Abstract:
A device, including an implant for placement within a hollow body organ. The implant includes a member having an undeployed shape for delivery within a hollow body and one or more deployed shapes for implantation therein. The member has sufficient rigidity in its deployed shape to exert an outward force against an interior of the hollow body so as to bring together two substantially opposing surfaces of the hollow body. The implant includes a means for changing the deployed shape of the member while implanted within the hollow body. The device includes a wearable element configured to be worn by a patient, and has an external device coupled thereto and configured to send and/or receive a wireless signal to control the means for changing the deployed shape.

Description:
[0001]    This case is related to the following commonly assigned and concurrently filed U.S. Applications, all of which are hereby incorporated herein by reference: 
         [0002]    U.S. Ser. No. ______ (Attorney Docket Number END6514USNP) titled DEVICES and METHODS FOR ADJUSTING A SATIATION AND SATIETY-INDUCING IMPLANTED DEVICE; U.S. Ser. No. ______ (Attorney Docket Number END6515USNP) titled Sensor Trigger; U.S. Ser. No. ______ (Attorney Docket Number END6516USNP) titled AUTOMATICALLY ADJUSTING INTRA-GASTRIC SATIATION AND SATIETY CREATION DEVICE; U.S. Ser. No. ______ (Attorney Docket Number END6517USNP) titled OPTIMIZING THE OPERATION OF AN INTRA-GASTRIC SATIETY CREATION DEVICE; U.S. Ser. No. ______ (Attorney Docket Number END6518USNP) titled POWERING IMPLANTABLE DISTENSION SYSTEMS USING INTERNAL ENERGY HARVESTING MEANS; U.S. Ser. No. ______ (Attorney Docket Number END6519USNP) titled WEARABLE ELEMENTS FOR INTRA-GASTRIC SATIETY CREATION SYSTEMS; U.S. Ser. No. ______ (Attorney Docket Number END6520USNP) titled INTRA-GASTRIC SATIETY CREATION DEVICE WITH DATA HANDLING DEVICES AND METHODS; U.S. Ser. No. ______ (Attorney Docket Number END6521USNP) titled GUI FOR AN IMPLANTABLE DISTENSION DEVICE AND A DATA LOGGER; U.S. Ser. No. ______ (Attorney Docket Number END6522USNP) titled METHODS AND DEVICES FOR FIXING ANTENNA ORIENTATION IN AN INTRA-GASTRIC SATIETY CREATION SYSTEM; U.S. Ser. No. ______ (Attorney Docket Number END6523USNP) titled METHODS AND DEVICES FOR PREDICTING INTRA-GASTRIC SATIETY CREATION DEVICE SYSTEM PERFORMANCE; U.S. Ser. No. ______ (Attorney Docket Number END6524USNP) titled CONSTANT FORCE MECHANISMS for Regulating Distension Devices; U.S. Ser. No. ______ (Attorney Docket Number END6525USNP) titled A METHOD OF REMOTELY ADJUSTING A SATIATION AND SATIETY-INDUCING IMPLANTED DEVICE. 
     
    
     FIELD OF THE INVENTION 
       [0003]    The present invention relates to wearable elements for use with implantable distension devices. 
       BACKGROUND OF THE INVENTION 
       [0004]    Obesity is becoming a growing concern, particularly in the United States, as the number of obese people continues to increase, and more is learned about the negative health effects of obesity. Morbid obesity, in which a person is 100 pounds or more over ideal body weight, in particular poses significant risks for severe health problems. Accordingly, a great deal of attention is being focused on treating obese patients. One proposed method of treating morbid obesity has been to place a distension device, such as a, spring-loaded coil inside the stomach. Examples of satiation and satiety inducing gastric implants, optimal design features, as well as methods for installing and removing them are described in commonly owned and pending U.S. patent application Ser. No. 11/469,564, filed Sep. 1, 2006, and pending U.S. patent application Ser. No. 11/469,562, filed Sep. 1, 2006, which are hereby incorporated herein by reference in their entirety. One effect of the coil is to more rapidly induce feelings of satiation defined herein as achieving a level of fullness during a meal that helps regulate the amount of food consumed. Another effect of the coil is to prolong the effect of satiety which is defined herein as delaying the onset of hunger after a meal which in turn regulates the frequency of eating. By way of a non-limiting list of examples, positive impacts on satiation and satiety may be achieved by an intragastric coil through one or more of the following mechanisms: reduction of stomach capacity, rapid engagement of stretch receptors, alterations in gastric motility, pressure induced alteration in gut hormone levels, and alterations to the flow of food either into or out of the stomach. 
         [0005]    With each of the above-described stomach distension devices, safe, effective treatment requires that the device be regularly monitored and adjusted to vary the degree of distension applied to the stomach. 
