MRI driven magnetic microswimmers

Metal-Plastic Hybrid Additive Manufacturing to Realize Small-Scale Self-Propelled Catalytic Engines

Microengines driven by catalytic decomposition of a fuel have been an interesting research area recently due to their diverse applications, such as environmental monitoring and drug delivery. Literature reports a number of studies on this topic where researchers have made various attempts to manufacture such microengines. Some such methods are deposition of catalytic metal layers on sacrificial photoresists, electrochemical deposition of metal layers on polymeric structures, or 3D printing of structures followed by multi-step loading of structures with catalysts. These methods, even though proven to be effective, are tedious, time-consuming, and expensive. To address these issues, herein we report a 3D printing technique to realize microengines in a simple, rapid, and inexpensive single-step process. The printing of various shapes of microengines is achieved using digital light processing printing of a catalyst resin, where Pd(II) acts as a catalyst resin. The proposed integrated molding process can achieve cost-effective preparation of high-efficiency microengines. We demonstrate the locomotion of these microengines in 30% (w/w) H2O2 through the decomposition of H2O2 to generate oxygen to facilitate the self-propelled locomotion. The study characterizes the microengine based on several factors, such as the role of H2O2, Pd, shape, and design of the microengine, to get a full picture of the self-locomotion of microengines. The study shows that the developed method is feasible to manufacture microengines in a simple, rapid, and inexpensive manner to be suitable for numerous applications such as environmental monitoring, remediation, drug delivery, diagnosis, etc., through the modification of the catalyst resin and fuel, as desired.

A Magnetic Bio-Inspired Soft Carrier as a Temperature-Controlled Gastrointestinal Drug Delivery System

Currently, gastrointestinal bleeding in the colon wall and the small bowel is diagnosed and treated with endoscopes. However, the locations of this condition are often problematic to treat using traditional flexible and tethered tools. New studies commonly consider untethered devices for solving this problem. However, there still exists a gap in the extant literature, and more research is needed to diagnose and deliver drugs in the lower gastrointestinal tract using soft robotic carriers. This paper discusses the development of an untethered, magnetically-responsive bio-inspired soft carrier. A molding process is utilized to produce prototypes from Diisopropylidene-1,6-diphenyl-1,6-hexanediol-based Polymer with Ethylene Glycol Dimethacrylate (DiAPLEX) MP-3510 - a shape memory polymer with a low transition temperature to enable the fabrication of these carriers. The soft carrier design is validated through simulation results of deformation caused by magnetic elements embedded in the carrier in response to an external field. The thermal responsiveness of the fabricated prototype carriers is assessed ex vivo and in a phantom. The results indicate a feasible design capable of administering drugs to a target inside a phantom of a large intestine. The soft carrier introduces a method for the controlled release of drugs by utilizing the rubbery modulus of the polymer and increasing the recovery force through magnetic actuation.

The Future of Fetal Surgery

The field of fetal medicine has evolved significantly over the past several decades. Our ability to identify and treat the unborn patient has been shaped by advancements in imaging technology, genetic diagnosis, an improved understanding of fetal physiology, and the development and optimization of in utero surgical techniques. The future of the field will be shaped by medical innovators pushing for the continued refinement of minimally invasive surgical technique, the application of pioneering technologies such as robotic surgery and in utero stem cell and gene therapies, and the development of innovative ex utero fetal support systems.

A Review of Microrobot's System: Towards System Integration for Autonomous Actuation In Vivo

Microrobots have received great attention due to their great potential in the biomedical field, and there has been extraordinary progress on them in many respects, making it possible to use them in vivo clinically. However, the most important question is how to get microrobots to a given position accurately. Therefore, autonomous actuation technology based on medical imaging has become the solution receiving the most attention considering its low precision and efficiency of manual control. This paper investigates key components of microrobot’s autonomous actuation systems, including actuation systems, medical imaging systems, and control systems, hoping to help realize system integration of them. The hardware integration has two situations according to sharing the transmitting equipment or not, with the consideration of interference, efficiency, microrobot’s material and structure. Furthermore, system integration of hybrid actuation and multimodal imaging can improve the navigation effect of the microrobot. The software integration needs to consider the characteristics and deficiencies of the existing actuation algorithms, imaging algorithms, and the complex 3D working environment in vivo. Additionally, considering the moving distance in the human body, the autonomous actuation system combined with rapid delivery methods can deliver microrobots to specify position rapidly and precisely.

