Medical microrobots in reproductive medicine from the bench to the clinic

Anticoagulation colloidal microrobots based on heparin-mimicking polymers

Coagulation within blood vessels is a major cause of cardiovascular disease and global mortality, highlighting the urgent need for effective anticoagulant strategies. In this study, we introduce a dynamic and highly efficient anticoagulant platform, achieved through the fabrication of a novel colloidal microrobot with unique functional properties. The microrobot is a Janus colloidal sphere with one hemisphere coated with heparin-mimicking polymers and the other with gold. This structure endows the microrobot with self-propulsion capabilities, powered by biocompatible near-infrared (NIR) irradiation, without the need for chemical fuel. The heparin-mimicking polymers not only prevent blood clotting but also promote endothelial cell growth while inhibiting the proliferation of smooth muscle cells. Additionally, the self-propulsion feature allows the microrobot to travel long distances within blood vessels and precisely target sites for anticoagulation. Our work validates an approach for the production of biofunctionalized microrobots, which introduces a novel avenue for anticoagulation application through the development of innovative biofunctionalized colloidal devices.

Contrast-enhanced ultrasonography combined with microbubbles for uterine disorders: Current trends and future perspectives

Uterine disorders, including fibroids, polyps, and carcinomas, represent significant health concerns for women. Conventional diagnostic methods, including ultrasound and magnetic resonance imaging, often lack the sensitivity required to accurately delineate and evaluate these lesions. Consequently, there is a growing need for advanced imaging techniques to enhance both diagnostic precision and therapeutic decision-making. Standard imaging modalities typically provide low resolution, limiting their effectiveness in evaluating uterine pathology and determining optimal treatment strategies. In this context, microbubbles combined with contrast-enhanced ultrasonography offer a promising solution. This technique enhances the visualization of vascular patterns and tissue perfusion, facilitating a more accurate assessment of uterine lesions. Contrast-enhanced ultrasonography is less invasive, is more cost-effective, and offers real-time evaluation of vascular characteristics, making it a valuable tool for diagnosing uterine abnormalities. This review explores the clinical utility of contrast-enhanced ultrasonography with microbubbles in uterine diseases, focusing on its diagnostic accuracy, comparison with traditional imaging techniques, and its potential to improve the management of uterine pathology.

Biotemplated Diatom Microrobots for Dual-Drug Delivery in Targeted Neuroblastoma Therapy

Neuroblastoma, a highly malignant pediatric tumor, demands innovative targeted drug delivery strategies to overcome the limitations of conventional therapies. In this study, we developed magnetic diatom microrobots (DMs) using diatom frustules as biotemplates, leveraging their natural hierarchical porosity and biocompatibility. Functionalized with amino groups and folic acid, these microrobots demonstrated enhanced drug conjugation and tumor-targeting capabilities. Designed to carry either cisplatin (CDDP) or paclitaxel (PTX), the DMs facilitated complementary therapeutic effects through pH-responsive release, enabling synergistic neuroblastoma therapy. Magnetic actuation tests confirmed multimodal propulsion and precise motion control. In vitro experiments demonstrated enhanced therapeutic efficacy and reduced off-target effects compared to those of conventional approaches. These diatom-templated magnetic microrobots, with their facile fabrication and superior performance, represent a promising platform for targeted drug delivery and advanced cancer therapy.

Size and Illumination Matters: Local Magnetic Actuation and Fluorescence Imaging for Microrobotics

Combining local magnetic actuation with fluorescence imaging modalities promises to introduce significant advances in microrobotic-guided procedures. This review presents the advantages and challenges of this approach, emphasizing the need for careful design considerations to optimize performance and compatibility. Traditional microrobotic actuation systems rely on bulky electromagnets, which are unsuitable for clinical use due to high power requirements and limited operational workspace. In contrast, miniaturized electromagnets can be integrated into surgical instruments, offering low power consumption and high actuation forces at the target site. Fluorescence imaging modalities have been explored in microrobotics, showcasing spatiotemporal resolution and the capability to provide information from biological entities. However, limitations, such as shallow penetration depth and out-of-focus fluorescence, have motivated the development of advanced techniques such as two-photon microscopy. The potential of two-photon microscopy to overcome these limitations is highlighted, with supporting evidence from previous studies on rat tissue samples. Current challenges in optical penetration depth, temporal resolution, and field of view are also addressed in this review. While integrating miniaturized electromagnets with fluorescence imaging modalities holds the potential for microrobotic-guided procedures, ongoing research and technological advancements are essential to translating this approach into clinical practice.

