# Image-Guided Surgical and Pharmacotherapeutic Routines as Part of Diligent Medical Treatment
## 2 Image Guided Medical Procedures
### Implantable Drug Delivery Schemes  
Operational drug delivery (DD) devices are able to deliver drugs to the target location and maintain drug intensity within a curatively relevant range. The dosage provided should deliver the drug for a specific duration necessary to achieve the greatest positive effect with the least adverse side consequences to adjacent healthy matters. Classical DD by means of discontinuous oral or intravenous delivery can result in high and rapid blood drug intensities soon after administration, thus intolerable harmful consequence may occur for patients. Another problem with these delivery modes is that they undergo first-pass metabolic rate, resulting in a significant reduction in drug concentration by the liver before attaining normal spread and hence often multiple deliveries are needed. DD made locally,  
Figure 3: Schematics of an MRI IG-SI. sustainably, and supervised, can have the least adverse side effects possible. The use of DD implants enables such behavior. The most used DD schemes comprise polymer reservoir-based structures, pumps (peristaltic, infusion, and osmotic), and micro and nano electromechanical structures (MEMS and NEMS), see e.g., [79; 90; 91; 92; 93; 94]. Reservoir structures utilize drug release by dispersion via a film structure. The different pumps are used according to the type of disorder, the location of the implant, and the DD permanence. Larger ones are more suited to prolonged illnesses, while smaller pumps like the osmotic pump will be more suited to local-specific particular effects using DD of uniform release. Regarding MEMS and NEMS, they behave at micro and nano levels of DD without any significant danger due to a precipitous onset of the drug. Even though implants present sophisticated and effectual ways for controlled DD, all of them necessitate placing by medical staff. The corresponding SIs differ according to the implant location and are connected to possible defies and unfavorable outcomes. Even if side consequences are generally slight, in certain conditions they can be substantial. It may be noted that the convolution and restrictions of SI for implant placing and withdrawing have weighty influences on the technology tolerability by the patient. Intrinsically, upcoming mechanism layout should utilize MI methodologies and reduced implant sizes, and less introduction-withdrawal processes can fully influence their capacity. Future implants could be mainstream DD methodology, if thoughtfully designed with miniature size for MI insertion and continuous DD avoiding inclusion-exclusion with ease of drug filling. In fact, all of the implants described in the last paragraph are made from non-biodegradable materials and require the disposal of SI. Two next challenges should be acknowledged: The first concerns the facilitation of self-contained implanted DD systems addressing simple and spatially homogeneous problems using constant drug release and biodegradable structures that facilitate disposal of implanted systems [60; 61; 62; 63; 64; 65; 66; 67; 68; 69; 70; 71]. The second concerns the treatment of spatially complicated cases requiring non-uniform DD, focusing only on diseased areas and avoiding healthy areas. This requires mobile implants with actions in restricted areas. Such a problem is closely similar to that of a complex SI requiring precise spatial assistance, as the IG assistance discussed in the last section. This implanted therapy will be MI-NI-IG-RDD [42; 43; 44; 45; 46; 47; 48; 49; 50]. The implant structure may be of non-biodegradable material but must be MRI-compatible when using such imaging techniques [95; 96]. This procedure is similar to the MI-NI-IG-SI replacing the assisted actuated-robot with an assisted actuated-RDD implant. Wireless driving and monitoring transmission entails conveying strength and signals from an outside supply to the embedded device free of physical connection [95; 96].