Novel Clinical Applications and Technical Developments in Video Capsule Endoscopy

Video capsule endoscopy is entering its third decade. After slow acceptance, it has become the gold standard in diagnosing small intestinal disorders. This article summarizes new practical applications for capsule endoscopy outside the small intestine. From 2 randomized controlled trials, it is becoming clear that it has a role in the management of patients with hematemesis and nonhematemesis bleeding. Under active investigation are novel applications of capsule technology, including the potential ability to sample luminal contents or tissue, self-propelled capsules, incorporation of other imaging techniques beyond white light, such as ultrasound and fluorescents, and the possibility of drug delivery.

Magnetic Resonance Imaging-Compatible Optically Powered Miniature Wireless Modular Lorentz Force Actuators

Minimally invasive medical procedures under magnetic resonance imaging (MRI) guidance have significant clinical promise. However, this potential has not been fully realized yet due to challenges regarding MRI compatibility and miniaturization of active and precise positioning systems inside MRI scanners, i.e., restrictions on ferromagnetic materials and long conductive cables and limited space around the patient for additional instrumentation. Lorentz force-based electromagnetic actuators can overcome these challenges with the help of very high, axial, and uniform magnetic fields (3-7 Tesla) of the scanners. Here, a miniature, MRI-compatible, and optically powered wireless Lorentz force actuator module consisting of a solar cell and a coil with a small volume of 2.5 × 2.5 × 3.0 mm3 is proposed. Many of such actuator modules can be used to create various wireless active structures for future interventional MRI applications, such as positioning needles, markers, or other medical tools on the skin of a patient. As proof-of-concept prototypes toward such applications, a single actuator module that bends a flexible beam, four modules that rotate around an axis, and six modules that roll as a sphere are demonstrated inside a 7 Tesla preclinical MRI scanner.

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

Simple Summary

With the rapid advancements of medical technologies and patients’ higher expectations for precision diagnostic and surgical outcomes, gastroscopy has been increasingly adopted for the detection and treatment of pathologies in the upper digestive tract. Correspondingly, robotic gastroscopes with advanced functionalities, e.g., disposable, dextrous and not invasive solutions, have been developed in the last years. This article extensively reviews these novel devices and describes their functionalities and performance. In addition, the implementation of artificial intelligence technology into robotic gastroscopes, combined with remote telehealth endoscopy services, are discussed. The aim of this paper is to provide a clear and comprehensive view of contemporary robotic gastroscopes and ancillary technologies to support medical practitioners in their future clinical practice but also to inspire and drive new engineering developments.

Abstract

Upper gastrointestinal (UGI) tract pathology is common worldwide. With recent advancements in robotics, innovative diagnostic and treatment devices have been developed and several translational attempts made. This review paper aims to provide a highly pictorial critical review of robotic gastroscopes, so that clinicians and researchers can obtain a swift and comprehensive overview of key technologies and challenges. Therefore, the paper presents robotic gastroscopes, either commercial or at a progressed technology readiness level. Among them, we show tethered and wireless gastroscopes, as well as devices aimed for UGI surgery. The technological features of these instruments, as well as their clinical adoption and performance, are described and compared. Although the existing endoscopic devices have thus far provided substantial improvements in the effectiveness of diagnosis and treatment, there are certain aspects that represent unwavering predicaments of the current gastroenterology practice. A detailed list includes difficulties and risks, such as transmission of communicable diseases (e.g., COVID-19) due to the doctor–patient proximity, unchanged learning curves, variable detection rates, procedure-related adverse events, endoscopists’ and nurses’ burnouts, limited human and/or material resources, and patients’ preferences to choose non-invasive options that further interfere with the successful implementation and adoption of routine screening. The combination of robotics and artificial intelligence, as well as remote telehealth endoscopy services, are also discussed, as viable solutions to improve existing platforms for diagnosis and treatment are emerging.

Medical Imaging of Microrobots: Toward In Vivo Applications

Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications.