Swarm Autonomy: From Agent Functionalization to Machine Intelligence

Swarm behaviors are common in nature, where individual organisms collaborate via perception, communication, and adaptation. Emulating these dynamics, large groups of active agents can self-organize through localized interactions, giving rise to complex swarm behaviors, which exhibit potential for applications across various domains. This review presents a comprehensive summary and perspective of synthetic swarms, to bridge the gap between the microscale individual agents and potential applications of synthetic swarms. It is begun by examining active agents, the fundamental units of synthetic swarms, to understand the origins of their motility and functionality in the presence of external stimuli. Then inter-agent communications and agent-environment communications that contribute to the swarm generation are summarized. Furthermore, the swarm behaviors reported to date and the emergence of machine intelligence within these behaviors are reviewed. Eventually, the applications enabled by distinct synthetic swarms are summarized. By discussing the emergent machine intelligence in swarm behaviors, insights are offered into the design and deployment of autonomous synthetic swarms for real-world applications.

Imaging-guided bioresorbable acoustic hydrogel microrobots

Micro- and nanorobots excel in navigating the intricate and often inaccessible areas of the human body, offering immense potential for applications such as disease diagnosis, precision drug delivery, detoxification, and minimally invasive surgery. Despite their promise, practical deployment faces hurdles, including achieving stable propulsion in complex in vivo biological environments, real-time imaging and localization through deep tissue, and precise remote control for targeted therapy and ensuring high therapeutic efficacy. To overcome these obstacles, we introduce a hydrogel-based, imaging-guided, bioresorbable acoustic microrobot (BAM) designed to navigate the human body with high stability. Constructed using two-photon polymerization, a BAM comprises magnetic nanoparticles and therapeutic agents integrated into its hydrogel matrix for precision control and drug delivery. The microrobot features an optimized surface chemistry with a hydrophobic inner layer to substantially enhance microbubble retention in biofluids with multiday functionality and a hydrophilic outer layer to minimize aggregation and promote timely degradation. The dual-opening bubble-trapping cavity design enables a BAM to maintain consistent and efficient acoustic propulsion across a range of biological fluids. Under focused ultrasound stimulation, the entrapped microbubbles oscillate and enhance the contrast for real-time ultrasound imaging, facilitating precise tracking and control of BAM movement through wireless magnetic navigation. Moreover, the hydrolysis-driven biodegradability of BAMs ensures its safe dissolution after treatment, posing no risk of long-term residual harm. Thorough in vitro and in vivo experimental evidence demonstrates the promising capabilities of BAMs in biomedical applications. This approach shows promise for advancing minimally invasive medical interventions and targeted therapeutic delivery.

Magnetic soft microrobots for erectile dysfunction therapy

Erectile dysfunction (ED) is a major threat to male fertility and quality of life, and mesenchymal stromal cells (MSCs) are a promising therapeutic option. However, therapeutic outcomes are compromised by low MSC retention and survival rates in corpus cavernosum tissue. Here, we developed an innovative magnetic soft microrobot comprising an ultrasoft hydrogel microsphere embedded with a magnetic nanoparticle chain for MSC delivery. This design also features phenylboronic acid groups for scavenging reactive oxygen species (ROS). With a Young's modulus of less than 1 kPa, the ultrasoft microrobot adapts its shape within narrow blood vessels, ensuring a uniform distribution of MSCs within the corpus cavernosum. Our findings showed that compared with traditional MSC injections, the MSC delivery microrobot (MSC-Rob) significantly enhanced MSC retention and survival. In both rat and beagle ED models, MSC-Rob treatment accelerated the repair of corpus cavernosum tissue and restored erectile function. Single-cell RNA sequencing (scRNA-seq) revealed that MSC-Rob treatment facilitates nerve and blood vessel regeneration in the corpus cavernosum by increasing the presence of regenerative macrophages. Overall, our MSC-Rob not only advances the clinical application of MSCs for ED therapy but also broadens the scope of microrobots for other cell therapies.

