Surgical treatment of prostate cancer (one of the first cause of mortality by cancer in men) is in mutation with the introduction of robotic systems in the operating room (such as the da Vinci® telesurgery system or the ViKY® endoscope holder). However, robot assisted procedures do not exploit endo-urethral or fluorescence imaging yet, though they would allow the surgeon to “see beyond the visible”, helping him to perform his gesture optimally. These new per-operative imaging modalities are impatiently awaited by surgeons in order to bring pertinent therapeutic response to the surgical treatment of prostate cancer, a real Public Health problem doomed to increase in the future years. DEPORRA2 aims at demonstrating that we can offer the surgeon, the possibility to explore per-operatively the prostatic tissue, through an “augmented” robotic environment, by enriching the laparoscopic images with endo-urethral ultrasound imaging and with mini-camera imaging. DEPORRA2 is a “follow-up” project, in continuity with the DEPORRA project, in which we demonstrated our capacity to conceive and develop: 1) Miniature tools adapted to the radical prostatectomy problematic: flexible intraurethral ultrasound probe and associated software, bimodal fluorescence probe for the detection of the nature (prostatic / non prostatic) and quality (malignant / non malignant) of dissected tissue, stereoscopic “global vision” system; 2) Registration methods for the fusion of this multimodal information in an enriched robotic environment in view of offering the surgeon an exhaustive view of the surgical environment, based on which he will be able to undertake strategic per-operative decisions. We now need to change dimension and maturate these innovations towards medical devices ready for clinical validation. This will go through: 1) Putting in place harmonious software and navigation procedures guiding the surgeon in the realization of his gesture (e.g. avoid structures whose damage can induce a degradation of the quality of life) 2) Enhancing the most "mature" technological bricks of DEPORRA to bring them closer to clinical constraints (this will require a pushed evaluation on pre-clinical and clinical data that are currently gathered through running biomedical protocols). The less mature fluorescence characterization aspects have been removed from this follow-up project but are adressed in another running project (AAP INCA "translational research"). 3) The preparation of biomedical research in order to make a first estimation of the delivered medical service of the proposed innovations. A consortium of experts has been consituted to take up these challenges: Vermon brings its capacity to miniaturize and to dedicate ultrasound devices to the navigation of prostatic tissue; TIMC-IMAG/DyCTIM brings its expertise in the field of fluorescent tracers of the tissue nature, SQI brings its know-how in the development and risk analysis of medical devices (software + hardware). TIMC-IMAG/CAMI has a long experience in the conception and integration of multimodal systems for Computer Assisted Medical Interventions. Finally the Centre d’Investigation Clinique – Innovation Technologique of the Grenoble University Hospital brings, with its clinical partners, the environment for the support of (pre-)clinical validation of the prototypes. At the end of this industrial research project, we will have all the scientific, technical and clinical elements to make a high-stake product. DEPORRA2 will reinforce the position of complementary and highly specialized industrial actors, Vermon and SQI, by generating a niche line of business in the urology market thanks to an extremely innovative approach.

Today’s pacemakers are already pretty small, about 8 cm3, but to insert one a surgeon has to cut open a patient to install the device on the right side of the chest, near the heart. Wires, called leads, are then connected from the pacemaker through the veins to the stimulation locations within the heart, in order to provide electrical stimulation to the heart muscle. The leads are often pointed out as the weakest element in a pacing system. Examples of lead problems include: lead dislodgment lead malfunction, lead fracture, lead infection, cardiac perforation, coronary sinus dissection, vein thrombosis, cardiac valve injury, or lead thrombi. Overall, pacing lead failure occurs up to 21% of the time within 10 years after pacemaker implantation. Progress in microelectronics and micro-sensor technology has made possible all pacemaker components to fit in a very small volume (< 1 cm3). Such a tiny pacemaker can be directly implanted on the endocardium within a heart cavity without any lead. Hence, this is called a leadless pacemaker. Leadless pacemakers are expected to make a revolution on the next generation of pacemakers. Their main advantage is to remove leads. Moreover, it is believed that a leadless device would be much easier to implant. Therefore it should decrease the implantation time and the associated costs, and improve the patient comfort. Several companies such as SORIN Group, Medtronic, St Jude Medical and EBR System are developing their own leadless solutions. For this purpose, all pacemaker components (packaging, electronic circuits and micro-sensors) have reached industrial maturity for leadless implementation, except for the power source. Considering the current state-of-the art of lithium-based technology used to power pacemakers, a 0.6 cm3 battery could last approximately from 7 to 9 years. However, although the replacement of a current pacemaker is a common and relatively simple procedure, a replacement of a leadless pacemaker would be much more difficult. Hence, a solution would be to implant supplementary