Robotic-Assisted Colonoscopy Platform with a Magnetically-Actuated Soft-Tethered Capsule

Background and Aims: Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. Despite offering a prime paradigm for screening, CRC screening is often hampered by invasiveness. Endoo is a potentially painless colonoscopy method with an active locomotion tethered capsule offering diagnostic and therapeutic capabilities. Materials and Methods: The Endoo system comprises a soft-tethered capsule, which embeds a permanent magnet controlled by an external robot equipped with a second permanent magnet. Capsule navigation is achieved via closed-loop interaction between the two magnets. Ex-vivo tests were conducted by endoscopy experts and trainees to evaluate the basic key features, usability, and compliance in comparison with conventional colonoscopy (CC) in feasibility and pilot studies. Results: Endoo showed a 100% success rate in operating channel and target approach tests. Progression of the capsule was feasible and repeatable. The magnetic link was lost an average of 1.28 times per complete procedure but was restored in 100% of cases. The peak value of interaction forces was higher in the CC group than the Endoo group (4.12N vs. 1.17N). The cumulative interaction forces over time were higher in the CC group than the Endoo group between the splenic flexure and mid-transverse colon (16.53Ns vs. 1.67Ns, p < 0.001), as well as between the hepatic flexure and cecum (28.77Ns vs. 2.47Ns, p = 0.005). The polyp detection rates were comparable between groups (9.1 ± 0.9% vs. 8.7 ± 0.9%, CC and Endoo respectively, per procedure). Robotic colonoscopies were completed in 67% of the procedures performed with Endoo (53% experts and 100% trainees). Conclusions: Endoo allows smoother navigation than CC and possesses comparable features. Although further research is needed, magnetic capsule colonoscopy demonstrated promising results compared to CC.

X-ray-Powered Micromotors

Light-powered wireless manipulation of small objects in fluids has been of interest for biomedical and environmental applications. Although many techniques employing UV-vis-NIR light sources have been devised, new methods that hold greater penetrating power deep into medium are still in demand. Here, we develop a method to exploit X-rays to propel half-metal-coated Janus microparticles in aqueous solution. The Janus particles are simultaneously propelled and visualized in real-time by using a full-field transmission X-ray microscope. Our real-time observation discovers that the propulsive motion follows the bubble growth enhanced by water radiolysis near the particle surface under X-ray irradiation. We also show that the propulsion speed is remotely controlled by varying the radiation dose. We expect this work to open opportunities to employ light-powered micro/nanomotors in opaque environments, potentially by combining with medical imaging or nondestructive testing.

A review of magnet systems for targeted drug delivery

Magnetic drug targeting is a method by which magnetic drug carriers in the body are manipulated by external magnetic fields to reach the target area. This method is potentially promising in applications for treatment of diseases like cancers, nervous system diseases, sudden sensorineural hearing loss, and so on, due to the advantages in that it can improve efficacy, reduce drug dosage and side effects. Therefore, it has received extensive attention in recent years. Successful magnetic drug targeting requires a good magnet system to guide the drug carriers to the target site. Up to date there have been many efforts to design the magnet systems for targeted drug delivery. However, there are few comprehensive reviews on these systems. Here we review the progresses made in this field. We summarized the systems already developed or proposed, and categorized them into two groups: static field magnet systems and varying field magnet systems. Based on the requirements for more powerful targeting performance, the prospects and the future research directions in this field are anticipated.

In Situ Generated Medical Devices

Medical devices play a major role in all areas of modern medicine, largely contributing to the success of clinical procedures and to the health of patients worldwide. They span from simple commodity products such as gauzes and catheters, to highly advanced implants, e.g., heart valves and vascular grafts. In situ generated devices are an important family of devices that are formed at their site of clinical function that have distinct advantages. Among them, since they are formed within the body, they only require minimally invasive procedures, avoiding the pain and risks associated with open surgery. These devices also display enhanced conformability to local tissues and can reach sites that otherwise are inaccessible. This review aims at shedding light on the unique features of in situ generated devices and to underscore leading trends in the field, as they are reflected by key developments recently in the field over the last several years. Since the uniqueness of these devices stems from their in situ generation, the way they are formed is crucial. It is because of this fact that in this review, the medical devices are classified depending on whether their in situ generation entails chemical or physical phenomena.

Single-Sided Near-Field Wireless Power Transfer by A Three-Dimensional Coil Array

Wirelessly powered medical microrobots are often driven or localized by magnetic resonance imaging coils, whose signal-to-noise ratio is easily affected by the power transmitter coils that supply the microrobot. A controlled single-sided wireless power transmitter can enhance the imaging quality and suppress the radiation leakage. This paper presents a new form of electromagnet which automatically cancels the magnetic field to the back lobes by replacing the traditional circular coils with a three-dimensional (3D) coil scheme inspired by a generalized form of Halbach arrays. It is shown that, along with the miniaturization of the transmitter system, it allows for improved magnetic field intensity in the target side. Measurement of the produced magnetic patterns verifies that the power transfer to the back lobe is 15-fold smaller compared to the corresponding distance on the main lobe side, whilst maintaining a powering efficiency similar to that of conventional planar coils. To show the application of the proposed array, a wireless charging pad with an effective powering area of 144 cm² is fabricated on 3D-assembled printed circuit boards. This 3D structure obviates the need for traditional magnetic shield materials that place limitations on the working frequency and suffer from non-linearity and hysteresis effects.

