No description available.

Diagnosing early formation of tumors or lumps, particularly those caused by cancer, has been a challenging problem. To help physicians detect tumors more efficiently, various imaging techniques with different imaging modalities such as computer tomography, ultrasonic imaging, nuclear magnetic resonance imaging, and mammography, have been developed. However, each of these techniques has limitations, including exposure to radiation, excessive costs, and complexity of machinery. Tissue elasticity is an important indicator of tissue health, with increased stiffness pointing to an increased risk of cancer. In addition to increased tissue elasticity, geometric parameters such as size of a tissue inclusion are also important factors in assessing the tumor. The combined knowledge of tissue elasticity and its geometry would aid in tumor identification. In this research, we present a tactile sensation imaging system (TSIS) and algorithms which can be used for practical medical diagnostic experiments for measuring stiffness and geometry of tissue inclusion. The TSIS incorporates an optical waveguide sensing probe unit, a light source unit, a camera unit, and a computer unit. The optical method of total internal reflection phenomenon in an optical waveguide is adapted for the tactile sensation imaging principle. The light sources are attached along the edges of the waveguide and illuminates at a critical angle to totally reflect the light within the waveguide. Once the waveguide is deformed due to the stiff object, it causes the trapped light to change the critical angle and diffuse outside the waveguide. The scattered light is captured by a camera. To estimate various target parameters, we develop the tactile data processing algorithm for the target elasticity measurement via direct contact. This algorithm is accomplished by adopting a new non-rigid point matching algorithm called "topology preserving relaxation labeling (TPRL)." Using this algorithm, a series of tactile data is registered and strain information is calculated. The stress information is measured through the summation of pixel values of the tactile data. The stress and strain measurements are used to estimate the elasticity of the touched object. This method is validated by commercial soft polymer samples with a known Young's modulus. The experimental results show that using the TSIS and its algorithm, the elasticity of the touched object is estimated within 5.38% relative estimation error. We also develop a tissue inclusion parameter estimation method via indirect contact for the characterization of tissue inclusion. This method includes developing a forward algorithm and an inversion algorithm. The finite element modeling (FEM) based forward algorithm is designed to comprehensively predict the tactile data based on the parameters of an inclusion in the soft tissue. This algorithm is then used to develop an artificial neural network (ANN) based inversion algorithm for extracting various characteristics of tissue inclusions, such as size, depth, and Young's modulus. The estimation method is then validated by using realistic tissue phantoms with stiff inclusions. The experimental results show that the minimum relative estimation errors for the tissue inclusion size, depth, and hardness are 0.75%, 6.25%, and 17.03%, respectively. The work presented in this dissertation is the initial step towards early detection of malignant breast tumors. / Electrical and Computer Engineering

<p dir="ltr">Robotic surgery has transformed the landscape of minimally invasive procedures, offering unmatched precision and quicker patient recovery times. Despite all these advancements, training surgeons to use these sophisticated surgical systems effectively remains a daunting challenge, primarily due to high costs, limited accessibility, increased learning curve, and inconsistent training quality. Existing training modalities are limited by the high costs of original training robots, logistical challenges, lack of emphasis on hand movements, the necessity of expert presence, and limited scalability and effectiveness. This thesis introduces TrainVR, a low-cost based training system designed to overcome these hurdles and enhance the skillset of surgical trainees. TrainVR integrates affordable Virtual Reality (VR) technology with enhanced fidelity, creating an engaging and realistic training environment. TrainVR is designed to simulate realistic surgical environments and procedures, focusing on the development of motor, cognitive, and spatial skills for tasks required for robotic surgery through computer vision algorithms, gamified environments, performance analytics, and supporting both asynchronous and remote expert-led training scenarios. This system features customizable training modules, enabling trainees to practice a wide array of surgical procedures in a safe, virtual setting. The device also focuses on the importance of user’s hand, clutch, and ergonomics during surgical training which is crucial based on feedback from surgeons. The development of TrainVR involved crafting detailed 3D models of surgical instruments and anatomical structures, by integrating hardware, software and designing a user-friendly interface. We conducted testing with different game environments which compare the performance of the users and provide insights to improve the learning. The thesis concludes by experimenting and proposing new configurations to improve the fidelity and hand tracking which should closely match with the experience provided by the present training simulators at a substantially lower cost. TrainVR’s scalable design and compatibility with standard VR hardware make it accessible to a wide range of institutions, including those with limited resources. By offering a cost-effective, immersive, and adaptive training solution, TrainVR aims to enhance surgical education and ultimately improve patient care outcomes.</p>