         [0006]    Furthermore, requiring a patient to travel to a physician to have the implant powered and monitored is time consuming for both the patient and the physician. Monitoring the implant during a visit to a physician is also not necessarily the best indication of how the implant is performing when compared with data taken regularly during every day activities. Thus, there is a need for methods and devices that allow a patient to carry monitoring and powering systems. This would greatly improve the ease of use, reliability and efficiency of the implantable distension device for both the patient and the physician. In addition, being able to monitor the conditions of the implant and of physiological conditions on a regular basis by providing devices which are wearable by the patient during daily activities may reduce the risk of missing a problem with an adjustment that could cause damage to the patient&#39;s stomach and overall health. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0007]    The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which: 
           [0008]      FIG. 1  is a representation of an implantable distension device implanted in a patient to cause a distension in the patient&#39;s stomach; 
           [0009]      FIG. 1B  is a perspective view of the implantable distension device of  FIG. 1 ; 
           [0010]      FIG. 2A  is a perspective view of one embodiment of a wearable element having pockets disposed at a plurality of locations thereon and including external devices disposed within the pockets; 
           [0011]      FIG. 2B  is a perspective view of an exemplary pocket of  FIG. 2A  with an external device disposed therein; 
           [0012]      FIG. 2C  is a perspective view of another embodiment of a wearable element having a plurality of pockets disposed therein; 
           [0013]      FIG. 3A  is a representation of a wearable element with an external device disposed thereon in communication with an implantable communicating member; 
           [0014]      FIG. 3B  is a representation of magnetic fields produced by the external device of  FIG. 3A ; 
           [0015]      FIG. 3C  is a representation of a wearable element having an array of external devices disposed thereon in communication with an implantable communicating member; 
           [0016]      FIG. 4  is perspective view of a patient wearing another embodiment of a wearable element having an external device coupled thereto and coupled to an external device disposed at a distance apart from the external device and in proximity to the implantable distension device of  FIG. 1 ; 
           [0017]      FIG. 5A  is a perspective view of yet another embodiment of a wearable element formed from flexible straps in a grid-shape and including first and second external devices which can be coupled to the wearable element at a plurality of locations; 
           [0018]      FIG. 5B  is an alternate embodiment of the wearable element of  FIG. 4A  having flexible straps in the form of suspenders; 
           [0019]      FIG. 5C  is an alternate embodiment of the wearable element of  FIG. 4A  having flexible straps in the form of a “V”; 
           [0020]      FIG. 6A  is a perspective view of a double clip element coupled to an external device and adapted to attach to a wearable element; 
           [0021]      FIG. 6B  is a perspective view of a single clip element coupled to an external device and adapted to attach to a wearable element and electrically connected to a flexible battery; 
           [0022]      FIG. 7A  is a perspective view of another embodiment of a wearable element at least partially formed from a flexible battery; and 
           [0023]      FIG. 7B  is a perspective view of the wearable element of  FIG. 6A  having an external device coupled thereto. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0024]    Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention. 
         [0025]    The present invention provides wearable elements which allow for a more comfortable and efficient way of carrying external devices related to powering and monitoring an implantable distension device. The distension device may also be adjustable. Exemplary non-limiting examples of adjustable implantable distension devices (e.g., satiation and satiety inducing gastric implants), optimal design features, as well as methods for installing and removing them are described in commonly owned and pending U.S. patent application Ser. No. ______, filed on even date herewith and entitled “Devices and Methods for Adjusting a Satiation and Satiety-Inducing Implanted Device” [Atty. Docket No. END6514USNP], which is hereby incorporated herein by reference in its entirety. In one exemplary embodiment, a system for forming a distension in a stomach is provided and includes an implantable distension device adapted to cause a distension in a stomach and an implantable communicating member configured to send and/or receive a wireless signal. The distension device can include, for example, a gastric coil and a housing in communication with the gastric coil. The system can further include a wearable element configured to be worn by a patient and an external device coupled to the wearable element which is configured to send and/or receive a wireless signal to communicate with the implantable communicating member. In an exemplary embodiment, the external device is disposable at a plurality of locations relative to the wearable element. 
         [0026]    The external device can have a variety of configurations, and in one embodiment the external device can be an antenna positionable in proximity to the implantable communicating member and configured to receive data from the implantable communicating member. In another embodiment, the external device can be configured to send power to the implantable communicating member. In still another embodiment, the implantable communicating member can be an internal inductive coil and the external device can be an external inductive coil and the coils can be configured to resonate at substantially the same frequency to maximize power coupling. The wearable element can also include an alignment mechanism configured to indicate proper alignment between the external device and the implantable communicating member. 