Magnetic control of soft microrobots near step-out frequency: Characterization and analysis

Magnetically actuated soft microrobots hold promise for biomedical applications that necessitate precise control and adaptability in complex environments. These microrobots can be accurately steered below their step-out frequencies where they exhibit synchronized motion with external magnetic fields. However, the step-out frequencies of soft microrobots have not been investigated yet, as opposed to their rigid counterparts. In this work, we develop an analytic model from the magneto-elastohydrodynamics to establish the relationship between the step-out frequency of soft sperm-like microrobots and their magnetic properties, geometry, wave patterns, and the viscosity of the surrounding medium. We fabricate soft sperm-like microrobots using electrospinning and assess their swimming abilities in mediums with varying viscosities under an oscillating magnetic field. We observe slight variations in wave patterns of the sperm-like microrobots as the actuation frequency changes. Our theoretical model, which analyzes these wave patterns observed without exceeding the step-out threshold, quantitatively agrees with the experimentally measured step-out frequencies. By accurately predicting the step-out frequency, the proposed model lays a foundation for achieving precise control over individual soft microrobots and enabling selective control within a swarm when executing biomedical tasks.

Stabilization of CsPbBr3 Nanowires Through SU-8 Encapsulation for the Fabrication of Bilayer Microswimmers with Magnetic and Fluorescence Properties

All-inorganic cesium lead halide (CsPbX3, X = Cl, Br, I) perovskite nanocrystals have drawn great interest because of their excellent photophysical properties and potential applications. However, their poor stability in water greatly limited their use in applications that require stable structures. In this work, a facile approach to stabilize CsPbBr3 nanowires is developed by using SU-8 as a protection medium; thereby creating stable CsPbBr3/SU-8 microstructures. Through photolithography and layer-by-layer deposition, CsPbBr3/SU-8 is used to fabricate bilayer achiral microswimmers (BAMs), which consist of a top CsPbBr3/SU-8 layer and a bottom Fe3O4 magnetic layer. Compared to pure CsPbBr3 nanowires, the CsPbBr3/SU-8 shows long-term structural and fluorescence stability in water against ultrasonication treatment. Due to the magnetic layer, the motion of the microswimmers can be controlled precisely under a rotating magnetic field, allowing them to swim at low Reynolds number and tumble or roll on surfaces. Furthermore, CsPbBr3/SU-8 can be used to fabricate various types of planar microstructures with high throughput, high consistency, and fluorescence properties. This work provides a method for the stabilization of CsPbBr3 and demonstrates the potential to mass fabricate planar microstructures with various shapes, which can be used in different applications such as microrobotics.

Field-Directed Motion, Cargo Capture, and Closed-Loop Controlled Navigation of Microellipsoids

Microrobots have the potential for diverse applications, including targeted drug delivery and minimally invasive surgery. Despite advancements in microrobot design and actuation strategies, achieving precise control over their motion remains challenging due to the dominance of viscous drag, system disturbances, physicochemical heterogeneities, and stochastic Brownian forces. Here, a precise control over the interfacial motion of model microellipsoids is demonstrated using time-varying rotating magnetic fields. The impacts of microellipsoid aspect ratio, field characteristics, and magnetic properties of the medium and the particle on the motion are investigated. The role of mobile micro-vortices generated is highlighted by rotating microellipsoids in capturing, transporting, and releasing cargo objects. Furthermore, an approach is presented for controlled navigation through mazes based on real-time particle and obstacle sensing, path planning, and magnetic field actuation without human intervention. The study introduces a mechanism of directing motion of microparticles using rotating magnetic fields, and a control scheme for precise navigation and delivery of micron-sized cargo using simple microellipsoids as microbots.

Design and batch fabrication of anisotropic microparticles toward small-scale robots using microfluidics: recent advances

Small-scale robots with shape anisotropy have garnered significant scientific interest due to their enhanced mobility and precise control in recent years. Traditionally, these miniature robots are manufactured using established techniques such as molding, 3D printing, and microfabrication. However, the advent of microfluidics in recent years has emerged as a promising manufacturing technology, capitalizing on the precise and dynamic manipulation of fluids at the microscale to fabricate various complex-shaped anisotropic particles. This offers a versatile and controlled platform, enabling the efficient fabrication of small-scale robots with tailored morphologies and advanced functionalities from the microfluidic-derived anisotropic microparticles at high throughput. This review highlights the recent advances in the microfluidic fabrication of anisotropic microparticles and their potential applications in small-scale robots. In this review, the term 'small-scale robots' broadly encompasses micromotors endowed with capabilities for locomotion and manipulation. Firstly, the fundamental strategies for liquid template formation and the methodologies for generating anisotropic microparticles within the microfluidic system are briefly introduced. Subsequently, the functionality of shape-anisotropic particles in forming components for small-scale robots and actuation mechanisms are emphasized. Attention is then directed towards the diverse applications of these microparticle-derived microrobots in a variety of fields, including pollution remediation, cell microcarriers, drug delivery, and biofilm eradication. Finally, we discuss future directions for the fabrication and development of miniature robots from microfluidics, shedding light on the evolving landscape of this field.