capsules without extracting those whose batteries are depleted. This however can take very significant space in the heart and can hinder its operation. Therefore, long lasting regenerative energy sources as alternatives to traditional batteries are particularly interesting for leadless pacemakers. In a previous FUI project led by SORIN, it has been validated that a dedicated piezoelectric micro-scavenger could convert mechanical energy of human heart into electricity with sufficient level for powering a leadless pacemaker. With scientific objectives focused on reliability and robustness of piezoelectric scavengers, LAUREAT project aims at developing a fundamental technological building block which is the corner stone on the way to the industrialization of future cardiac implants. LAUREAT project aims at overcoming several technological and scientific barriers: Long term reliability of piezoelectric materials/devices, ageing effects over performances, defect mechanisms of piezoelectric materials/devices, design for reliability, reproducible manufacturing technology for materials at the frontier of bulk materials and thick films, high yield volume production with competitive cost. The project demonstrator will address a new piezoelectric µ-scavenger that converts heart motion into usable electrical energy. The scavenger will be designed to maximize conversion efficiency with high degree of reliability and robustness. It is here proposed to pave the way towards industrialization of reliable and self-autonomous leadless pacemakers as an alternative to current battery-powered implants. LAUREAT’s objective is to provide autonomous and robust solutions that will last for more than 20 years in operation (instead of less than 9 years for battery solutions) preventing replacement surgery for patients and reinforcing the competiveness of medical device industry in Europe.

Piezoelectric materials have the functionality of producing an electrical potential in response to an applied force or generating mechanical movement when subjected to an electric field. Nowadays, these materials are integrated in a wide range of devices such as fuel injectors, piezoelectric motors, printing heads and ultrasonic transducers (for NDT, underwater sonar systems or medical imaging). Since the discovery in the 50’s of lead zirconate titanate (PZT) piezoceramics, derived compositions have been developed to optimize their efficiency. Nowadays, PZT-based compositions are the dominant piezoceramics due to their high electromechanical properties and low cost. However, PZT materials contain lead (typically above 60 wt% in commercial products) and their increasing success is associated to health and environmental problems. From 2003 the European Union adopted the well-known waste electrical and electronic equipment directives (WEEE) and restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS). Therefore, tremendous efforts have been devoted to the development of competitive lead-free counterparts such as BaTiO3 or KNbO3 and their derivatives. In December 2012, the European Chemical Agency (ECHA) registered PZT in the candidate list of the REACH directive. Thereby the pressure increased again with the objective to replace as soon as possible lead-based materials by safer materials with at least equivalent performance. In HEcATE project, a wide French consortium proposes to set up a research axis from the development and optimisation of high efficiency piezoelectric lead-free materials to the manufacturing of several demonstrators and prototypes for underwater and medical applications via an up scaling approach. This consortium is composed of seven partners with four public laboratories (François-Rabelais University – GREMAN, University of Limoges - SPCTS in close collaboration with a Ceramic Technology Transfer Center, Institut de Chimie de la Matière Condensée de Bordeaux and l’Institut d’Electronique, de Microélectronique et de Nanotechnologie), one private research corporate laboratory (Thales Research & Technology), one pilot platform (Cristal innov) and one SME (VERMON SA). The project aims at developing engineered lead-free materials including single crystals and textured ceramics to achieve high performance while maintaining low cost by industrial processes. The lead-free materials developed within the project will be assessed through relevant prototypes. Simulation tools will also be designed to support developments of engineered materials and new demonstrator designs. HEcATE project addresses relevant challenges of the call through its thematic: “Challenge 3.3: Stimuler le renouveau industriel, axis Products (conception, processing & materials)”, related to material properties and functionalities. The main objectives defined by the project partners are: (1) Scaling up of the process for isotropic ceramics based on an analysis of the performance safety and cost-benefit; (2) Exploring lead-free single crystal processing and identification of the suitable orientation of single crystals to achieve high performance; (3) Exploring domain engineering possibilities through ceramics texturing in order to reduce cost as compared to single crystals; (4) Exploring an innovative deposition method for low cost thick films; (5) Fabrication of prototypes for medical imaging and underwater applications in view of large scale production. These objectives are of primary interest as we are now in a period where the transition to these new lead-free materials will be inescapable, so French industry must be prepared to commercialize these materials and end-users to integrate them in their devices. This is the condition to remain competitive but also be able to increase their markets in Europe and worldwide.