Yes / This paper outlined our method for developing polymer-linked contact lens type materials for rapid detection and differentiation of Gram-positive, Gram-negative bacteria and fungi in infected corneas. It can be applied to both model synthetic or ex-vivo corneal models and has been successfully trialed in an initial efficacy tested animal study. First a hydrogel substrate for the swab material is selected, we have demonstrated selective swabs using a glycerol monomethacrylate hydrogel. Alternatively any commercial material with carboxylic acid functional groups is suitable but risks nonspecific adhesion. This is then functionalised via use of N-hydroxysuccinimide reaction with amine groups on the specified highly branched polymer ligand (either individually gram negative, gram positive or fungal binding polymers or a combination of all three can be employed for desired sensing application). The hydrogel is then cut into swabs suitable for sampling, used, and then the presence of gram positive, game negative and fungi are disclosed by the sequential addition of dyes (fluorescent vancomycin, fluorescein isothiocyanate and calcofluor white). In summary this method presents: Method to produce glycerol monomethacrylate hydrogels to minimize nonspecific binding Methods of attaching pathogen binding highly branched polymers to produce selective hydrogel swabs Method for disclosing bound pathogens to this swab using sequential dye addition

The theses is regarding at the beginning the theoretical conception of joint trading policy and tariff union, esspecially law regulations concerning with an import form third countries. As a kind of change-over of acts is an implementation of these law regulations, acting as a connected point between these regulations and theirs application. The practic sample of import of the medical device is based on the mentioned regulations with the attaching of the principles for an international purchase contract and the other juridical institutes which are regarding the case in several details. At the end of the case is enclosed also the sample of delivery of the imported goods to one of European countries as an example of intracommunitary performance.

Dans le cadre du développement accru d’implants crâniens actifs, l’étude de la résistance du complexe crâne-implant face à des chocs modérés est nécessaire afin d’assurer la sécurité du patient. Le but de cette thèse est de quantifier l’interaction mécanique entre le crâne et l’implant afin de développer un modèle éléments finis prédictif utilisable pour la conception des futurs dispositifs. Dans un premier temps, des essais matériaux sur titane et silicone ont permis d’extraire les paramètres élastiques, plastiques et de viscosité de leurs lois de comportement. Ces paramètres ont ensuite été implémentés dans un modèle éléments finis de l’implant sous sollicitations dynamiques, validé par des essais de choc de 2,5 J. L’implant dissipe une partie de l’énergie du choc et le modèle obtenu permet d’optimiser la conception de l’implant afin qu’il reste fonctionnel et étanche après l’impact. La troisième partie porte sur l’élaboration d’un modèle éléments finis du complexe crâne-implant sous sollicitations dynamiques. Des essais sur têtes cadavériques ovines ont permis d’optimiser les paramètres d’endommagement du crâne. Le modèle complet du complexe crâne-implant, corrélé à des essais de choc, apporte des éléments de réponses sur le comportement du crâne implanté face un choc mécanique, permettant ainsi d’optimiser la conception de l’implant afin de garantir l’intégrité du crâne.Ce modèle représente un premier outil pour l’analyse de l’interaction mécanique entre crâne et implant actif, et permet de dimensionner ce dernier de sorte à garantir son fonctionnement et son étanchéité, tout en assurant l’intégrité du crâne. / Active cranial implants are more and more developed to cure neurological diseases. In this context it is necessary to evaluate the mechanical resistance of the skull-implant complex under impact conditions as to ensure the patient’s security. The aim of this study is to quantify the mechanical interactions between the skull and the implant as to develop a finite element model for predictive purpose and for use in cranial implant design methodologies for future implants. First, material tests were necessary to identify the material law parameters of titanium and silicone. They were then used in a finite element model of the implant under dynamic loading, validated against 2.5 J-impact tests. The implant dissipates part of the impact energy and the model enables to optimize the design of implants for it to keep functional and hermetic after the impact. In the third part, a finite element model of the skull-implant complex is developed under dynamic loading. Impact tests on ovine cadaver heads are performed for model validation by enhancing the damage parameters of the three-layered skull and give insight into the behavior of the implanted skull under impact.This model is a primary tool for analyzing the mechanical interaction between the skull and an active implant and enables for an optimized design for functional and hermetic implants, while keeping the skull safe.

