An Electromagnetically Controllable Microrobotic Interventional System for Targeted, Real-Time Cardiovascular Intervention

Multifunctional Magnetic Catheter Robot with Triaxial Force Sensing Capability for Minimally Invasive Surgery

Magnetic continuum robots offer flexibility and controllability, making them promising for minimally invasive surgery (MIS). However, the clinical application of these robots is relatively limited due to the difficulty of integrating miniaturized triaxial force sensors and their single functionality. This paper proposes a multifunctional magnetic catheter robot with magnetic actuation steering and triaxial force-sensing capabilities. The robot features 3 channels at its tip that integrate multi-segmented magnets, a novel triaxial force sensor, and various functional instruments. The sensor is calibrated, demonstrating high sensitivity and accuracy. The steering characterization of the robot confirms that the catheter tip exhibits effective flexibility and force sensing. Palpation experiments involving various hard lumps are performed on porcine kidney, with results verifying that the robot can reliably detect abnormal hard lumps within tissues. Additionally, palpation experiments in bronchial phantom demonstrate the robot's imaging and palpation capabilities for lung nodules with an integrated endoscope. Further, the robot, equipped with biopsy forceps, successfully performs palpation and biopsy functions on simulated stomach polyps, demonstrating its capability for effective tissue manipulation. By leveraging force-sensing capabilities and integrating multifunctional instruments, the robot shows potential for expanded applications in MIS, paving the way for important advancements in clinical procedures.

Materials Advances in Devices for Heart Disease Interventions

Heart disease encompasses a range of conditions that affect the heart, including coronary artery disease, arrhythmias, congenital heart defects, heart valve disease, and conditions that affect the heart muscle. Intervention strategies can be categorized according to when they are administered and include: 1) Monitoring cardiac function using sensor technology to inform diagnosis and treatment, 2) Managing symptoms by restoring cardiac output, electrophysiology, and hemodynamics, and often serving as bridge-to-recovery or bridge-to-transplantation strategies, and 3) Repairing damaged tissue, including myocardium and heart valves, when management strategies are insufficient. Each intervention approach and technology require specific material properties to function optimally, relying on materials that support their action and interface with the body, with new technologies increasingly depending on advances in materials science and engineering. This review explores material properties and requirements driving innovation in advanced intervention strategies for heart disease and highlights key examples of recent progress in the field driven by advances in materials research.

Shortwave Infrared Imaging of a Quantum Dot-Based Magnetic Guidewire Toward Non-Fluoroscopic Peripheral Vascular Interventions

Peripheral vascular interventions (PVIs) offer several benefits to patients with lower extremity arterial diseases, including reduced pain, simpler anesthesia, and shorter recovery time, compared to open surgery. However, to monitor the endovascular tools inside the body, PVIs are conducted under X-ray fluoroscopy, which poses serious long-term health risks to physicians and patients. Shortwave infrared (SWIR) imaging of quantum dots (QDs) has shown great potential in bioimaging due to the non-ionizing penetration of SWIR light through tissues. In this paper, a QD-based magnetic guidewire and its system is introduced that allows X-ray-free detection under SWIR imaging and precise steering via magnetic manipulation. The QD magnetic guidewire contains a flexible silicone tube encapsulating a QD polydimethylsiloxane (PDMS) composite, where HgCdSe/HgS/CdS/CdZnS/ZnS/SiO2 core/multi-shell QDs are dispersed in the PDMS matrix for SWIR imaging upon near-infrared excitation, as well as a permanent magnet for magnetic steering. The SWIR penetration of the QD magnetic guidewire is investigated within an artificial tissue model (1% Intralipid) and explore the potential for non-fluoroscopic PVIs within a vascular phantom model. The QD magnetic guidewire is biocompatible in its entirety, with excellent resistance to photobleaching and chemical alteration, which is a promising sign for its future clinical implementation.