Advanced materials for micro/nanorobotics

Autonomous micro/nanorobots capable of performing programmed missions are at the forefront of next-generation micromachinery. These small robotic systems are predominantly constructed using functional components sourced from micro- and nanoscale materials; therefore, combining them with various advanced materials represents a pivotal direction toward achieving a higher level of intelligence and multifunctionality. This review provides a comprehensive overview of advanced materials for innovative micro/nanorobotics, focusing on the five families of materials that have witnessed the most rapid advancements over the last decade: two-dimensional materials, metal-organic frameworks, semiconductors, polymers, and biological cells. Their unique physicochemical, mechanical, optical, and biological properties have been integrated into micro/nanorobots to achieve greater maneuverability, programmability, intelligence, and multifunctionality in collective behaviors. The design and fabrication methods for hybrid robotic systems are discussed based on the material categories. In addition, their promising potential for powering motion and/or (multi-)functionality is described and the fundamental principles underlying them are explained. Finally, their extensive use in a variety of applications, including environmental remediation, (bio)sensing, therapeutics, etc., and remaining challenges and perspectives for future research are discussed.

Magnetically Driven Quadruped Soft Robot with Multimodal Motion for Targeted Drug Delivery

Untethered magnetic soft robots show great potential for biomedical and small-scale micromanipulation applications due to their high flexibility and ability to cause minimal damage. However, most current research on these robots focuses on marine and reptilian biomimicry, which limits their ability to move in unstructured environments. In this work, we design a quadruped soft robot with a magnetic top cover and a specific magnetization angle, drawing inspiration from the common locomotion patterns of quadrupeds in nature and integrating our unique actuation principle. It can crawl and tumble and, by adjusting the magnetic field parameters, it adapts its locomotion to environmental conditions, enabling it to cross obstacles and perform remote transportation and release of cargo.

Transcervical uterine flushing and embryo transfer in sheep: Morphophysiological basis for approaches currently used, major challenges, potential improvements, and new directions (alas, including some old ideas)

At present, the success of non-surgical embryo recovery (NSER) and transfer (NSET) hinges upon the cervical passage of catheters, but penetration of the uterine cervix in ewes is problematic due to its anatomical structure (i.e., long and narrow cervical lumen with misaligned folds and rings). It is a major obstacle limiting the widespread application of NSER and NSET in sheep. While initial attempts to traverse the uterine cervix focused on adapting or re-designing insemination catheters, more recent studies demonstrated that cervical relaxation protocols were instrumental for transcervical penetration in the ewe. An application of such protocols more than tripled cervical penetration rates (currently at 90-95 %) in sheep of different breeds (e.g., Dorper, Lacaune, Santa Inês, crossbred, and indigenous Brazilian breeds) and ages/parity. There is now sufficient evidence to suggest that even repeatedly performed cervical passages do not adversely affect overall health and reproductive function of ewes. Despite these improvements, appropriate selection of donors and recipients remains one of the most important requirements for maintaining high success rates of NSER and NSET, respectively. Non-surgical ovine embryo recovery has gradually become a commercially viable method as even though the procedure still cannot be performed by untrained individuals, it is inexpensive, yields satisfactory results, and complies with current public expectations of animal welfare standards. This article reviews critical morphophysiological aspects of transcervical embryo flushing and transfer, and the prospect of both techniques to replace surgical methods for multiple ovulation and embryo transfer (MOET) programs in sheep. We have also discussed some potential pharmacological and technical developments in the field of non-invasive embryo recovery and deposition.

Neurological insights into brain-targeted cancer therapy and bioinspired microrobots

Cancer, a multifaceted and pernicious disease, continuously challenges medicine, requiring innovative treatments. Brain cancers pose unique and daunting challenges due to the intricacies of the central nervous system and the blood-brain barrier. In this era of precision medicine, the convergence of neurology, oncology, and cutting-edge technology has given birth to a promising avenue - targeted cancer therapy. Furthermore, bioinspired microrobots have emerged as an ingenious approach to drug delivery, enabling precision and control in cancer treatment. This Keynote review explores the intricate web of neurological insights into brain-targeted cancer therapy and the paradigm-shifting world of bioinspired microrobots. It serves as a critical and comprehensive overview of these evolving fields, aiming to underscore their integration and potential for revolutionary cancer treatments.