MRI-powered biomedical devices

Magnetic resonance imaging (MRI) is beneficial for imaging-guided procedures because it provides higher resolution images and better soft tissue contrast than computed tomography (CT), ultrasound, and X-ray. MRI can be used to streamline diagnostics and treatment because it does not require patients to be repositioned between scans of different areas of the body. It is even possible to use MRI to visualize, power, and control medical devices inside the human body to access remote locations and perform minimally invasive procedures. Therefore, MR conditional medical devices have the potential to improve a wide variety of medical procedures; this potential is explored in terms of practical considerations pertaining to clinical applications and the MRI environment. Recent advancements in this field are introduced with a review of clinically relevant research in the areas of interventional tools, endovascular microbots, and closed-loop controlled MRI robots. Challenges related to technology and clinical feasibility are discussed, including MRI based propulsion and control, navigation of medical devices through the human body, clinical adoptability, and regulatory issues. The development of MRI-powered medical devices is an emerging field, but the potential clinical impact of these devices is promising.

An RF-gated wireless power transfer system for wireless MRI receive arrays

In MRI systems, cable-free receive arrays would simplify setup while reducing the bulk and weight of coil arrays and improve patient comfort and throughput. Since battery power would limit scan time, wireless power transfer (WPT) is a viable option to continuously supply several watts of power to on-coil electronics. To minimize added noise and decouple the wireless power system from MRI coils, restrictions are placed on the coil geometry of the wireless power system, which are shown to limit its efficiency. Continuous power harvesting can also cause a large increase in the background noise of the image due to diode rectifier up-conversion of noise around the frequency of the transmitted power. However, by RF gating the transmitted power off during the MRI receive time while continuing to supply power from a storage capacitor, WPT is demonstrated to have minimal impact on image quality at received power levels up to 11 W. The integration of WPT with a 1.5T scanner is demonstrated.

A magnetically actuated anchoring system for a wireless endoscopic capsule

In this study, we propose a new magnetically actuated anchoring system for wireless capsule endoscopes (WCE) by employing the principle of a switchable magnetic spring. A force model is derived to predict the magnetic force needed to support the interaction between the anchors and the intestinal lumen. The theoretical and experimental analysis conducted shows that the magnetic spring is capable of providing the force needed to activate the anchoring mechanism, which consists of four foldable legs. A prototype capsule with a size comparable with the size of a commercial WCE was designed, fabricated, and tested. The in-vitro tests with a real small intestine show that the proposed anchoring mechanism is able to raise the friction force between the anchoring legs and inner wall of the intestine by more than two times after its activation using an external magnetic field. Experimental results presented demonstrate that the proposed anchoring system, which has a low foot-print not taking up too much space on the capsule, can provide a reliable anchoring capability with the capsule inside the intestinal lumen.

Magnetically guided capsule endoscopy

Wireless capsule endoscopy (WCE) is a powerful tool for medical screening and diagnosis, where a small capsule is swallowed and moved by means of natural peristalsis and gravity through the human gastrointestinal (GI) tract. The camera-integrated capsule allows for visualization of the small intestine, a region which was previously inaccessible to classical flexible endoscopy. As a diagnostic tool, it allows to localize the sources of bleedings in the middle part of the gastrointestinal tract and to identify diseases, such as inflammatory bowel disease (Crohn's disease), polyposis syndrome, and tumors. The screening and diagnostic efficacy of the WCE, especially in the stomach region, is hampered by a variety of technical challenges like the lack of active capsular position and orientation control. Therapeutic functionality is absent in most commercial capsules, due to constraints in capsular volume and energy storage. The possibility of using body-exogenous magnetic fields to guide, orient, power, and operate the capsule and its mechanisms has led to increasing research in Magnetically Guided Capsule Endoscopy (MGCE). This work shortly reviews the history and state-of-art in WCE technology. It highlights the magnetic technologies for advancing diagnostic and therapeutic functionalities of WCE. Not restricting itself to the GI tract, the review further investigates the technological developments in magnetically guided microrobots that can navigate through the various air- and fluid-filled lumina and cavities in the body for minimally invasive medicine.