Multi-Section Magnetic Soft Robot with Multirobot Navigation System for Vasculature Intervention

Magnetic soft robots have recently become a promising technology that has been applied to minimally invasive cardiovascular surgery. This paper presents the analytical modeling of a novel multi-section magnetic soft robot (MS-MSR) with multi-curvature bending, which is maneuvered by an associated collaborative multirobot navigation system (CMNS) with magnetic actuation and ultrasound guidance targeted for intravascular intervention. The kinematic and dynamic analysis of the MS-MSR's telescopic motion is performed using the optimized Cosserat rod model by considering the effect of an external heterogeneous magnetic field, which is generated by a mobile magnetic actuation manipulator to adapt to complex steering scenarios. Meanwhile, an extracorporeal mobile ultrasound navigation manipulator is exploited to track the magnetic soft robot's distal tip motion to realize a closed-loop control. We also conduct a quadratic programming-based optimization scheme to synchronize the multi-objective task-space motion of CMNS with null-space projection. It allows the formulation of a comprehensive controller with motion priority for multirobot collaboration. Experimental results demonstrate that the proposed magnetic soft robot can be successfully navigated within the multi-bifurcation intravascular environment with a shape modeling error 3.62 ± 1.28 ∘ and a tip error of 1.08 ± 0.45 mm under the actuation of a CMNS through in vitro ultrasound-guided vasculature interventional tests.

Medical Microrobots

Scientists around the world have long aimed to produce miniature robots that can be controlled inside the human body to aid doctors in identifying and treating diseases. Such microrobots hold the potential to access hard-to-reach areas of the body through the natural lumina. Wireless access has the potential to overcome drawbacks of systemic therapy, as well as to enable completely new minimally invasive procedures. The aim of this review is fourfold: first, to provide a collection of valuable anatomical and physiological information on the target working environments together with engineering tools for the design of medical microrobots; second, to provide a comprehensive updated survey of the technological state of the art in relevant classes of medical microrobots; third, to analyze currently available tracking and closed-loop control strategies compatible with the in-body environment; and fourth, to explore the challenges still in place, to steer and inspire future research.

Magnetically Selective Versatile Transport of Microrobotic Carriers

Field-driven transport systems offer great promise for use as biofunctionalized carriers in microrobotics, biomedicine, and cell delivery applications. Despite the construction of artificial microtubules using several micromagnets, which provide a promising transport pathway for the synchronous delivery of microrobotic carriers to the targeted location inside microvascular networks, the selective transport of different microrobotic carriers remains an unexplored challenge. This study demonstrated the selective manipulation and transport of microrobotics along a patterned micromagnet using applied magnetic fields. Owing to varied field strengths, the magnetic beads used as the microrobotic carriers with different sizes revealed varied locomotion, including all of them moving along the same direction, selective rotation, bidirectional locomotion, and all of them moving in a reversed direction. Furthermore, cells immobilized with magnetic beads and nanoparticles also revealed varied locomotion. It is expected that such steering strategies of microrobotic carriers can be used in microvascular channels for the targeted delivery of drugs or cells in an organized manner.

Multi-level magnetic microrobot delivery strategy within a hierarchical vascularized organ-on-a-chip