A Human-Scale Clinically Ready Electromagnetic Navigation System for Magnetically Responsive Biomaterials and Medical Devices

Magnetic navigation systems are used to precisely manipulate magnetically responsive materials enabling the realization of new minimally invasive procedures using magnetic medical devices. Their widespread applicability has been constrained by high infrastructure demands and costs. The study reports on a portable electromagnetic navigation system, the Navion, which is capable of generating a large magnetic field over a large workspace. The system is easy to install in hospital operating rooms and transportable through health care facilities, aiding in the widespread adoption of magnetically responsive medical devices. First, the design and implementation approach for the system are introduced and its performance is characterized. Next, in vitro navigation of different microrobot structures is demonstrated using magnetic field gradients and rotating magnetic fields. Spherical permanent magnets, electroplated cylindrical microrobots, microparticle swarms, and magnetic composite bacteria-inspired helical structures are investigated. The navigation of magnetic catheters is also demonstrated in two challenging endovascular tasks: 1) an angiography procedure and 2) deep navigation within the circle of Willis. Catheter navigation is demonstrated in a porcine model in vivo to perform an angiography under magnetic guidance.

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.

FERTILTY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Fertility care in low- and middle-income countries

Infertility affects millions worldwide, with significant medical, financial, and emotional challenges, particularly in low- and middle-income countries (LMICs). Cultural, religious, financial, and gender-related barriers hinder access to treatment, exacerbating social and economic consequences, especially for women. Despite its prevalence, infertility often remains overlooked due to competing health priorities. However, global initiatives recognise infertility as a reproductive health concern, advocating for universal access to high-quality fertility care. In LMICs, limited resources and infrastructure impede access to treatment, prompting people to turn to alternative, often ineffective, non-biomedical solutions. Addressing these challenges requires implementing affordable fertility care services tailored to local contexts, supported by political commitment and community engagement. Emerging technologies offer promising solutions, but comprehensive education and training programs are essential for their effective implementation. By integrating fertility care into broader health policies and fostering partnerships, we can ensure equitable access to infertility treatment and support reproductive health worldwide.

Roadmap for Clinical Translation of Mobile Microrobotics

Medical microrobotics is an emerging field to revolutionize clinical applications in diagnostics and therapeutics of various diseases. On the other hand, the mobile microrobotics field has important obstacles to pass before clinical translation. This article focuses on these challenges and provides a roadmap of medical microrobots to enable their clinical use. From the concept of a "magic bullet" to the physicochemical interactions of microrobots in complex biological environments in medical applications, there are several translational steps to consider. Clinical translation of mobile microrobots is only possible with a close collaboration between clinical experts and microrobotics researchers to address the technical challenges in microfabrication, safety, and imaging. The clinical application potential can be materialized by designing microrobots that can solve the current main challenges, such as actuation limitations, material stability, and imaging constraints. The strengths and weaknesses of the current progress in the microrobotics field are discussed and a roadmap for their clinical applications in the near future is outlined.

Light-Responsive Hydrogel Microcrawlers, Powered and Steered with Spatially Homogeneous Illumination

Sub-millimeter untethered locomoting robots hold promise to radically change multiple areas of human activity such as microfabrication/assembly or health care. To overcome the associated hurdles of such a degree of robot miniaturization, radically new approaches are being adopted, often relying on soft actuating polymeric materials. Here, we present light-driven, crawling microrobots that locomote by a single degree of freedom actuation of their light-responsive tail section. The direction of locomotion is dictated by the robot body design and independent of the spatial modulation of the light stimuli, allowing simultaneous multidirectional motion of multiple robots. Moreover, we present a method for steering such robots by reversibly deforming their front section, using ultraviolet (UV) light as a trigger. The deformation dictates the robot locomotion, performing right- or left-hand turning when the UV is turned on or off respectively. The robots' motion and navigation are not coupled to the position of the light sources, which enables simultaneous locomotion of multiple robots, steering of robots and brings about flexibility with the methods to deliver the light to the place of robot operation.

