Electronically integrated microcatheters based on self-assembling polymer films

Magnetic localization and manipulation of locking synchronous motors

Three-dimensional (3D) localization of magneto-surgical devices is essential for safe and efficient navigation. However, existing magnetic localization methods either limit device miniaturization due to internal sensors or require additional excitation fields and external sensor arrays. Herein, we formulate a localization method based on the special properties of rotating magnetic dipoles, which allow reconstruction of position and rotation axis from a single external tri-axial magnetometer. The rotating dipole is realized through a permanent magnet synchronous motor (PMSM) that can reversibly (un)lock using the heat-induced phase transition of a low melting point alloy. Sequential localization and manipulation is performed by an external mobile electromagnet equipped with a single eye-in-hand Hall effect sensor. We describe the PMSM's thermal and magnetic properties, formulate the governing localization equations, quantify and validate 3D tracking of PMSM pose trajectory, and demonstrate sequential localization and manipulation in a benchtop experiment.

Unlocking Micro-Origami Energy Storage

Transforming thin films into high-order stacks has proven effective for robust energy storage in macroscopic configurations like cylindrical, prismatic, and pouch cells. However, the lack of tools at the submillimeter scales has hindered the creation of similar high-order stacks for micro- and nanoscale energy storage devices, a critical step toward autonomous intelligent microsystems. This Spotlight on Applications article presents recent advancements in micro-origami technology, focusing on shaping nano/micrometer-thick films into three-dimensional architectures to achieve folded or rolled structures for microscale energy storage devices. Micro-Swiss-rolls, created through a roll-up process actuated by inherent strain in multiple layer stacks, have been employed to develop on-chip microbatteries and microsupercapacitors with superior performance compared to their planar counterparts. The technology allows additional functionalities to be integrated into the same device using multifunctional materials. Despite significant progress, the key challenge for micro-origami technology in creating microscale energy storage devices lies in diversifying shape-morphing mechanisms to expand material choices, improve process reliability, and enhance reproducibility. Additionally, developing a universal microscale energy storage device that can cater to various tiny devices is intricate. Therefore, considering the integration of energy storage into final applications during the development phase is crucial. Micro-origami energy storage systems are poised to significantly impact the future of autonomous tiny devices, such as smart dust and microrobots.

Submillimeter fiber robots capable of decoupled macro-micro motion for endoluminal manipulation

Endoluminal and endocavitary intervention via natural orifices of the body is an emerging trend in medicine, further underpinning the future of early intervention and precision surgery. This motivates the development of small continuum robots to navigate freely in confined and tortuous environment. The trade-off between a large range of motion and high precision with concomitant actuation cross-talk poses a major challenge. Here, we present a submillimeter-scale fiber robot (~1 mm) capable of decoupled macro and micro manipulations for intervention and operation. The thin optical fibers, working both as mechanical tendons and light waveguides, can be pulled/pushed to actuate the macro tendon-driven continuum robot and transmit light to actuate the liquid crystal elastomer-based micro built-in light-driven parallel robot. The combination of the decoupled macro and micro motions can accomplish accurate cross-scale motion from several millimeters down to tens of micrometers. In vivo animal studies are performed to demonstrate its positioning accuracy of precise micro operations in endoluminal or endocavitary intervention.

Conformal printed electronics on flexible substrates and inflatable catheters using lathe-based aerosol jet printing

With the growth of additive manufacturing (AM), there has been increasing demand for fabricating conformal electronics that directly integrate with larger components to enable unique functionality. However, fabrication of conformal electronics is challenging because devices must merge with host substrates regardless of curvilinearity, topography, or substrate material. In this work, we employ aerosol jet (AJ) printing, an AM method for jet printing electronics using ink-based materials, and a custom-made lathe mechanism for mounting flexible substrates and 3D objects on a rotating axis. Using this method of lathe-based AJ printing, conformal electronics are printed around the circumference of rotational bodies with 3D curvilinear surfaces through cylindrical-coordinate motion. We characterize the diverse capabilities of lathe AJ (LAJ) printing and demonstrate flexible conformal electronics including multilayer carbon nanotube transistors. Lastly, a graphene sensor is conformally printed on an inflated catheter balloon for temperature and inflation monitoring, thus highlighting the versatilities of LAJ printing.