Targeted microrobotic delivery within the circulatory system holds significant potential for medical theranostic applications. Existing delivery strategies of microrobots encounter challenges such as slow speed, limited navigation control, and dispersal under dynamic flow conditions. Furthermore, within the realm of microrobots, in vitro testing platforms often lack essential biological microenvironments, while in vivo studies conducted on animal models are constrained by limited detection resolution. In this study, we propose a multi-level magnetic delivery strategy that integrates a tethered microrobotic guidewire and untethered swimming microrobots. The amalgamation compensates for their inherent constraints, ensuring a robust and highly efficient delivery of microrobots under complex physiological conditions over extensive distances. Concurrently, a hierarchical vascular network encompassing engineered arteries/veins and capillary networks was constructed by integrating vasculogenesis and endothelial cell (EC) lining strategies, thereby providing an in vivo-like testing platform for microrobots. Experimental evidence demonstrates that the flexible microrobotic guidewire can be precisely directed to any entrance of the second-tier branches, with its inner lumen providing an "express lane" for rapid passage of microrobots through complex fluidic environments without direct contact. After release, dynamically assembled swarms could effectively locomote on the micro-topography of the EC-lined channel surface without becoming trapped and congregate within specified regions inside capillary lumens when guided collectively by a biologically safe magnetic field. Additionally, the superparamagnetic capabilities of microrobotic swarms ensure their dissolution into monodispersed entities upon withdrawal of the magnetic field, mitigating the risk of intravascular thrombosis. The hierarchical vascularized organ-on-a-chip platform establishes a comprehensive testing platform that integrates imaging, control, and a functional 3D microvascular environment, thereby enhancing its suitability for microrobotic applications encompassing targeted drug delivery, thrombus ablation, sensing and diagnosis, etc.

Advancements in materials, manufacturing, propulsion and localization: propelling soft robotics for medical applications

Soft robotics is an emerging field showing immense potential for biomedical applications. This review summarizes recent advancements in soft robotics for in vitro and in vivo medical contexts. Their inherent flexibility, adaptability, and biocompatibility enable diverse capabilities from surgical assistance to minimally invasive diagnosis and therapy. Intelligent stimuli-responsive materials and bioinspired designs are enhancing functionality while improving biocompatibility. Additive manufacturing techniques facilitate rapid prototyping and customization. Untethered chemical, biological, and wireless propulsion methods are overcoming previous constraints to access new sites. Meanwhile, advances in tracking modalities like computed tomography, fluorescence and ultrasound imaging enable precision localization and control enable in vivo applications. While still maturing, soft robotics promises more intelligent, less invasive technologies to improve patient care. Continuing research into biocompatibility, power supplies, biomimetics, and seamless localization will help translate soft robots into widespread clinical practice.

Magnetically assisted soft milli-tools for occluded lumen morphology detection

Methodologies based on intravascular imaging have revolutionized the diagnosis and treatment of endovascular diseases. However, current methods are limited in detecting, i.e., visualizing and crossing, complicated occluded vessels. Therefore, we propose a miniature soft tool comprising a magnet-assisted active deformation segment (ADS) and a fluid drag-driven segment (FDS) to visualize and cross the occlusions with various morphologies. First, via soft-bodied deformation and interaction, the ADS could visualize the structure details of partial occlusions with features as small as 0.5 millimeters. Then, by leveraging the fluidic drag from the pulsatile flow, the FDS could automatically detect an entry point selectively from severe occlusions with complicated microchannels whose diameters are down to 0.2 millimeters. The functions have been validated in both biologically relevant phantoms and organs ex vivo. This soft tool could help enhance the efficacy of minimally invasive medicine for the diagnosis and treatment of occlusions in various circulatory systems.

Microrobots for Biomedicine: Unsolved Challenges and Opportunities for Translation

Microrobots are being explored for biomedical applications, such as drug delivery, biological cargo transport, and minimally invasive surgery. However, current efforts largely focus on proof-of-concept studies with nontranslatable materials through a "design-and-apply" approach, limiting the potential for clinical adaptation. While these proof-of-concept studies have been key to advancing microrobot technologies, we believe that the distinguishing capabilities of microrobots will be most readily brought to patient bedsides through a "design-by-problem" approach, which involves focusing on unsolved problems to inform the design of microrobots with practical capabilities. As outlined below, we propose that the clinical translation of microrobots will be accelerated by a judicious choice of target applications, improved delivery considerations, and the rational selection of translation-ready biomaterials, ultimately reducing patient burden and enhancing the efficacy of therapeutic drugs for difficult-to-treat diseases.