Micro/Nanorobotics in In Vitro Fertilization: A Paradigm Shift in Assisted Reproductive Technologies

In vitro fertilization (IVF) has transformed the sector of assisted reproductive technology (ART) by presenting hope to couples facing infertility challenges. However, conventional IVF strategies include their own set of problems such as success rates, invasive procedures, and ethical issues. The integration of micro/nanorobotics into IVF provides a prospect to address these challenging issues. This article provides an outline of the use of micro/nanorobotics in IVF specializing in advancing sperm manipulation, egg retrieval, embryo culture, and capacity future improvements in this swiftly evolving discipline. The article additionally explores the challenges and obstacles associated with the integration of micro/nanorobotics into IVF, in addition to the ethical concerns and regulatory elements related to the usage of advanced technologies in ART. A comprehensive discussion of the risk and safety considerations related to using micro/nanorobotics in IVF techniques is likewise presented. Through this exploration, we delve into the core principles, benefits, challenges, and potential impact of micro/nanorobotics in revolutionizing IVF procedures and enhancing affected person outcomes.

Soft Millirobot Capable of Switching Motion Modes on the Fly for Targeted Drug Delivery in the Oviduct

Small-scale magnetic robots with fixed magnetizations have limited locomotion modes, restricting their applications in complex environments in vivo. Here we present a morphology-reconfigurable millirobot that can switch the locomotion modes locally by reprogramming its magnetizations during navigation, in response to distinct magnetic field patterns. By continuously switching its locomotion modes between the high-velocity rigid motion and high-adaptability soft actuation, the millirobot efficiently navigates in small lumens with intricate internal structures and complex surface topographies. As demonstrations, the millirobot performs multimodal locomotion including woodlouse-like rolling and flipping, sperm-like rotating, and snake-like gliding to negotiate different terrains, including the unrestricted channel and high platform, narrow channel, and solid-liquid interface, respectively. Finally, we demonstrate the drug delivery capability of the millirobot through the oviduct-mimicking phantom and ex vivo oviduct. The magnetization reprogramming strategy during navigation represents a promising approach for developing self-adaptive robots for performing complex tasks in vivo.

Untethered Microgrippers for Precision Medicine

Microgrippers, a branch of micro/nanorobots, refer to motile miniaturized machines that are of a size in the range of several to hundreds of micrometers. Compared with tethered grippers or other microscopic diagnostic and surgical equipment, untethered microgrippers play an indispensable role in biomedical applications because of their characteristics such as miniaturized size, dexterous shape tranformation, and  controllable motion, which enables the microgrippers to enter hard-to-reach regions to execute specific medical tasks for disease diagnosis and treatment. To date, numerous medical microgrippers are developed, and their potential in cell manipulation, targeted drug delivery, biopsy, and minimally invasive surgery  are explored. To achieve controlled locomotion and efficient target-oriented actions, the materials, size, microarchitecture, and morphology of microgrippers shall be deliberately designed. In this review, the authors summarizes the latest progress in untethered micrometer-scale grippers. The working mechanisms of shape-morphing and actuation methods for effective movement are first introduced. Then, the design principle and state-of-the-art fabrication techniques of microgrippers are discussed. Finally, their applications in the precise medicine are highlighted, followed by offering future perspectives for the development of untethered medical microgrippers.

Tracking and navigation of a microswarm under laser speckle contrast imaging for targeted delivery

Micro/nanorobotic swarms consisting of numerous tiny building blocks show great potential in biomedical applications because of their collective active delivery ability, enhanced imaging contrast, and environment-adaptive capability. However, in vivo real-time imaging and tracking of micro/nanorobotic swarms remain a challenge, considering the limited imaging size and spatial-temporal resolution of current imaging modalities. Here, we propose a strategy that enables real-time tracking and navigation of a microswarm in stagnant and flowing blood environments by using laser speckle contrast imaging (LSCI), featuring full-field imaging, high temporal-spatial resolution, and noninvasiveness. The change in dynamic convection induced by the microswarm can be quantitatively investigated by analyzing the perfusion unit (PU) distribution, offering an alternative approach to investigate the swarm behavior and its interaction with various blood environments. Both the microswarm and surrounding environment were monitored and imaged by LSCI in real time, and the images were further analyzed for simultaneous swarm tracking and navigation in the complex vascular system. Moreover, our strategy realized real-time tracking and delivery of a microswarm in vivo, showing promising potential for LSCI-guided active delivery of microswarm in the vascular system.