Ellipsoidal Brownian self-driven particles in a magnetic field

We study the two-dimensional Brownian dynamics of an ellipsoidal paramagnetic microswimmer moving at a low Reynolds number and subject to a magnetic field. Its corresponding mean-square displacement, showing the effect of a particles's shape, activity, and magnetic field on the microswimmer's diffusion, is analytically obtained. Comparison between analytical and computational results shows good agreement. In addition, the effect of self-propulsion on the transition time from anisotropic to isotropic diffusion of the ellipse is investigated.

Biodegradable microrobots for targeting cell delivery

These days, cell delivery is considered a potential method for treatment of many genetic diseases or tissue regeneration applications. In conventional cell delivery methods, cells are encapsulated in or cultured on biocompatible polymers. However, the main problem with these carriers is their lack of targeting ability. For tissue regeneration or many cell treatments, it is needed to deliver cells to a specific site of action. Magnetic microrobots based on industrial photoresists have been studied in literature for magnetically controllable carriers. However, there are some issues about biodegradation and removal of these microrobots from the body. In this paper, we hypothesis fabrication of new generation of biodegradable magnetic microrobots based on additive manufacturing methods to overcome this problem and to bring this evolving field to a new level.

Diffusion of active chiral particles

The diffusion of chiral active Brownian particles in three-dimensional space is studied analytically, by consideration of the corresponding Fokker-Planck equation for the probability density of finding a particle at position x and moving along the direction v[over ̂] at time t, and numerically, by the use of Langevin dynamics simulations. The analysis is focused on the marginal probability density of finding a particle at a given location and at a given time (independently of its direction of motion), which is found from an infinite hierarchy of differential-recurrence relations for the coefficients that appear in the multipole expansion of the probability distribution, which contains the whole kinematic information. This approach allows the explicit calculation of the time dependence of the mean-squared displacement and the time dependence of the kurtosis of the marginal probability distribution, quantities from which the effective diffusion coefficient and the "shape" of the positions distribution are examined. Oscillations between two characteristic values were found in the time evolution of the kurtosis, namely, between the value that corresponds to a Gaussian and the one that corresponds to a distribution of spherical shell shape. In the case of an ensemble of particles, each one rotating around a uniformly distributed random axis, evidence is found of the so-called effect "anomalous, yet Brownian, diffusion," for which particles follow a non-Gaussian distribution for the positions yet the mean-squared displacement is a linear function of time.

Ballistic behavior and trapping of self-driven particles in a Poiseuille flow

We study the two- and three-dimensional dynamics of a Brownian self-driven particle at low Reynolds number in a Poiseuille flow. A deterministic analysis is also performed and we find that under certain conditions the swimmer becomes trapped, thus performing closed orbits as observed in related experiments. Further analysis enables us to provide an analytic expression to achieve this trapping phenomenon. We then turn to Brownian dynamics simulations, where we show the effect of a Poiseuille flow, self-propulsion, and confinement on the diffusion of the swimmer in both two and three dimensions. It is found that for long times the mean-square displacement (MSD) along the flow direction is always quadratic in time, whereas for shorter times (before the particle reaches the walls) its MSD has also a quartic time behavior. It is also found that self-propelled particles will spread less in a Poiseuille flow than passive ones under the same circumstances.

Frontiers of robotic endoscopic capsules: a review

Digestive diseases are a major burden for society and healthcare systems, and with an aging population, the importance of their effective management will become critical. Healthcare systems worldwide already struggle to insure quality and affordability of healthcare delivery and this will be a significant challenge in the midterm future. Wireless capsule endoscopy (WCE), introduced in 2000 by Given Imaging Ltd., is an example of disruptive technology and represents an attractive alternative to traditional diagnostic techniques. WCE overcomes conventional endoscopy enabling inspection of the digestive system without discomfort or the need for sedation. Thus, it has the advantage of encouraging patients to undergo gastrointestinal (GI) tract examinations and of facilitating mass screening programmes. With the integration of further capabilities based on microrobotics, e.g. active locomotion and embedded therapeutic modules, WCE could become the key-technology for GI diagnosis and treatment. This review presents a research update on WCE and describes the state-of-the-art of current endoscopic devices with a focus on research-oriented robotic capsule endoscopes enabled by microsystem technologies. The article also presents a visionary perspective on WCE potential for screening, diagnostic and therapeutic endoscopic procedures.