Multifunctional ferromagnetic fiber robots for navigation, sensing, and treatment in minimally invasive surgery

Small-scale robots capable of remote active steering and navigation offer great potential for biomedical applications. However, the current design and manufacturing procedure impede their miniaturization and integration of various diagnostic and therapeutic functionalities. Here, we present a robotic fiber platform for integrating navigation, sensing, and therapeutic functions at a submillimeter scale. These fiber robots consist of ferromagnetic, electrical, optical, and microfluidic components, fabricated with a thermal drawing process. Under magnetic actuation, they can navigate through complex and constrained environments, such as artificial vessels and brain phantoms. Moreover, we utilize Langendorff mouse hearts model, glioblastoma microplatforms, and in vivo mouse models to demonstrate the capabilities of sensing electrophysiology signals and performing localized treatment. Additionally, we demonstrate that the fiber robots can serve as endoscopes with embedded waveguides. These fiber robots provide a versatile platform for targeted multimodal detection and treatment at hard-to-reach locations in a minimally invasive and remotely controllable manner.

Magnetic Soft Helical Manipulators with Local Dipole Interactions for Flexibility and Forces

Magnetic continuum manipulators (MCMs) are a class of continuum robots that can be actuated without direct contact by an external magnetic field. MCMs operating in confined workspaces, such as those targeting medical applications, require flexible magnetic structures that contain combinations of magnetic components and polymers to navigate long and tortuous paths. In cylindrical MCM designs, a significant trade-off exists between magnetic moment and bending flexibility as the ratio between length and diameter decreases. In this study, we propose a new MCM design framework that enables increasing diameter without compromising on flexibility and magnetic moment. Magnetic soft composite helices constitute bending regions of the MCM and are separated by permanent ring magnets. Local dipole interactions between the permanent magnets can reduce bending stiffness, depending on their size and spacing. For the particular segment geometry presented herein, the local dipole interactions result in a 31% increase in angular deflection of composite helices inside an external magnetic field, compared to helices without local interactions. In addition, we demonstrate fabrication, maneuverability, and example applications of a multisegment MCM in a phantom of the abdominal aorta, such as passing contrast dye and guidewires.

Current Advances and Future Perspectives of Advanced Polymer Processing for Bone and Tissue Engineering: Morphological Control and Applications

Advanced polymer processing has received extensive attention due to its unique control of complex force fields and customizability, and has been widely applied in various fields, especially in preparation of functional devices for bioengineering and biotechnology. This review aims to provide an overview of various advanced polymer processing techniques including rotation extrusion, electrospinning, micro injection molding, 3D printing and their recent progresses in the field of cell proliferation, bone repair, and artificial blood vessels. This review dose not only attempts to provide a comprehensive understanding of advanced polymer processing, but also aims to guide for design and fabrication of next-generation device for biomedical engineering.

Reprogrammable Soft Swimmers for Minimally Invasive Thrombus Extraction

Thrombosis-related diseases are the primary cause of death in the world. Despite recent advances in thrombosis treatment methods, their invasive nature remains a crucial factor, which leads to considerable deadly consequences. Soft magnetic robots are attracting widespread interest due to their fast response, remote actuation, and shape reprogrammability and can potentially avoid the side effects of conventional approaches. This paper outlines a new approach to the thrombosis treatment via reprogrammable magnetic soft robots that penetrate, hook, and extract the plasma clots in a vein-mimicking system under applied rotating magnetic fields. We present shape-switching bioinspired soft swimmers, capable of locomotion by different mechanisms in vein-mimicking flow conditions and whose swimming efficiency is similar to animals. Further, we demonstrate the potential of a developed robot for minimally invasive thromboextraction with and without fibrinolytic usage, including hooking the plasma clot for 3.1 ± 1.1 min and extracting it from the vein-mimicking system under the applied magnetic fields. We consider an interesting solution for thrombosis treatment to avoid substantial drawbacks of the existing methods.