A ciência e a tecnologia cada vez mais vêm proporcionando avanços em produtos inovadores. Particularmente na área da saúde nota-se eminente sinergismo entre os materiais utilizados, suas propriedades de biocompatibilidade, biofuncionalidade, processabilidade, esterilidade e a área de aplicabilidade no organismo humano. O setor farmacêutico por apresentar grande complexidade exige conhecimentos multidisciplinares, atualizados e em conformidade às tendências internacionais. A Agência Nacional de Vigilância Sanitária (ANVISA) tem sob sua responsabilidade extensa diversidade de bens, serviços e produtos, dentre eles estão os correlatos, que também compreende os produtos para saúde. Os produtos para saúde são classificados conforme o seu risco, no Brasil podendo apresentar até quatro classes, sendo as classes III e IV as que caracterizam maior risco. Para alguns produtos, devido seu risco sanitário, é compulsório a Certificação de Conformidade pelo Instituto Nacional de Metrologia, Qualidade e Tecnologia (INMETRO) previamente a concessão de seu registro sanitário pela ANVISA. Dentre as normas técnicas aplicáveis pelo INMETRO estão as normas da Associação Brasileira de Normas Técnicas (ABNT) e na sua ausência, as normas da International Organization for Standardization (ISO). Outros requisitos técnicos e regulatórios devem ser contemplados com o propósito de comprovação da segurança e eficácia dos produtos. Entretanto, as regulamentações sanitárias inerentes a essa categoria de produtos ainda se encontram incipientes no país. A desenvoltura do setor produtivo nesse segmento pode ser evidenciada pelo aumento de novas solicitações na ANVISA e de seu crescimento na balança comercial. No entanto, observa-se pouco estudo e entendimento do setor regulado e regulador referente à relação mútua entre ANVISA, INMETRO e ABNT e quanto à regulação sanitária aplicável para obtenção da anuência do produto ao consumo. Na conjuntura das demandas apontadas o objetivo deste estudo foi avaliar o processo regulatório aplicável à cadeia produtiva dos produtos para saúde com a finalidade de compreender a relação entre ANVISA, INMETRO e ABNT na garantia da qualidade, segurança e eficácia dos produtos. A metodologia aplicada neste trabalho foi à pesquisa qualitativa. Com o auxílio da pesquisa documental constatou-se que o processo regulatório brasileiro é complexo, específico e robusto e apresenta estrutura e exigências semelhantes dos Estados Unidos e União Europeia. A fiscalização pós-uso é uma tendência internacional e a ANVISA vem adotando com frequência com intuito de acompanhar a qualidade dos produtos comercializados. As três instituições apresentam competências definidas e regulamentadas, bem como mecanismos de inter-relação por meio de conselhos consultivos. O estudo de caso caracterizou que o perfil dos profissionais do setor regulado apresenta em grande percentual formação na área da saúde e nível de pós-graduação, porém o nível de conhecimento dos principais conceitos relativos aos produtos para saúde é parcial, reforçando a necessidade de incentivos de capacitação de recursos humanos em regulação em saúde. / The science and technology increasingly been providing advancements in innovative products. Particularly in the health score is eminent synergism between the materials used, their properties of biocompatibility, biofunctionality, processability, sterility and applicability area of the human body. The pharmaceutical sector to present great complexity requires multidisciplinary knowledge, up to date and in line with international trends. The National Health Surveillance Agency (ANVISA) has under its responsibility extensive range of goods, services and products, among them are correlates, which also includes medical devices. Medical devices are classified according to their risk in Brazil may present up to four classes, and classes III and IV which characterize the greatest risk. For some products, because of their health risk, it is compulsory Compliance Certification by the National Institute of Metrology, Quality and Technology (INMETRO) prior to granting its sanitary registry by ANVISA. From among the technical standards the INMETRO are the standards of the Brazilian Association of Technical Standards (ABNT) and in his absence, the standards of the International Organization for Standardization (ISO).Other technical and regulatory requirements must be included for the purpose of proving the safety and efficacy of products. However, the sanitary regulations inherent in this product category is still incipient in the country. The resourcefulness of the productive sector in this segment can be evidenced by the increase in new requests in ANVISA and its growth in the trade balance. However, there is little study and understanding of the regulated and regulatory sector concerning the mutual relationship between ANVISA, INMETRO and ABNT and on the sanitary regulation applicable to obtaining the approval of the product for consumption. In the context of the demands indicated the objective of this study was to evaluate the regulatory procedure applicable to the production chain of medical devices in order to understand the relationship between ANVISA, INMETRO and ABNT in ensuring quality, safety and efficacy of products. The methodology used in this study was the qualitative research. With the assistance of documentary research it was found that the Brazilian regulatory process is complex, specific and robust and has similar structure and requirements of the United States and European Union. The postmarketing monitoring is an international trend and ANVISA has adopted often aiming to monitor the quality of marketed products. The three institutions have defined and regulated competences and interrelation through advisory boards mechanisms. The case study characterized the profile of professionals in the regulated sector has a large percentage of training in health and post-graduate level, but the level of knowledge of the main concepts related to medical devices is partial, reinforcing the need for incentives training of human resources in health regulation.