Evolution of the Microrobots: Stimuli-Responsive Materials and Additive Manufacturing Technologies Turn Small Structures into Microscale Robots

The development of functional microsystems and microrobots that have characterized the last decade is the result of a synergistic and effective interaction between the progress of fabrication techniques and the increased availability of smart and responsive materials to be employed in the latter. Functional structures on the microscale have been relevant for a vast plethora of technologies that find application in different sectors including automotive, sensing devices, and consumer electronics, but are now also entering medical clinics. Working on or inside the human body requires increasing complexity and functionality on an ever-smaller scale, which is becoming possible as a result of emerging technology and smart materials over the past decades. In recent years, additive manufacturing has risen to the forefront of this evolution as the most prominent method to fabricate complex 3D structures. In this review, we discuss the rapid 3D manufacturing techniques that have emerged and how they have enabled a great leap in microrobotic applications. The arrival of smart materials with inherent functionalities has propelled microrobots to great complexity and complex applications. We focus on which materials are important for actuation and what the possibilities are for supplying the required energy. Furthermore, we provide an updated view of a new generation of microrobots in terms of both materials and fabrication technology. While two-photon lithography may be the state-of-the-art technology at the moment, in terms of resolution and design freedom, new methods such as two-step are on the horizon. In the more distant future, innovations like molecular motors could make microscale robots redundant and bring about nanofabrication.

Scaling a Hydraulic Motor for Minimally Invasive Medical Devices

Aligned with the medical device industry's trend of miniaturization, academic and commercial researchers are constantly attempting to reduce device sizes. Many applications require miniature actuators (2 mm range) to perform mechanical work; however, biocompatible micromotors are not readily available. To that end, a hydraulic motor-driven cutting module that aims to combine cutting and drug delivery is presented. The hydraulic motor prototype developed has an outside diameter (OD) of ~4 mm (twice the target size) and a 1 mm drive shaft to attach a cutter. Four different designs were explored and fabricated using additive manufacturing. The benchtop experimental data of the prototypes are presented herein. For the prototype motor with fluid inlet perpendicular to the blades, the average angular velocity was 10,593 RPM at a flowrate of 3.6 mL/s and 42,597 RPM at 10.1 mL/s. This design was numerically modeled using 3D-transient simulations in ANSYS CFX (version 2022 R2) to determine the performance characteristics and the internal resistance of the motor. Simplified mathematical models were also used to compute and compare the peak torque with the simulation estimates. The viability of current design represents a crucial milestone in scaling the hydraulic motor to a 2 mm OD to power a microcutter.

Intelligent Navigation of a Magnetic Microrobot with Model-Free Deep Reinforcement Learning in a Real-World Environment

Microrobotics has opened new horizons for various applications, especially in medicine. However, it also witnessed challenges in achieving maximum optimal performance. One key challenge is the intelligent, autonomous, and precise navigation control of microrobots in fluid environments. The intelligence and autonomy in microrobot control, without the need for prior knowledge of the entire system, can offer significant opportunities in scenarios where their models are unavailable. In this study, two control systems based on model-free deep reinforcement learning were implemented to control the movement of a disk-shaped magnetic microrobot in a real-world environment. The training and results of an off-policy SAC algorithm and an on-policy TRPO algorithm revealed that the microrobot successfully learned the optimal path to reach random target positions. During training, the TRPO exhibited a higher sample efficiency and greater stability. The TRPO and SAC showed 100% and 97.5% success rates in reaching the targets in the evaluation phase, respectively. These findings offer basic insights into achieving intelligent and autonomous navigation control for microrobots to advance their capabilities for various applications.

Three-degrees-of-freedom orientation manipulation of small untethered robots with a single anisotropic soft magnet

Magnetic actuation has been well exploited for untethered manipulation and locomotion of small-scale robots in complex environments such as intracorporeal lumens. Most existing magnetic actuation systems employ a permanent magnet onboard the robot. However, only 2-DoF orientation of the permanent-magnet robot can be controlled since no torque can be generated about its axis of magnetic moment, which limits the dexterity of manipulation. Here, we propose a new magnetic actuation method using a single soft magnet with an anisotropic geometry (e.g., triaxial ellipsoids) for full 3-DoF orientation manipulation. The fundamental actuation principle of anisotropic magnetization and 3-DoF torque generation are analytically modeled and experimentally validated. The hierarchical orientation stability about three principal axes is investigated, based on which we propose and validate a multi-step open-loop control strategy to alternatingly manipulate the direction of the longest axis of the soft magnet and the rotation about it for dexterous 3-DoF orientation manipulation.