Bio-Inspired Dynamically Morphing Microelectronics toward High-Density Energy Applications and Intelligent Biomedical Implants

Choreographing the adaptive shapes of patterned surfaces to exhibit designable mechanical interactions with their environment remains an intricate challenge. Here, a novel category of strain-engineered dynamic-shape materials, empowering diverse multi-dimensional shape modulations that are combined to form fine-grained adaptive microarchitectures is introduced. Using micro-origami tessellation technology, heterogeneous materials are provided with strategic creases featuring stimuli-responsive micro-hinges that morph precisely upon chemical and electrical cues. Freestanding multifaceted foldable packages, auxetic mesosurfaces, and morphable cages are three of the forms demonstrated herein of these complex 4-dimensional (4D) metamaterials. These systems are integrated in dual proof-of-concept bioelectronic demonstrations: a soft foldable supercapacitor enhancing its power density (≈108 mW cm-2), and a bio-adaptive device with a dynamic shape that may enable novel smart-implant technologies. This work demonstrates that intelligent material systems are now ready to support ultra-flexible 4D microelectronics, which can impart autonomy to devices culminating in the tangible realization of microelectronic morphogenesis.

Smart Hydrogel Swelling State Detection Based on a Power-Transfer Transduction Principle

Stimulus-responsive (smart) hydrogels are a promising sensing material for biomedical contexts due to their reversible swelling change in response to target analytes. The design of application-specific sensors that utilize this behavior requires the development of suitable transduction concepts. The presented study investigates a power-transfer-based readout approach that is sensitive to small volumetric changes of the smart hydrogel. The concept employs two thin film polyimide substrates with embedded conductive strip lines, which are shielded from each other except at the tip region, where the smart hydrogel is sandwiched in between. The hydrogel's volume change in response to a target analyte alters the distance and orientation of the thin films, affecting the amount of transferred power between the two transducer parts and, consequently, the measured sensor output voltage. With proper calibration, the output signal can be used to determine the swelling change of the hydrogel and, consequently, to quantify the stimulus. In proof-of-principle experiments with glucose- and pH-sensitive smart hydrogels, high sensitivity to small analyte concentration changes was found along with very good reproducibility and stability. The concept was tested with two exemplary hydrogels, but the transduction principle in general is independent of the specific hydrogel material, as long as it exhibits a stimulus-dependent volume change. The application vision of the presented research is to integrate in situ blood analyte monitoring capabilities into standard (micro)catheters. The developed sensor is designed to fit into a catheter without obstructing its normal use and, therefore, offers great potential for providing a universally applicable transducer platform for smart catheter-based sensing.

An Approach for 3D Microprinting Soft Robotic Surgical Tools at 1.5 French Length Scales for Endovascular Interventions

A wide range of endovascular interventions rely on surgical tools such as guidewire-catheter systems for navigating through blood vessels to, for example, deliver embolic materials, stents, and/or therapeutic agents to target sites as well as biopsy tools (e.g., forceps and punch needles) for medical diagnostics. In response to the difficulties in maneuvering such endovascular instruments safely and effectively to access intended sites in the body, researchers have developed an array of soft robotic surgical tools that harness fluidic (e.g., pneumatic or hydraulic) actuation schemes to support on-demand steering and control. Despite considerable progress, scaling these tools down to the sizes required for medical procedures such as cerebral aneurysm treatment and liver chemoembolization have been hindered by manufacturing-induced constraints. To provide a pathway to overcome these miniaturization challenges, this work presents a novel additive manufacturing strategy for 3D microprinting integrated soft actuators directly atop multilumen microfluidic tubing via "Two-Photon Direct Laser Writing (DLW)". As an exemplar, a two-actuator tip was 3D printed onto custom dual-lumen tubing-resulting in a system akin to a 1.5 French (Fr) guidewire with a steerable tip. Experimental results revealed independent actuator control via the discretized lumens, with tip bending of approximately 60° under input pressures of 130 kPa via hydraulic actuation. These results suggest that the presented strategy could be extended to achieve new classes of fluidically actuated soft robotic surgical tools at unprecedented length scales for emerging applications in minimally invasive surgery.