Experimental Investigation of the Spiral Structure of a Magnetic Capsule Endoscope

Fitting a wireless capsule endoscope (WCE) with a navigation feature can maximize its functional benefits. The rotation of a spiral-type capsule can be converted to translational motion. The study investigated how the spiral structure and rotational speed affected the capsule's translation speed. A hand-held instrument, including two permanent magnets, a stepper motor, a controller and a power supplier, were designed to generate rotational magnetic fields. The surfaces of custom-built permanent magnet rings magnetized radially were mounted in spiral lines with different lead angles and diameters, acting as mock-up capsules. The experimental results demonstrate that the rotational speed of the magnetic field and the spiral have significant effects on the translational speed of a capsule. The spiral line with a larger lead angle and the rotating magnetic field with a higher speed can change the capsule's rotation into a translational motion more efficiently in the intestine.

Capsule endoscopy of the future: What's on the horizon?

Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review, we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings. Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years.

Two-dimensional motion of Brownian swimmers in linear flows

The motion of viruses and bacteria and even synthetic microswimmers can be affected by thermal fluctuations and by external flows. In this work, we study the effect of linear external flows and thermal fluctuations on the diffusion of those swimmers modeled as spherical active (self-propelled) particles moving in two dimensions. General formulae for their mean-square displacement under a general linear flow are presented. We also provide, at short and long times, explicit expressions for the mean-square displacement of a swimmer immersed in three canonical flows, namely, solid-body rotation, shear and extensional flows. These expressions can now be used to estimate the effect of external flows on the displacement of Brownian microswimmers. Finally, our theoretical results are validated by using Brownian dynamics simulations.

Magnetically driven medical devices: a review

A widely accepted definition of a medical device is an instrument or apparatus that is used to diagnose, prevent or treat disease. Medical devices take a broad range of forms and utilize various methods to operate, such as physical, mechanical or thermal. Of particular interest in this paper are the medical devices that utilize magnetic field sources to operate. The exploitation of magnetic fields to operate or drive medical devices has become increasingly popular due to interesting characteristics of magnetic fields that are not offered by other phenomena, such as mechanical contact, hydrodynamics and thermodynamics. Today, there is a wide range of magnetically driven medical devices purposed for different anatomical regions of the body. A review of these devices is presented and organized into two groups: permanent magnetically driven devices and electromagnetically driven devices. Within each category, the discussion will be further segregated into anatomical regions (e.g., gastrointestinal, ocular, abdominal, thoracic, etc.).

Current state of micro-robots/devices as substitutes for screening colonoscopy: assessment based on technology readiness levels

BACKGROUND

Previous reports have described several candidates, which have the potential to replace colonoscopy, but to date, there is still no device capable of fully replacing flexible colonoscopy in the management of colonic disorders and for mass adult population screening for asymptomatic colorectal cancer.

MATERIALS AND METHODS

NASA developed the TRL methodology to describe and define the stages of development before use and marketing of any device. The definitions of the TRLS used in the present review are those formulated by "The US Department of Defense Technology Readiness Assessment Guidance" but adapted to micro-robots for colonoscopy. All the devices included are reported in scientific literature. They were identified by a systematic search in Web of Science, PubMed and IEEE Xplore amongst other sources. Devices that clearly lack the potential for full replacement of flexible colonoscopy were excluded.

ASSESSMENT OF THE CURRENT SITUATION

The technological salient features of all the devices included for assessment are described briefly, with particular focus on device propulsion. The devices are classified according to the TRL criteria based on the reported information. An analysis is next undertaken of the characteristics and salient features of the devices included in the review: wireless/tethered devices, data storage-transmission and navigation, additional functionality, residual technology challenges and clinical and socio-economical needs.

CONCLUSIONS

Few devices currently possess the required functionality and performance to replace the conventional colonoscopy. The requirements, including functionalities which favour the development of a micro-robot platform to replace colonoscopy, are highlighted.

Smoluchowski diffusion equation for active Brownian swimmers

We study the free diffusion in two dimensions of active Brownian swimmers subject to passive fluctuations on the translational motion and to active fluctuations on the rotational one. The Smoluchowski equation is derived from a Langevin-like model of active swimmers and analytically solved in the long-time regime for arbitrary values of the Péclet number; this allows us to analyze the out-of-equilibrium evolution of the positions distribution of active particles at all time regimes. Explicit expressions for the mean-square displacement and for the kurtosis of the probability distribution function are presented and the effects of persistence discussed. We show through Brownian dynamics simulations that our prescription for the mean-square displacement gives the exact time dependence at all times. The departure of the probability distribution from a Gaussian, measured by the kurtosis, is also analyzed both analytically and computationally. We find that for the inverse of Péclet numbers ≲0.1, the distance from Gaussian increases as ∼t(-2) at short times, while it diminishes as ∼t(-1) in the asymptotic limit.