         [0027]    In another embodiment, the system can include a first external device and a second external device that are coupled to one another and are positionable at a plurality of locations on the wearable element at a distance apart from one another. In one exemplary embodiment, the first external device can be configured to receive data from the implantable communicating member and the second external device can also optionally be configured to provide power to the first external device. 
         [0028]    The wearable element can also have a variety of configurations, and in one exemplary embodiment the wearable element can be a flexible battery adapted to flex in response to motion of a user wearing the flexible battery. In another exemplary embodiment, the wearable element can be formed from a plurality of elastic straps. In addition, the wearable element can be adjustable to a variety of patient sizes and shapes. In still another embodiment, the wearable element can be a belt, a vest, a sash, or an adhesive patch. In other aspects, the wearable element can include at least one pocket formed therein which is movable relative to the wearable element. In one embodiment, the pocket includes at least one battery disposed therein which is configured to provide power to the external device. 
         [0029]    Methods are also provided for communicating with an implantable distension device. In one embodiment, the method can include positioning an external device on a wearable element worn by a patient at one of a plurality of locations to align the external device with an implantable communicating member on an implantable distension device implanted in the patient. The external device can be activated to wirelessly transfer a signal through tissue to the implantable communicating member. For example, the external device can deliver energy to the implantable communicating member and/or receive data from the implantable communicating member. In addition, the external device can be an external inductive coil and the implantable communicating member can be an internal inductive coil and the method can further include using inductive coupling between the external coil and the internal coil to generate power. The two coils can be tuned to resonate at substantially the same frequency to maximize power coupling. 
         [0030]    While the external device can be positioned at a variety of locations, in one exemplary embodiment the external device can be positioned on a skin surface in proximity to the implantable communicating member. The external device can be positioned on the wearable element or at a distance apart from the wearable element. For example, the wearable element can include a plurality of flexible straps, and the external device can be removably mated to the flexible straps in proximity to the implantable communicating member. Alternatively, or in addition, the external device can be disposed within a pocket on the wearable element. In another aspect of the invention, the wearable element can be a flexible battery. The external device can be coupled to the flexible battery and can deliver energy to the implantable communicating member generated by the flexible battery. 
         [0031]    While the present invention disclosed herein can be used with a variety of distension systems known in the art,  FIGS. 1 and 1B  illustrate one exemplary embodiment of a food intake limiting distension system  10 . As shown, the system  10  generally includes an adjustable gastric coil  20  that is configured to be implanted in the patient&#39;s stomach  40 , and an injection port  30  that is coupled to the adjustable gastric coil  20 , e.g., via a catheter  50 . The system  10  can also include an implantable communicating member  60 . While the implantable communicating member  60  can have various configurations and can be positioned anywhere along the system  10 , including within the injection port  30 , in the illustrated embodiment, the implantable communicating member  60  is disposed within a housing positioned adjacent to the injection port  30  and is coupled to the adjustable gastric coil  20 . The implantable communicating member  60  can be effective to send/or receive a wireless signal. The implantable communicating member  60  can also be effective to power various components of the system, measure/monitor various conditions of the gastric coil  20 , and/or measure/monitor various physiological parameters. For example, the implantable communicating member  60  can be a sensor for measuring and monitoring various parameters of the system  10 ; an antenna such as a wire dipole antenna, a monopole antenna, or an inductive coil; and/or any other device known in the art which is capable of sending and receiving signals through tissue and/or aiding in the powering, measuring, and/or monitoring of the system  10  and/or other physiological parameters. 
         [0032]    While not shown in  FIGS. 1 and 1B , the system  10  can also include an external portion that is configured to communicate via a wireless signal with the implantable communicating member  60 . The external portion can have a variety of configurations, and various exemplary configurations will be discussed herein. In general, however, the external portion preferably includes an external device which can take the form of any powering, receiving, sending, and/or monitoring device known in the art. For example, the external device can be an antenna such as a wire dipole antenna, a monopole antenna, or an inductive coil; a battery or other power supply; a monitoring device; an alignment mechanism; or any other device known in the art as needed to communicate via a wireless signal with the implantable communicating member  60 . The wireless signal can take the form of any signal known in the art, for example an energy signal, a power transfer signal, and/or a data signal. In an exemplary embodiment, the external device is configured to be positioned on the skin surface above the implantable communicating member  60  to non-invasively communicate with the implantable communicating member  60  and thereby send power to the implantable communicating member  60  and/or obtain data from the implantable communicating member  60 . Alternatively, the external device can be disposed at a position remote to the implantable communicating member  60 . In another embodiment, the external portion can include a gauge or alignment mechanism that can indicate, for example, alignment between the external device and the communicating member and/or the strength of a signal being communicated between the external device and the communicating member. In addition, the gauge or alignment mechanism can provide an indication if the signal strength between the external device and the communicating member falls below an acceptable level. The indication given by the gauge or alignment mechanism can take the form of any notification means known in the art, including a light, such as an LED, an audible noise, and/or a vibration. 