L’Imagerie par Résonance Magnétique (IRM) est une technique d’imagerie de référence pour réaliser des diagnostics médicaux. Pour des patients implantés avec des dispositifs médicaux actifs, l’IRM peut engendrer des risques qui doivent être étudiés et minimisés. En effet, ces dispositifs sont constitués en partie de matériaux conducteurs et/ou magnétiques qui interagissent avec l’environnement électromagnétique d’une IRM. Lorsque ces dispositifs ont des câbles, une des interactions les plus problématiques est l’induction d’énergie dans ses câbles qui peut entrainer des stimulations, des dysfonctionnements ou des brûlures. Le premier objectif de cette thèse est de développer des outils pour étudier et quantifier ces interactions électromagnétiques d’une IRM sur un câble. Pour cela, des capteurs innovants compatibles IRM ont été développés pour mesurer la tension induite sur un câble, aux bornes de l’électronique d’entrée d’un dispositif médical actif. Des bancs de tests ont également été mis en place pour simuler les champs électromagnétiques d’une IRM. Le second objectif de cette thèse est de concevoir des câbles innovants qui réduisent au maximum ses interactions électromagnétiques avec une IRM. Nous avons réalisé un câble constitué d’un fil conducteur qui limite l’énergie induite par l’IRM grâce à son bobinage variable. Nous avons réalisé un deuxième câble avec un conducteur de fine épaisseur et des ruptures d’impédances sur sa longueur / Magnetic Resonance Imaging (MRI) is an established imaging technique for medical diagnostics but could expose patients with active medical devices to risks that need to be studied and minimized. In fact, these devices encompass conductive and/or magnetic materials which interact with the electromagnetic field of the MRI. When these devices contain leads, MRI induced energy within the lead is considered to be one of the most problematic interaction as it can lead to stimulations, malfunction or burns. The first goal of this thesis is to create tools to study and quantify the electromagnetic interactions between an MRI and a lead. This has led to the design of novel MRI compatible sensors that measure induced voltage within leads connected active medical device entry terminals. Experimental MRI set-ups were also developed to simulate the MRI’s electromagnetic field. The second goal of this thesis is to design new leads that are minimally affected by the MRI’s electromagnetic field. Two proofs of concept were achieved. On the one hand, a lead capable of reducing MRI induced energy thanks to its winding was made. On the second hand, a second lead with a thin conductor and impedance mismatches along its length was created

O principal objetivo deste trabalho foi a verificação de como a utilização de um Sistema de Medição de Gestão contribui para o aprimoramento do Sistema de Gestão de um Laboratório de Ensaios de equipamentos médicos através da determinação, implementação e avaliação de um modelo otimizado de Sistema de Medição. O modelo proposto foi elaborado a partir do levantamento de todos os indicadores possíveis contidos nas prescrições da Norma ABNT NBR ISO/IEC 17025:2005, determinando-se também diretrizes para interpretação dos requisitos visando a melhoria contínua do Sistema de Gestão e selecionando-se os indicadores mais importantes a partir da voz do cliente, obtida através da análise de incidentes críticos relatados por eles. O modelo foi validado em um Laboratório de Ensaios de equipamentos médicos acreditado pelo INMETRO e é composto por indicadores que atendem os requisitos da Norma ABNT NBR ISO/IEC 17025:2005, selecionados de acordo com o estudo dos processos do Laboratório e alinhados com as necessidades dos clientes. Os elementos do Sistema de Medição devem auxiliar a alta administração de um Laboratório de Ensaios de equipamentos médicos a tomar decisões estratégicas de administração e de organização visando a melhoria de desempenho em todas as atividades realizadas, adotando e atendendo as prescrições da Norma ABNT NBR ISO/IEC 17025:2005, sendo esta uma importante contribuição desta proposta de trabalho, pois apenas o texto desta Norma não permite uma definição clara de como obter a melhoria contínua dos seus processos, e a determinação de diretrizes adicionais, a exemplo do que a Norma ABNT ISO 9004 faz com as prescrições da Norma ABNT ISO 9001, facilitará a implementação de um Sistema de Medição em Sistema de Gestão. Os resultados da validação do modelo de Sistema de Medição permitem concluir que sua implementação contribui para o aprimoramento do Sistema de Gestão de Laboratórios de Ensaios de equipamentos médicos. A adoção de um Sistema de Medição de Gestão pode permitir que os Laboratórios obtenham