Constraints on implant design resulting from the needs of surgical placement—implications for implantable artificial muscles

Abstract Design of a medical implant needs to ensure the device can be positioned accurately and removed subsequently if needed. This necessitates specific design considerations for implantation. This review is an opinion paper considering how an operation to introduce an implant into a patient may affect design, focusing on development of implantable artificial muscles (IAMs). Compatibility with endoscopic ports or the Seldinger technique will help deliver treatment with shorter hospital stay and quicker recovery. This means an IAM device has to have configurations to suit both deployment and use. Replacement of the device or removal as an emergency means it must be easy to extract without damage to the patient’s tissues, using standard surgical equipment. The implant has to be compatible with processes for sterilizing medical devices. But design of the packaging of the implant is equally important, since transfer of the device from its sterile-packaged storage state to the operating table for deployment into a patient is a vulnerable process in which contamination can occur. Implant surgery is a high-risk healthcare intervention. Those developing IAMs should consider aspects relating to surgical approach, deployment, wear, fixation, avoidance of perioperative complications and subsequent removal.