         [0033]    In one exemplary embodiment, a first external device can be configured to transmit power to the implantable communicating member  60  via a passive telemetry system. For example, a burst of radio frequency power can be sent by the first external device to the implantable communicating member which is sufficient to allow the implantable communicating member  60  to send data and measurements back to the first external device. The first external device can optionally be electrically coupled to a second external device which can record and/or display the various measurement readings or other data received by the first external device. The second external device can also send electrical power to the first external device as needed for communicating with the implantable communicating member  60 . The first external device and/or the second external device can be programmed so that the first external device communicates with the implantable communicating member  60  at random intervals or at predetermined time periods so that the patient is not required to activate any device in order for the first external device and the implantable communicating member  60  to communicate. Alternatively, communication between the first external device and the implantable communicating member  60 , or between the first external device and the second external device, can be manually activated by the patient or other user. 
         [0034]    In one exemplary embodiment, the second external device is a rechargeable battery system configured to send power to the first external device as needed. The second external device can also include circuitry configured to control the amount of power sent through the first external device to the implantable communicating member  60 . Alternatively, a single external device can perform all, any one, or any combination of the functions noted above. In still another embodiment, the external device can include multiple battery systems in connection with one another to maximize available power as will be described in more detail below. A person skilled in the art will appreciate that any number of external devices can be used to perform any number of functions needed to power, monitor, and otherwise wirelessly communicate with the implantable communicating member  60 . In the same way, a single external device can be configured to perform all of the above noted functions as needed. 
         [0035]    The external portion can also include a wearable element that is configured to be worn by a patient, and that is coupled to one or more external devices. The wearable element can be particularly effective to allow the external device(s) to be worn by the user, thus allowing for communication between the external device(s) and the implantable communicating member as may be desired.  FIGS. 2A-6B  illustrate various exemplary wearable elements. In each of the various embodiments, external devices are integral with or coupled to a wearable element which allows for a more comfortable and efficient way of carrying the external devices. 
         [0036]    As used herein, the term “wearable” can refer to any article of manufacture designed to be worn on or borne by the body or any portion of the body of a wearer. When in the form of a garment, the wearable element can be, for example, in the form of a vest, a shirt, a tank top, a bodysuit, a jacket, or any other form which fits over and/or around the upper torso of a wearer. In addition, the wearable element can also include any other article of clothing in the form of gloves, pants, socks, etc. The term “wearable” can encompass not only garments, but also coils, straps, belts, patches, etc. When in the form of a coil, the wearable element can be, for example, in the form of a torso coil, a waist coil, a neck coil, an arm coil, a head coil, etc. The wearable element can also encompass adhesive patches which can be applied as needed on a patient&#39;s body. 
         [0037]    As this is a component of the system that is in direct and daily contact with the patient, features that make this interaction more appealing to the patient can serve to increase patient compliance with wearing it. 
         [0038]    Such features include matching the patient&#39;s skin color, providing chest support for women, designed to avoid bunching together, making it small, light weight, portable, and body contouring, including additional pockets for holding miscellaneous items such as iPods, making it of materials that don&#39;t interfere with airport security such as any non-metallic materials, etc 
         [0039]    In use, the wearable element can generally be wearable over some portion of a patient&#39;s body. The wearable element can be configured to be fitted tightly to the portion of the patient&#39;s body so as to fit under a patient&#39;s clothing. It can also be configured to fit loosely over a patient&#39;s body or over a patient&#39;s clothing. Adjustability elements can be included on the wearable element so that the wearable element can be adapted to fit patients of various sizes and shapes. The wearable element can be made of various materials, but a light and resilient material is preferred to optimize comfort and ease of use for the patient. In an exemplary embodiment, the wearable element is made from materials commonly used in fabric and textile applications. For example, the wearable element can be made from elastomeric yarns (such as spandex) and/or comfort yarns (such as nylon, polyester, or cotton). Any combination of materials can be formed as necessary to maximize comfort and ease of use for the patient, as well as to provide ease of cleaning. The wearable element may be comprised of a plurality of fabrics such that portions are elastic and other portions are soft or non distensible. Some portions may be more or less rigid or moldable about the patient&#39;s anatomy whereas other portions may be moldable. The wearable element can also be adapted to be worn for extended lengths of time by the patient or it can be adapted to be worn only at specific times as needed for powering, monitoring, and/or otherwise communicating with the implantable communicating member. 
