatus according to claim 93, wherein the control device comprises an external control unit outside the patient's body for directly controlling the surgical implant and the pump in response to signals from the sensor.

96. The apparatus of claim 41, further comprising a control device for controlling the pump assembly.

97. The apparatus according to claim 96, wherein said control device comprises a remote control device for controlling said pump assembly from outside the patient's body.

98. The apparatus according to claim 97, wherein said remote control device comprises a wireless remote control device.

99. An apparatus according to claim 98, wherein said wireless remote control is adapted to transmit a wireless control signal for controlling said pump assembly.

100. The apparatus of claim 99, wherein the control signal comprises a frequency signal, an amplitude signal, or a frequency or amplitude modulated signal.

101. The apparatus of claim 99, wherein the control signal comprises an analog signal or a digital signal, or a combination of a frequency signal and a digital signal.

102. The apparatus according to claim 96, wherein the control device comprises a microprocessor.

103. An apparatus according to claim 98, wherein said wireless remote control comprises at least one external signal transmitting device or transceiver and at least one internal signal receiver or transceiver implantable in the patient.

104. The apparatus according to claim 99, wherein said wireless remote control device transmits a carrying signal carrying the control signal.

105. The apparatus of claim 104, wherein the carrier signal comprises a digital signal, an analog signal, or a combination of a digital signal and a frequency signal.

106. The apparatus according to claim 105, wherein the signal comprises a wave signal.

107. The apparatus of claim 99, wherein the control signal comprises a wave signal comprising one of a sound wave signal, an ultrasonic wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultraviolet light signal, a laser light signal, a microwave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal.

108. The apparatus of claim 99, wherein the control signal comprises an electric field or a magnetic field, or a combination of an electric field and a magnetic field.

109. The apparatus according to claim 101, wherein said remote control device emits an electromagnetic carrier wave signal for carrying either a digital control signal or an analog control signal.

110. An apparatus according to claim 41, further comprising an external data communicator and an implantable internal data communicator communicating with the external data communicator, wherein the internal communicator feeds data relating to the pump assembly back to the external data communicator or the external data communicator feeds data to the internal data communicator.