Dual-Frequency Ultrasound Assisted Thrombolysis in Interventional Therapy of Deep Vein Thrombosis

Deep vein thrombosis (DVT) is one of the main causes of disability and death worldwide. Currently, the treatment of DVT still needs a long time and faces a high risk of major bleeding. It is necessary to find a rapid and safe method for the therapy of DVT. Here, a dual-frequency ultrasound assisted thrombolysis (DF-UAT) is reported for the interventional treatment of DVT. A series of piezoelectric elements are placed in an interventional catheter to emit ultrasound waves with two independent frequencies in turn. The low-frequency ultrasound drives the drug-loaded droplets into the thrombus, while the high-frequency ultrasound causes the cavitation of the droplets in the thrombus. With the joint effect of the enhanced drug diffusion and the cavitation under the dual-frequency ultrasound, the thrombolytic efficacy can be improved. In a proof-of-concept experiment performed with living sheep, the recanalization of the iliac vein is realized in 15 min using the DF-UAT technology. Therefore, the DF-UAT can be one of the most promising methods in the interventional treatment of DVT.

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.

Robust and self-lubricating polyvinyl alcohol tubes with a mucosa-like hierarchical architecture for endotracheal intubation

Mechanical mismatch between interventional intubation tubes and human tissues often triggers inevitable friction and causes secondary injury to patients during interventional therapy. Herein, we propose a fabrication strategy of a self-lubricating polyvinyl alcohol (PVA) tube by industrial extrusion technology followed by simple infiltration with water. First, biocompatible glycerin was introduced to weaken the intrinsic hydrogen interaction of PVA by new molecular complexation, broadening the gap between the melting and decomposition temperatures and enabling the stable extrusion of the PVA tube. Subsequently, the as-prepared PVA tube was infiltrated with an aqueous solution to construct a strong hydrogen bonding network between PVA and water molecules, forming a soft hydration layer similar to the upper epithelium layer of mucosa. Benefiting from the solid and liquid properties of the hydration layer as well as the small proportion relative to the whole, the infiltrated PVA tube exhibited excellent hydration lubrication behavior and robust mechanical property. The friction coefficient, tensile strength and elongation at break were measured to be 0.05, 26.2 MPa and 654%, respectively, surpassing the values of 0.5, 16.4 MPa and 240% observed in a commercial polyvinyl chloride tube. In vitro, the PVA intubation tube demonstrated significant biocompatibility, and short-term exposure exhibited minimal impacts on the morphology and proliferation of L929 cells. Ultimately, the potential of the infiltrated PVA tube for interventional intubation was demonstrated successfully using an in vivo rabbit model, providing a new idea for the follow-up development of interventional intubation tubes.

Microelectronic Morphogenesis: Smart Materials with Electronics Assembling into Artificial Organisms

Microelectronic morphogenesis is the creation and maintenance of complex functional structures by microelectronic information within shape-changing materials. Only recently has in-built information technology begun to be used to reshape materials and their functions in three dimensions to form smart microdevices and microrobots. Electronic information that controls morphology is inheritable like its biological counterpart, genetic information, and is set to open new vistas of technology leading to artificial organisms when coupled with modular design and self-assembly that can make reversible microscopic electrical connections. Three core capabilities of cells in organisms, self-maintenance (homeostatic metabolism utilizing free energy), self-containment (distinguishing self from nonself), and self-reproduction (cell division with inherited properties), once well out of reach for technology, are now within the grasp of information-directed materials. Construction-aware electronics can be used to proof-read and initiate game-changing error correction in microelectronic self-assembly. Furthermore, noncontact communication and electronically supported learning enable one to implement guided self-assembly and enhance functionality. Here, the fundamental breakthroughs that have opened the pathway to this prospective path are reviewed, the extent and way in which the core properties of life can be addressed are analyzed, and the potential and indeed necessity of such technology for sustainable high technology in society is discussed.