         [0040]    In one exemplary embodiment shown in  FIG. 2A , a wearable element is provided in the form of a vest  200 . The vest  200  is made to fit over and around a patient&#39;s upper torso, and thus generally includes shoulder straps  202  that rest on the patient&#39;s shoulders. The vest  200  can also include arm cut-outs  204  in each side through which a patient&#39;s arms can fit. In the illustrated embodiment, the vest  200  also includes a belt  208  configured to surround the lower torso or waist of the patient and which can be tightened or loosened as needed for a better fit to the patient. Alternatively or in addition, adjustability elements can be provided on the vest  200  so that it can be adjusted to fit patients of various sizes and shapes. The adjustability elements can be in the form of buckles, clasps, buttons, snaps, ties, straps, zippers, Velcro™, etc. 
         [0041]    As also shown in  FIG. 2A , at least one pocket  210  can be formed in or disposed on an exterior surface of the vest  200 . As shown in  FIGS. 2A and 2B , the pocket  210  can be formed to a size large enough to contain at least one external device  212 , such as an inductance coil, an antenna, a battery, or other circuitry, as described in detail above. The pocket  210  can be removably attached to the vest  200  via Velcro™, stitching, adhesive, or any other attachment means known in the art, so that the pocket  210  can be placed in proximity to an implantable communicating member implanted within the patient or anywhere else on or in the wearable element as needed. A removable pocket  210  allows for adjustments to be made to the location of the external device  212  so as to properly align the external device  212  with the implantable communicating member. As an example, in  FIG. 2A , the pocket  210  is shown in three alternate locations on the vest  200 , and it will be understood by those skilled in the art that the pocket  210  can be attached at any location on the vest  200  as needed. The pocket  210  can also be integrally formed in the vest  200  at a fixed location, and the vest  200  can include any number of pockets  210 . 
         [0042]    In another exemplary embodiment shown in  FIG. 2C , a wearable element  220  is provided having a plurality of pockets  210  formed therein or disposed thereon. This allows for multiple external devices  212  to be placed in pockets  210  and carried by the patient as needed. Providing a plurality of pockets  210  on the wearable element  220  allows for greater control in weight distribution of multiple external devices, as well as flexibility in placement for patient comfort. 
         [0043]    In use, for example, one pocket attached to a wearable element can be placed in proximity to an implantable communicating member and can hold an external device, such as an antenna, for communicating with the implantable communicating member. Simultaneously, another pocket can be disposed towards the bottom of the wearable element and can hold another external device, such as a rechargeable battery system or reader device, that is connected to the antenna. 
         [0044]    As another example, two pockets can be disposed next to each other on a wearable element in proximity to the implantable communicating member, each holding an external device. A first external device can be an antenna for obtaining data or measurements from the implantable communicating member and a second external device can be an inductive coil for providing power to the implantable communicating member. Alternatively or in addition, one pocket can hold an alignment mechanism for monitoring proper alignment of the first and/or second external devices with the implantable communicating member. 
         [0045]    In a final example most clearly illustrated in  FIG. 2C , multiple pockets  210  can be disposed in different locations on the wearable element  220  to hold multiple battery units. If it is determined that a battery should be used to provide power to a certain external device, then having just one battery unit for all the powering needs of the implant could be extremely heavy for the patient to carry in a single pocket on a wearable element. Thus, several smaller battery units can be connected to one another and used in place of the single battery. Evenly spacing multiple pockets  210  containing the smaller battery units around the wearable element  220  could prevent the discomfort of having a single heavy battery unit attached to one location on the patient. The smaller battery units can be disposed in multiple pockets around the wearable element  220  so that the weight is distributed in a more even fashion. Advantageously, the pockets may be attachable by non permanent means such as Velcro™. As such the pocket locations may be adjusted or moved on a patient to patient basis, or multiple times for a given patient to address needs of comfort, usability and functionality. 
         [0046]      FIGS. 3A and 3B  illustrate an embodiment of a wearable element in the form of a vest  300  having an external device in the form of an external inductive coil  306  adapted to communicate through inductive coupling with an implantable communicating member in the form of an internal inductive coil  310 .  FIG. 3B  illustrates magnetic fields  350  produced by the external inductive coil  306  that are capable of generating current within the internal inductive coil  310  through methods well known in the art. The internal and external inductive coils  306 ,  310  can be configured to resonate at substantially the same frequency to maximize power coupling. The vest  300  can fit over and/or around the torso of a patient and can contain adjustability elements for fitting the vest  300  to patients of various sizes and shapes. In addition, the vest  300  can include an external device in the form of a reader device  370  for powering the external coil  306  and/or for receiving and recording data from an implantable communicating member. 