Acoustic Trapping and Manipulation of Hollow Microparticles under Fluid Flow Using a Single-Lens Focused Ultrasound Transducer

Microparticle manipulation and trapping play pivotal roles in biotechnology. To achieve effective manipulation within fluidic flow conditions and confined spaces, it is necessary to consider the physical properties of microparticles and the types of trapping forces applied. While acoustic waves have shown potential for manipulating microparticles, the existing setups involve complex actuation mechanisms and unstable microbubbles. Consequently, the need persists for an easily deployable acoustic actuation setup with stable microparticles. Here, we propose the use of hollow borosilicate microparticles possessing a rigid thin shell, which can be efficiently trapped and manipulated using a single-lens focused ultrasound (FUS) transducer under physiologically relevant flow conditions. These hollow microparticles offer stability and advantageous acoustic properties. They can be scaled up and mass-produced, making them suitable for systemic delivery. Our research demonstrates the successful trapping dynamics of FUS within circular tubings of varying diameters, validating the effectiveness of the method under realistic flow rates and ultrasound amplitudes. We also showcase the ability to remove hollow microparticles by steering the FUS transducer against the flow. Furthermore, we present potential biomedical applications, such as active cell tagging and navigation in bifurcated channels as well as ultrasound imaging in mouse cadaver liver tissue.

Magnetic Microrobots as a Platform for Cell Clean Up

Mobile magnetic microrobots have been extensively used in a wide range of biomedical applications due to their numerous advantages. Magnetic microrobots in particular have been developed and shown great potential over the past two decades for the manipulation and migration of both single cells and cell aggregates. The efficient clearance of cell aggregates is crucial to prevent uncontrolled cell proliferation, tissue damage, and invasive surgeries, especially for those related to the vascular system. In this work, we showed cellular manipulation and mobility to achieve cellular clean up on Human Liver Cancer (HepG2) cells by using two types of untethered magnetic microrobots that are different in type and size. We performed the cellular clean up in the microchannel, which can demonstrate the closed working environment, and also on a glass slide to present an air-liquid interface. We showed that the microrobots could be able to move a cluster of cells in both conditions which could make them useful for sorting and separation applications. Furthermore, cell viability was assessed by using a trypan blue staining assay on HepG2 cells right after and 24 hours after microrobot actuation.

Four-Dimensional-Printed Microrobots and Their Applications: A Review

Owing to their small size, microrobots have many potential applications. In addition, four-dimensional (4D) printing facilitates reversible shape transformation over time or upon the application of stimuli. By combining the concept of microrobots and 4D printing, it may be possible to realize more sophisticated next-generation microrobot designs that can be actuated by applying various stimuli, and also demonstrates profound implications for various applications, including drug delivery, cells delivery, soft robotics, object release and others. Herein, recent advances in 4D-printed microrobots are reviewed, including strategies for facilitating shape transformations, diverse types of external stimuli, and medical and nonmedical applications of microrobots. Finally, to conclude the paper, the challenges and the prospects of 4D-printed microrobots are highlighted.

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.

Chemical tunability of advanced materials used in the fabrication of micro/nanobots

Micro and nanobots (MNBs) are unprecedented in their ability to be chemically tuned for autonomous tasks with enhanced targeting and functionality while maintaining their mobility. A myriad of chemical modifications involving a large variety of advanced materials have been demonstrated to be effective in the design of MNBs. Furthermore, they can be controlled for their autonomous motion, and their ability to carry chemical or biological payloads. In addition, MNBs can be modified to achieve targetability with specificity for biological implications. MNBs by virtue of their chemical compositions may be limited by their biocompatibility, tissue accumulation, poor biodegradability and toxicity. This review presents a note on artificial intelligence materials (AIMs), their importance, and the dimensional scales at which intrinsic autonomy can be achieved for diverse utility. We briefly discuss the evolution of such systems with a focus on their advancements in nanomedicine. We highlight MNBs covering their contemporary traits and the emergence of a few start-ups in specific areas. Furthermore, we showcase various examples, demonstrating that chemical tunability is an attractive primary approach for designing MNBs with immense capabilities both in biology and chemistry. Finally, we cover biosafety and ethical considerations in designing MNBs in the era of artificial intelligence for varied applications.

In vivo applications of micro/nanorobots

Untethered robots in the size range of micro/nano-scale offer unprecedented access to hard-to-reach areas of the body. In these challenging environments, autonomous task completion capabilities of micro/nanorobots have been the subject of research in recent years. However, most of the studies have presented preliminary in vitro results that can significantly differ under in vivo settings. Here, we focus on the studies conducted with animal models to reveal the current status of micro/nanorobotic applications in real-world conditions. By a categorization based on target locations, we highlight the main strategies employed in organs and other body parts. We also discuss key challenges that require interest before the successful translation of micro/nanorobots to the clinic.