A New Concept for Magnetic Capsule Colonoscopy Based on an Electromagnetic System

Traditional endoscopy based on flexible endoscopes is reliable and effective, but poorly tolerated by patients; it also requires extended training by physicians. In order to reduce the invasiveness of these procedures, wireless passive capsule endoscopy has been proposed and clinically used during the past decade. A capsule endoscope with an active locomotion mechanism is desirable for carrying out controllable interactive procedures that are normally not possible using passive devices. Due to many difficulties in embedding actuators in swallowable devices, many researchers and companies have adopted an external magnetic field actuation solution. Magnetic resonance modified systems or permanent magnets are used to manoeuvre capsules remotely; however, both these cases present some limitations: magnetic resonance systems are bulky and expensive and permanent magnets are intrinsically unstable to control, and it is impossible to switch them off. Within this framework, the authors present the design and assessment of a magnetic system for endoscopic capsules based on an electromagnetic approach. In particular, the use of a single electromagnet was proposed and investigated: magnetic attraction, locomotion forces and magnetic torques were modelled for guaranteeing the reliable navigation of the capsule and based on these specifications, an electromagnet was designed, developed and experimentally evaluated. The results demonstrated the feasibility of the proposed approach for active locomotion capsule endoscopy.

Effective diffusion of confined active Brownian swimmers

We theoretically find the effect of confinement and thermal fluctuations on the diffusivity of a spherical active swimmer moving inside a two-dimensional narrow cavity of general shape. The explicit formulas for the effective diffusion coefficient of a swimmer moving inside two particular cavities are presented. We also compare our analytical results with Brownian dynamics simulations and we obtain excellent agreement.

A CMOS micromachined capacitive tactile sensor with integrated readout circuits and compensation of process variations

This paper presents a capacitive tactile sensor fabricated in a standard CMOS process. Both of the sensor and readout circuits are integrated on a single chip by a TSMC 0.35 μm CMOS MEMS technology. In order to improve the sensitivity, a T-shaped protrusion is proposed and implemented. This sensor comprises the metal layer and the dielectric layer without extra thin film deposition, and can be completed with few post-processing steps. By a nano-indenter, the measured spring constant of the T-shaped structure is 2.19 kNewton/m. Fully differential correlated double sampling capacitor-to-voltage converter (CDS-CVC) and reference capacitor correction are utilized to compensate process variations and improve the accuracy of the readout circuits. The measured displacement-to-voltage transductance is 7.15 mV/nm, and the sensitivity is 3.26 mV/μNewton. The overall power dissipation is 132.8 μW.

Numerical modelling of chirality-induced bi-directional swimming of artificial flagella

Biomimetic micro-swimmers can be used for various medical applications, such as targeted drug delivery and micro-object (e.g. biological cells) manipulation, in lab-on-a-chip devices. Bacteria swim using a bundle of flagella (flexible hair-like structures) that form a rotating cork-screw of chiral shape. To mimic bacterial swimming, we employ a computational approach to design a bacterial (chirality-induced) swimmer whose chiral shape and rotational velocity can be controlled by an external magnetic field. In our model, we numerically solve the coupled governing equations that describe the system dynamics (i.e. solid mechanics, fluid dynamics and magnetostatics). We explore the swimming response as a function of the characteristic dimensionless parameters and put special emphasis on controlling the swimming direction. Our results provide fundamental physical insight on the chirality-induced propulsion, and it provides guidelines for the design of magnetic bi-directional micro-swimmers.

Evaluation of magnetic resonance imaging issues for implantable microfabricated magnetic actuators

The mechanical robustness of microfabricated torsional magnetic actuators in withstanding the strong static fields (7 T) and time-varying field gradients (17 T/m) produced by an MR system was studied in this investigation. The static and dynamic mechanical characteristics of 30 devices were quantitatively measured before and after exposure to both strong uniform and non-uniform magnetic fields. The results showed no statistically significant change in both the static and dynamic mechanical performance, which mitigate concerns about the mechanical stability of these devices in association with MR systems under the conditions used for this assessment. The MR-induced heating was also measured in a 3-T/128-MHz MR system. The results showed a minimal increase (1.6 °C) in temperature due to the presence of the magnetic microactuator array. Finally, the size of the MR-image artifacts created by the magnetic microdevices were quantified. The signal loss caused by the devices was approximately four times greater than the size of the device.

