The idea isn’t exactly new. GÃ¶tz von Berlichingen, a historic German figure from the early 1500s, was made famous by Goethe as much as by his iron hand: A prosthesis that still is a heritage in the von Berlichingen family. Its delicate mechanics with which the robber-knight was able to move every finger independently were built by a master craftsman in Renaissance Nuremburg. Not only was the device strong enough to grasp and firmly hold a rein (though no sword), it still works today.
Despite a continuous wave of scientific advancements in engineering and technology since then, Mother Nature still manages to be an inexhaustible source of inspiration. Evolution, it turns out, has yielded some technologies that scientists around the world are still trying to emulate—and with increasing success.
They call it bionics. Applying biological methods and systems found in nature to engineering systems already has led to numerous innovations in all fields of engineering, and medical device research is no exception. Bionic technology is already in use and FDA-approved in applications such as hearing systems, artificial retinas, and prosthetics, and could soon even enable artificial organs. In fact, a June 2014 paper in the New England Journal of Medicine detailed a successful attempt to create a bionic pancreas.
New materials and technologies are paving the way for further progress. Recent developments in the construction of nanostructures, for instance, may open doors to developments few dared to foresee just 20 years ago.
Restoring Sight to the Blind
In 2011, IEEE Spectrum created a Web site called “The Bionic Body Shop” where one could shop for no fewer than 18 bionic devices, ranging from brain-machine interfaces to drug-delivery devices to robotic feet. All of them had at least seen clinical trials, and most of them were already commercially available and used by patients around the world.
Innovation hasn’t stopped since then. The first commercial implantation in the United States of a retinal prosthesis system designed for patients suffering from retinitis pigmentosa (RP), a degenerative retinal disease that often results in complete blindness, occurred earlier this year. The first-ever commercial implantation of the system occurred in Italy in 2011.
“The idea behind the bionic eye started with cochlear implants for patients with hearing loss,” explains Gregoire Cosendai, vice president, Europe, at Sylmar, California-based Second Sight Medical Products Inc. “In cochlear implants, the auditory nerve is stimulated by electrical currents to restore hearing to the deaf. The first experiments took place in 1991 on a small group of 20 blind volunteers to demonstrate the feasibility of creating spots of vision.”
In development for more than 20 years, the Argus II system captures the picture in the user’s field of vision from a small, head-mounted digital camera and communicates the image to an implanted electrode array attached to the eye. This array then stimulates the retina’s remaining cells, which transmit the visual information along the optic nerve to the brain.
Advances in human-machine neural interfaces, electronic knees with microprocessors able to recalibrate 1000 times per second, and the creation of muscle-like actuators from synthetic or animal tissue are breathing new life into prostheses and orthotic devices. Muscle-like actuators might even make a handshake with an artificial hand feel real again.
And some of the most exciting bionics breakthroughs are hailing from patients themselves. Hugh Herr, for example, lost both of his legs at the age of 17 after he got lost in a blizzard during a mountaineering expedition and wasn’t found for three days. Three decades later, Herr serves as director of the biomechatronics group at the Massachusetts Institute of Technology (MIT) Media Lab in Cambridge, Massachusetts, and has developed advanced prostheses that he uses to walk, run, and even rock climb.
For Herr, the solutions to disability don’t lie in biological or pharmacological cures; they are found in advanced engineering. “My legs weren’t grown back; I wasn’t given a total limb transplant,” he notes. “If you eliminate the synthetics, all I can do is crawl. But with them, I can more or less do anything.”
Herr’s goal is to connect prosthetics directly to the peripheral nerves in amputees’ residual limbs. Such a system would enable even more precise commands to the prosthesis. But the most significant advantage would be its capability of sending sensory information back up the nerves. How would it feel if an amputee could again feel the grass between his prosthetic toes? “When that happens it will not matter what the prosthetic is made of; it will be you,” Herr says. “I feel, therefore I am.”
Barriers to Bionics
All of these devices and projects have one thing in common: They are about the body electric. Learning the electrical language that the brain uses to govern our movements, moods and memories seems to be at the center of bionics research. As it turns out, many afflictions and conditions might be effectively treated by overwriting the faulty or damaged electrical systems inside a patient’s body.
So, are we on track towards a cyborg future, where malfunctioning parts of the body can easily be replaced with prostheses, as long as our brains are functioning correctly?
Probably not, according to Brian Mech, vice president of business development at Second Sight. “When it takes more than 10 years to get the technology to market and $125 million, most investors are going to say no,” he says. “No one has that kind of time horizon.”
Many novel developments in the field of bionics reach prototype status but never obtain the funding to go from lab to market. Maysam Ghovanloo, associate professor in the school of electrical and computer engineering at the Georgia Institute of Technology and founding director of the school’s GT-Bionics Lab, bemoans the fact that, “for every 10 of these great new progresses, maybe one actually becomes commercially available.”
Ekso Bionics, a Richmond, California-based maker of a wearable robotic exoskeleton that enables patients with lower-extremity paralysis to walk again, went public after no venture capital firm bit on their offer. “The going would be a lot faster if it was easier to prove to people that they need a bionics investment strategy,” says Ekso Bionics CEO Nathan Harding. Add to that the fact that bionic prostheses often are only needed by a rather small number of disabled people, and the funding problems might become insurmountable.
But even if the company gets funded and the product hits the market, challenges still exist. Prosthetists, who are responsible for billing, don’t know before they order a prosthesis whether the device will be covered by payers. Since bionic prostheses are three or four times more expensive than traditional prostheses, possible developments are often scaled back from the get-go to keep them affordable.
Intelligent business strategies are thus needed for these innovative companies. For Ekso Bionics, a difficult lab-to-market situation resulted in a diversification of the target group: The company licensed its exoskeleton to Lockheed Martin for military development in 2009. Other companies like Ottobock have adopted a platform approach to developing new technologies. Instead of creating a new foot from scratch, for example, it will use a combination of existing technologies paired with some innovations.
And though Googling ‘bionics investment boom’ doesn’t yet yield many convincing results, there’s still hope that the ever-changing landscape of technological development will eventually lead the financial markets to seriously invest in bionic engineering. Its massive potential isn’t going away anytime soon.
Ute Eppinger is a freelance writer based in Germany.