         [0047]    The vest  300  can generally be wearable over a patient&#39;s torso and can be configured to be fitted tightly to the torso so as to fit under a patient&#39;s clothing or to fit loosely over a patient&#39;s body or over a patient&#39;s clothing. The external inductive coil  306  can be formed from wound metal wire, for example copper wire, and can conform to various sizes and shapes as needed for powering the internal inductive coil  310 , as is well known in the art. The external inductive coil  306  can be adapted to be positioned adjacent to a tissue surface and in proximity to the internal inductive coil  310 . For example, the external inductive coil  306  can be formed in a front panel  330   a  or a rear panel  330   b  of the vest  300 . The external inductive coil  306  can be formed integrally with the vest  300  or can be disposed on an exterior or interior surface of the vest  300  and can be attached to or disposed within the vest  300  in any way known in the art which is effective to allow proper alignment of the external inductive coil  306  with the internal inductive coil  310 . Thus, the external inductive coil  306  can optionally be removably attached to the vest  300  so that the external coil  306  can be moved and aligned as needed. Alternatively, the external inductive coil  306  can be integrally formed in an interior portion of the vest  300  with a predetermined alignment based on where the internal inductive coil  310  will be positioned. The internal coil  310  can also be formed of metal wire, for example copper magnet wire, and can be of a size and shape to achieve the desired power and/or signal coupling from the corresponding external inductive coil  306  or inductive coils  306   a - 306   d.    
         [0048]    In an exemplary embodiment, the external inductive coil  306  can be in electrical communication with the external reader  370 . The external reader  370  can provide power to the external inductive coil  306  taken from any power source  340  known in the art, for example a battery or wall electrical outlet. The external reader  370  can be configured so that a user can control the amount of power coupled through the external inductive coil  306  to the internal inductive coil  310 , as well as other aspects of using the external inductive coil  306 . The external reader  370  can be configured in various ways. For example, it can be positioned on the vest  300 , in a hand-held device, or at a position remote from the vest  300 , as shown in  FIG. 3A . As will be appreciated by those skilled in the art, the external inductive coil  306  can alternatively be directly coupled to a power source  340 . The external reader  370  can optionally be configured to receive, record, and/or display data received from a communicating member. The data can be received by any methods known in the art. For example, the external inductive coil  306  can include an antenna configured for receiving data from a communicating member and/or the external reader  370  can include an antenna for receiving the data from a communicating member. The data and measurements taken from the communicating member can be displayed or recorded by the external reader  370  for later review. 
         [0049]    In another embodiment shown in  FIG. 3C , a wearable element is provided in the form of a sash or belt  360  having an array of four external coils  306   a ,  306   b ,  306   c ,  306   d  disposed around the belt  360  so as to surround an implanted interior coil  310 . This configuration allows inductive coupling to occur with the interior coil  310  in two perpendicular directions. A person skilled in the art will appreciate that any number of coils can be disposed around or over any wearable element to inductively couple with an implanted coil or any number of implanted coils. 
         [0050]      FIG. 4  shows another embodiment of a wearable element in the form of a belt, sash, or  400 . The belt  400  is configured to be disposed around the waist, stomach, or hips of a patient and to hold a first external device  410  so that a patient is prevented from having to wear a bulky device under their clothing. The belt  400  can also include adjustability elements such as a buckle, button, clasp, zipper, Velcro™, or string laces, to adjust the size of the belt  400  to fit patients of various sizes and shapes. In one embodiment, as shown, the first external device  410  can be a processor or reader device, and it can be electrically connected to a second external device, such as an antenna  412 , which can be placed under a patient&#39;s clothes in proximity to an implantable communicating member. An adhesive or other attachment mechanism can be used to maintain the antenna in a fixed position. In this way, the antenna  412  can send power to and/or receive data from the implantable communicating member and send the data to the second external device  410  which can display or record the data. Alternatively or in addition, the second external device  410  can be in the form of a battery unit or other powering device for providing power to the antenna  412 . In addition, the belt  400  can include an alignment mechanism, as described above, which monitors the alignment between the antenna  412  and the implantable communicating member. The alignment mechanism can indicate, for example, whether alignment between the antenna  412  and the communicating member should be readjusted and/or realigned for better communication. The indication given by the alignment mechanism can take the form of any notification means known in the art, including a light, such as an LED, an audible noise, and/or a vibration. 
         [0051]    In another embodiment,  FIGS. 5A-5C  illustrate wearable elements  500   a ,  500   b , and  500   c  formed from straps which are worn on the upper torso of a patient. The wearable elements  500   a ,  500   b , and  500   c  can be placed over a vest as described above in reference to  FIG. 2A , or over a wearable element made from a flexible battery, as described in detail below in reference to  FIGS. 7A and 7B . Alternatively, the wearable elements  500   a ,  500   b , and  500   c  can be worn over or under a patient&#39;s clothing. 