From passive tool holders to microsurgeons: safer, smaller, smarter surgical robots

Within only a few decades from its initial introduction, the field of surgical robotics has evolved into a dynamic and rapidly growing research area with increasing clinical uptake worldwide. Initially introduced for stereotaxic neurosurgery, surgical robots are now involved in an increasing number of procedures, demonstrating their practical clinical potential while propelling further advances in surgical innovations. Emerging platforms are also able to perform complex interventions through only a single-entry incision, and navigate through natural anatomical pathways in a tethered or wireless fashion. New devices facilitate superhuman dexterity and enable the performance of surgical steps that are otherwise impossible. They also allow seamless integration of microimaging techniques at the cellular level, significantly expanding the capabilities of surgeons. This paper provides an overview of the significant achievements in surgical robotics and identifies the current trends and future research directions of the field in making surgical robots safer, smaller, and smarter.

An integrated system for wireless capsule endoscopy in a liquid-distended stomach

The design and development of a functional integrated system for gastroscopy is reported in this paper. The device takes advantage of four propellers enabling locomotion in a liquid environment and generating a maximum propulsive force of 25.5 mN. The capsule has been equipped with a miniaturized wireless vision system that acquires images with a frame rate of 30 fps (frames per second). The overall size of the capsule is 32 mm in length and 22 mm in diameter, with the possibility of decreasing the diameter to swallowable dimensions. The capsule is remotely controlled by the user who can intuitively drive the device by looking at the video streaming on the graphical interface. The average speed of the device is 1.5 cm/s that allows for a fine control of the capsule motion as demonstrated in experimental tasks consisting of passing through circular targets. The video system performances have been characterized by evaluating the contrast, the focus, and the capability of acquiring and perceiving different colors. The usability of the device has been tested on bench and on explanted tissues by three users in real time target-identification tasks, in order to assess the success of the integration process. The lifetime of the capsule with active motors and vision system is 13 min, that is, a timeframe consistent with traditional gastroscopic examinations.

Passive elastic mechanism to mimic fish-muscle action in anguilliform swimming

Swimmers in nature use body undulations to generate propulsive and manoeuvring forces. The anguilliform kinematics is driven by muscular actions all along the body, involving a complex temporal and spatial coordination of all the local actuations. Such swimming kinematics can be reproduced artificially, in a simpler way, by using the elasticity of the body passively. Here, we present experiments on self-propelled elastic swimmers at a free surface in the inertial regime. By addressing the fluid-structure interaction problem of anguilliform swimming, we show that our artificial swimmers are well described by coupling a beam theory with the potential flow model of Lighthill. In particular, we show that the propagative nature of the elastic wave producing the propulsive force is strongly dependent on the dissipation of energy along the body of the swimmer.

Magnetic fish-robot based on multi-motion control of a flexible magnetic actuator

This paper presents a biologically inspired fish-robot driven by a single flexible magnetic actuator with a rotating magnetic field in a three-axis Helmholtz coil. Generally, magnetic fish-robots are powered by alternating and gradient magnetic fields, which provide a single motion such as bending the fish-robot's fins. On the other hand, a flexible magnetic actuator driven by an external rotating magnetic field can create several gaits such as the bending vibration, the twisting vibration, and their combination. Most magnetic fish-like micro-robots do not have pectoral fins on the side and are simply propelled by the tail fin. The proposed robot can swim and perform a variety of maneuvers with the addition of pectoral fins and control of the magnetic torque direction. In this paper, we find that the robot's dynamic actuation correlates with the magnetic actuator and the rotating magnetic field. The proposed robot is also equipped with new features, such as a total of six degrees of freedom, a new control method that stabilizes posture, three-dimensional swimming, a new velocity control, and new turning abilities.

Advanced technologies for gastrointestinal endoscopy

The gastrointestinal tract is home to some of the most deadly human diseases. Exacerbating the problem is the difficulty of accessing it for diagnosis or intervention and the concomitant patient discomfort. Flexible endoscopy has established itself as the method of choice and its diagnostic accuracy is high, but there remain technical limitations in modern scopes, and the procedure is poorly tolerated by patients, leading to low rates of compliance with screening guidelines. Although advancement in clinical endoscope design has been slow in recent years, a critical mass of enabling technologies is now paving the way for the next generation of gastrointestinal endoscopes. This review describes current endoscopes and provides an overview of innovative flexible scopes and wireless capsules that can enable painless endoscopy and/or enhanced diagnostic and therapeutic capabilities. We provide a perspective on the potential of these new technologies to address the limitations of current endoscopes in mass cancer screening and other contexts and thus to save many lives.