maior controle e aprimoramento de seus processos, assim como ocorreu no Laboratório em que o modelo foi validado. / The main purpose of this work was the determination, implementation and evaluation of an optimized model of Measurement System for continuous improvement of a Management System for Testing Laboratory of medical equipment. The proposed model was developed from a survey of all possible indicators contained in the requirements of Standard ABNT NBR ISO/IEC 17025, also determining guidelines for interpretation of the requirements for continuous improvement of the management system and selecting the most important indicators from the customer\'s choice obtained from the analysis of critical incidents given by them. The model was validated in a Testing Laboratory of medical equipment accredited by INMETRO and is composed of indicators that meet the requirements of Standard ABNT NBR ISO / IEC 17025, selected according to the analysis of processes of the Testing Laboratory and aligned with the customers needs. These elements should help the managers of a Testing Laboratory of medical equipment to make strategic planning to improve performance in all activities, adopting and meeting the requirements of Standard ABNT NBR ISO/IEC 17025 which is one of the main contribution of this proposed work, as all Testing Laboratories are only concerned to meet the requirements of Standard ISO/IEC 17025 and only the text of this standard does not allow a clear definition of how to improve continuous process and the determination of additional guidelines, similar to what the standard ISO 9004 makes with the requirements of standard ISO 9001, will help the implementation of a Measurement System. The adoption of a Measurement System can allow Laboratories to gain greater control of their processes.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-11-23T16:32:16Z No. of bitstreams: 1 Rafael Stefani_.pdf: 1159352 bytes, checksum: 2997007b7807eb211a566cbfb832e378 (MD5) / Made available in DSpace on 2015-11-23T16:32:16Z (GMT). No. of bitstreams: 1 Rafael Stefani_.pdf: 1159352 bytes, checksum: 2997007b7807eb211a566cbfb832e378 (MD5) Previous issue date: 2015-08-15 / Nenhuma / A Economia da Tecnologia tem como natureza estudar o desenvolvimento do progresso técnico, as suas dimensões microeconômicas, o processo de difusão tecnológica e a sua influência no desenvolvimento econômico. Frequentemente combinada com o pensamento evolucionista, a Economia da Tecnologia estuda a firma sob uma perspectiva sistêmica, na qual a história, os vínculos externos, o território e as instituições formam, em conjunto, o Sistema de Inovação que é capaz de condicionar o desempenho tecnológico e competitivo da região. Para esse enfoque, o espaço importa, e diferentes proximidades são relevantes para se compreender o comportamento inovador da firma. A Geografia Econômica, a partir da virada institucional, ocupa-se cada vez mais com a ideia de evolução (NELSON; WINTER, 1982) e de proximidade na formação da paisagem econômica, que entende as experiências e as competências aprendidas por indivíduos em determinada localidade ao longo do tempo como elemento que pode, em grande medida, determinar o presente e a trajetória futura do espaço. Para investigar o caminho traçado pela região, economistas têm procurado pistas em diversas disciplinas relacionadas (ciência regional, geografia da inovação, etc.) originando um subcampo dentro da economia intitulado Geografia Econômica Evolucionária. Nesta corrente, a inovação é capaz de provocar alteração na dinâmica econômica regional, e o conhecimento assume postura central nesse contexto. A ideia fundamental é que existe a necessidade de interação e comunicação para ocorrer a troca de conhecimento entre agentes, que é sustentada por diversos tipos de proximidade. Partindo desses conceitos, o trabalho procura entender o comportamento das dinâmicas de proximidades nas interações estabelecidas pelas firmas para a realização de suas atividades inovativas e utiliza como objeto de análise o setor de equipamentos médico-hospitalares do Rio Grande do Sul. Como forma de atingir seu objetivo, o trabalho faz uso de pesquisa survey para a coleta de dados e utiliza ferramenta voltada à análise de redes sociais. Os resultados indicam que a proximidade geográfica e a proximidade social atuam como importante drive na formação das relações da amostra. A proximidade institucional demonstrou alguma importância para o setor; porém, não se pode dizer o mesmo para as dimensões cognitiva e organizacional. O profissional da saúde (médico, enfermeiro, odontologista, etc.) é identificado como agente que assume caráter estratégico e é capaz de induzir a inovação. Também se pode citar uma