         [0052]    In the embodiment illustrated in  FIG. 5A , the straps are elastic so as to fit tightly over a vest or a patient&#39;s torso and are in the form of checkered or grid-shaped straps  510 . The wearable element  500   a  can include adjustability elements, for example a buckle, button, clasp, or zipper, to adjust the size to fit under or over a patient&#39;s clothing and to fit to the specific size and shape of a patient. The grid-shaped straps  510  can be made from various materials, such as a non-elastic or elastic material. 
         [0053]      FIGS. 5B and 5C  show alternate strap patterns or shapes for the wearable elements  500   b  and  500   c , respectively. In  FIG. 5B , the straps are in the shape of suspenders  512  connected to a horizontal strap  514 , and in  FIG. 5C  the straps are in the shape of a “V”  520 , also connected to a horizontal strap  514 . The straps  512 ,  520  and/or the horizontal straps  514  can include a buckle  516  or other clasp mechanism to facilitate size adjustments. A person skilled in the art will appreciate that strap shapes and arrangements are in no way limited to these three embodiments and can take the form of any shape or arrangement as needed. 
         [0054]    In an exemplary embodiment, in use, each of the wearable elements of  FIGS. 5A-5C  is adapted to couple to an external device. While various mating techniques can be used to mate an external device to the straps,  FIGS. 6A and 6B  illustrate various clips for engaging the straps. In particular, clips  602 ,  612  are particularly advantageous as they allow an external device  600  to be clipped to various locations on the wearable elements  500   a ,  500   b , and  500   c  described above. The clips  602 ,  612  can be made of various materials such as plastic, metal, etc. and each have a horizontal portion  604 . Clip  612  has one leg  606  extending perpendicularly from the horizontal portion  604 , and clip  602  has two legs  606  extending from the horizontal portion  604 . The horizontal portion  604  can be rigidly attached to the external device  600  by any mating means known in the art, such as rivets, screws, glue, etc. The legs  606  can be rigid or flexible, but in the illustrated embodiment they are flexible and have a curvature associated with their shape which is effective to cause at least a portion of the legs  606  to press against the external device  600 . In use, the legs  606  can be flexed away from the device  600  to engage the straps of the wearable elements in  FIGS. 5A-5C . After the straps are engaged, the legs  606  can be released and will flex back to their original position pressed against the external device  600 . 
         [0055]      FIG. 7A  shows another embodiment of a wearable element. In certain embodiments, it may be necessary to provide power to an external device. Providing this power through a rechargeable battery would be the most convenient for the patient, although conventional batteries, such as lead-acid batteries are extremely heavy. Thus,  FIG. 7A  shows a wearable element in the form of a flexible battery vest  700  made, at least in part, from a thin flexible battery. The flexible battery can be, for example a lithium polymer battery such as Solicore&#39;s Flexion™ line of lithium polymer batteries or an ultra-thin organic radical battery from, for example, NEC®, both of which are thin and flexible and can be made into the shape of any article of clothing as needed. In addition, both the lithium polymer battery and the organic radical battery can be charged and recharged quickly and have a low weight. These characteristics provide optimum batteries from which to form a wearable article of clothing, such as the flexible battery vest  700 , that a patient can wear to provide power to an external device and that flexes in response to the motion of a patient. The shape of the wearable flexible battery can vary. In the illustrated embodiment, the wearable element includes a front panel  702  and a rear panel  704 , each of which can be made from a flexible battery, and attached to or integrally formed with one another to form the flexible battery vest  700 . In the illustrated embodiment, the flexible battery vest  600  also includes a belt  710  which can also be made from a flexible battery if desired. Both the flexible battery vest  700  and the belt  710  can include adjustability elements to adjust the size to fit patients of various sizes and shapes. 
         [0056]    In another embodiment, the wearable element can be in the form of an adhesive patch that can be applied to the patient directly, or to one of the other embodiments of wearable elements described herein. The adhesive patch can be formed from a flexible battery, and it can be attached directly to a wearable element or disposed within a pocket that is attached to a wearable element, as described above in reference to  FIGS. 2A-2C . A person skilled in the art will appreciate that any wearable element configured to be worn on any part of the body can be formed of a flexible battery with the same effects and characteristics described herein. 
         [0057]    As further shown in  FIG. 7B , the flexible battery vest  700  can also include an external device  712  that is electrically coupled to the flexible battery vest  700  and can be placed under the clothing of a patient or attached to the flexible battery vest  700 . Alternatively, the wearable elements  500   a ,  500   b , and  500   c  of  FIGS. 5A-5C  can be placed over the flexible battery vest  700  and adjusted to fit tightly thereto or under the flexible battery vest  700  to fit tightly to the patient. An external device can be clipped to the wearable elements  500   a ,  500   b , and  500   c  and can be in electrical communication with the flexible battery vest  700 , thereby providing power as needed to the external device. 
         [0058]    In use, in each of the various embodiments disclosed herein, the external device can be positioned on a wearable element worn by a patient at one of a plurality of locations to align the external device with an implantable communicating member on an implantable distension device implanted in a patient. Once positioned as desired, the external device can be activated to transfer a signal through tissue to the implantable communicating member. 
         [0059]    In one exemplary embodiment, the wearable element can be placed on or around the patient depending on the form of the wearable element. Once placed on or around the patient, adjustability elements can be adjusted to fit the wearable element to the patient, whether under the patient&#39;s clothing or over the patient&#39;s clothing. Once a proper and comfortable fit is attained, external devices can be attached to the wearable element as necessary and as will be described in detail below. 
         [0060]    In the embodiment shown in  FIG. 2A , the vest  200  can be placed over a patient&#39;s head to rest on a patient&#39;s shoulders. Alternatively, the belt or coil  208  can be opened to allow the vest  200  to be slipped sideways over a patient&#39;s body. Once the vest  200  is situated on a patient&#39;s torso, the adjustability elements can be modified to properly fit the vest  200  to the patient. When the vest  200  is fitted to the patient comfortably, one or more pockets containing one or more external devices can be removably attached to the vest  200  and aligned as needed. For example, a pocket  210  containing a external device  212  can be placed in proximity to and in alignment with an implantable communicating member to send power to and/or receive data from the implantable communicating member. A person skilled in the art will appreciate that any number of pockets containing external devices can be removably positioned on or about the vest  200  as needed. Alternatively, the vest  200  can be prepared with one or more pockets attached in predetermined locations to correspond to a known implant location or other requirement. In this case, an external device  212  can be placed into the pocket  210  once the vest  200  is fitted to the patient. Start here 
         [0061]    Once the external devices  212  are in the proper location with the proper alignment, if necessary they can be activated by a physician, a user, or by self-actuation to perform any number of actions. For example, where the external device is an antenna, activation of the antenna can be effective to send power or energy to an implantable communicating member to enable the implantable communicating member to send back data to the antenna regarding the data and other measurements taken concerning the implantable distension device. Alternatively, where the external device is an inductive coil, activation of the coil can be effective to communicate with an implantable communicating member, for example an inductive coil, to thereby transfer power to the implantable distension system through inductive coupling. 
         [0062]    In the embodiment shown in  FIGS. 3A-3C , the vest  300  and the belt  360  can be placed over and/or around the patient and the size adjusted to properly fit the patient. The external inductive coil  306  can be activated to inductively couple with the internal inductive coil  310  so that electricity is generated within the internal inductive coil  310 . In an exemplary embodiment, the external reader  370  and/or the external inductive coil  306  can send and/or receive data and/or measurements from an implantable communicating member as needed. 
         [0063]    In the embodiment shown in  FIG. 4 , the belt or coil  400  can be placed around the waist or stomach area of a patient and the size adjusted to properly fit the patient. The external device  410  can be attached to the coil  400  by a buckle, clip, hook and loop, or other attachment means so that the patient does not have to wear a bulky external device under clothing. Where the external device is an antenna  412 , it can be placed on the patient&#39;s skin in proximity to an implantable communicating member to communicate with the implantable communicating member as needed. Once the antenna  412  is properly aligned within the implantable communicating member, the antenna  412  can be placed in electrical communication with the external device  410  and can thereby receive power that can be transmitted to the implantable communicating member and send data received from the implantable communicating member to the external device  410 . The external device  410  can then record the data obtained from the implantable communicating member and display the data as a read-out, or save the data for later review by a physician. 
         [0064]    In the embodiment shown in  FIGS. 5A-5C , the wearable elements  500   a ,  500   b , and  500   c  can be placed under a patient&#39;s clothing, over a patient&#39;s clothing, or over one of the wearable elements described above and adjusted to fit the patient. One or more external devices can then be clipped to the flexible straps using the single or double clips shown in  FIGS. 6A and 6B . The external devices can be activated to send power to the implantable communicating member, receive data from the implantable communicating member, or simply monitor the implantable distension system at various predetermined or random intervals. 
         [0065]    In the embodiment shown in  FIGS. 7A and 7B , the flexible battery vest  700  is placed over and around a patient&#39;s torso and secured thereto. The battery can be activated so as to provide power as needed to any external devices attached to or disposed over or under the flexible battery vest  700 . 
         [0066]    Any patent, publication, application or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material. 
         [0067]    One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.