relação intensa (porém menos estratégica) com fornecedores de peças especializadas e os hospitais, estes últimos utilizados sob condições específicas. As relações com universidades são realizadas em situações críticas (gargalos tecnológicos), para as quais não são encontradas soluções no ambiente interno ou junto aos fornecedores. Como contribuição central do trabalho para a discussão teórica da área, destaca-se o olhar do estudo, atento à formação estrutural da rede de contatos construída pelas firmas voltadas à produção de equipamentos médicos, hospitalares e odontológicos do RS. Essa pesquisa também contribui para uma literatura sobre as dinâmicas de proximidade que recentemente vêm ganhando destaque, e que transita ativamente nos periódicos internacionais, mas, a priori, ainda ocupa um espaço relativamente pequeno nos principais jornais e revistas nacionais. Finalmente, considerando o ponto de vista evolucionário e a centralidade que a inovação representa nesse contexto, a pesquisa tem potencial para auxiliar no aprofundamento da literatura voltada para a dinâmica inovativa da saúde, especialmente, do setor médico-hospitalar do Rio Grande do Sul, tema que concentra baixa produção bibliográfica e merece maiores aprofundamentos para sua promoção. / The Economics of Technology has as nature study the development of technical progress, its microeconomic dimensions, the technological diffusion process and its influence on economic development. Often combined with evolutionary thought, the Economics of Technology studies the firm from a systemic perspective, in which the history, external links, the territory and the institutions together form the Innovation System that is capable of conditioning the technological performance and competitive in the region. For this approach, the space matter and proximity is considered, on occasion, an asset and hence is sought.The Economic Geography increasingly sees the idea of evolution (Nelson and Winter, 1982) in shaping the economic landscape. It is believed that experiences and skills learned over time by individuals in a given location can to a large extent determine the present and the future trajectory of the space. To investigate the path dependence by the region, economists have looked for clues in various related disciplines (regional sciences, geography of innovation, etc.) resulting in a subfield within the economy titled Evolutionary Economic Geography. In essence, the economic landscape innovative process is considered central element and uneven between regions, since knowledge takes central position in this context. The main idea is that there is a great need for interaction and communication to occur knowledge exchange between agents, which is supported by types of proximity. From this premise, the work seeks to understand the vicinity of dynamics of behavior in interactions established by firms to carry out their innovative activities and uses as analyzed in the sector of medical device of Rio Grande do Sul. To reach this goal, the work uses survey research to collect data and tool aimed at analyzing social networks. The results indicate that the geographical proximity and social proximity act as important drive to formation of the sample relations. Institutional proximity showed some importance for the sector, however, cannot say the same for the dimensions of cognitive and organizational proximity. The health professional (physician, nurse, dentist, etc.) is identified as an agent that takes a strategic nature and is capable of inducing innovation. It’s possible to observe an intense relationship (but less strategic) with suppliers of specialized parts and hospitals, the latter under specific conditions. Relations with universities are carried out in critical situations (technological bottlenecks), which are not found solutions inside environment or with suppliers. As a central contribution of this work to the theoretical discussion of the area, there is the look of the study, turned to the structural formation of the network built by firms geared to the production of medical device of RS. This research also contributes to the literature on the dynamics proximity that growing, and actively moves in international journals, but, a priori, still occupies a relatively small space in publications and national academic journals. Finally, considering the evolutionary point of view and the centrality that innovation is in this context, research has the potential to assist in the further development of targeted literature for the innovative dynamics of health, especially the medical device sector of Rio Grande do Sul, theme concentrating low bibliographic production and deserves further insights for your promotion.