Mechanically-Guided 3D Assembly for Architected Flexible Electronics

Architected flexible electronic devices with rationally designed 3D geometries have found essential applications in biology, medicine, therapeutics, sensing/imaging, energy, robotics, and daily healthcare. Mechanically-guided 3D assembly methods, exploiting mechanics principles of materials and structures to transform planar electronic devices fabricated using mature semiconductor techniques into 3D architected ones, are promising routes to such architected flexible electronic devices. Here, we comprehensively review mechanically-guided 3D assembly methods for architected flexible electronics. Mainstream methods of mechanically-guided 3D assembly are classified and discussed on the basis of their fundamental deformation modes (i.e., rolling, folding, curving, and buckling). Diverse 3D interconnects and device forms are then summarized, which correspond to the two key components of an architected flexible electronic device. Afterward, structure-induced functionalities are highlighted to provide guidelines for function-driven structural designs of flexible electronics, followed by a collective summary of their resulting applications. Finally, conclusions and outlooks are given, covering routes to achieve extreme deformations and dimensions, inverse design methods, and encapsulation strategies of architected 3D flexible electronics, as well as perspectives on future applications.

Magnetically assisted soft milli-tools for occluded lumen morphology detection

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

Stability of navigation in catheter-based endovascular procedures

Endovascular procedures provide surgeons and other interventionalists with minimally invasive methods to treat vascular diseases by passing guidewires, catheters, sheaths and treatment devices into the vasculature to and navigate toward a treatment site. The efficiency of this navigation affects patient outcomes, but is frequently compromised by catheter "herniation", in which the catheter-guidewire system bulges out from the intended endovascular pathway so that the interventionalist can no longer advance it. Here, we showed herniation to be a bifurcation phenomenon that can be predicted and controlled using mechanical characterizations of catheter-guidewire systems and patientspecific clinical imaging. We demonstrated our approach in laboratory models and, retrospectively, in patients who underwent procedures involving transradial neurovascular procedures with an endovascular pathway from the wrist, up in the arm, around the aortic arch, and into the neurovasculature. Our analyses identified a mathematical navigation stability criterion that predicted herniation in all of these settings. Results show that herniation can be predicted through bifurcation analysis, and provide a framework for selecting catheter-guidewire systems to avoid herniation in specific patient anatomy.

Responsive Magnetic Nanocomposites for Intelligent Shape-Morphing Microrobots

With the development of advanced biomedical theragnosis and bioengineering tools, smart and soft responsive microstructures and nanostructures have emerged. These structures can transform their body shape on demand and convert external power into mechanical actions. Here, we survey the key advances in the design of responsive polymer-particle nanocomposites that led to the development of smart shape-morphing microscale robotic devices. We overview the technological roadmap of the field and highlight the emerging opportunities in programming magnetically responsive nanomaterials in polymeric matrixes, as magnetic materials offer a rich spectrum of properties that can be encoded with various magnetization information. The use of magnetic fields as a tether-free control can easily penetrate biological tissues. With the advances in nanotechnology and manufacturing techniques, microrobotic devices can be realized with the desired magnetic reconfigurability. We emphasize that future fabrication techniques will be the key to bridging the gaps between integrating sophisticated functionalities of nanoscale materials and reducing the complexity and footprints of microscale intelligent robots.

Self-folding soft-robotic chains with reconfigurable shapes and functionalities

Magnetic continuum soft robots can actively steer their tip under an external magnetic field, enabling them to effectively navigate in complex in vivo environments and perform minimally invasive interventions. However, the geometries and functionalities of these robotic tools are limited by the inner diameter of the supporting catheter as well as the natural orifices and access ports of the human body. Here, we present a class of magnetic soft-robotic chains (MaSoChains) that can self-fold into large assemblies with stable configurations using a combination of elastic and magnetic energies. By pushing and pulling the MaSoChain relative to its catheter sheath, repeated assembly and disassembly with programmable shapes and functions are achieved. MaSoChains are compatible with state-of-the-art magnetic navigation technologies and provide many desirable features and functions that are difficult to realize through existing surgical tools. This strategy can be further customized and implemented for a wide spectrum of tools for minimally invasive interventions.

Medical microrobots in reproductive medicine from the bench to the clinic

Medical microrobotics is an emerging field that aims at non-invasive diagnosis and therapy inside the human body through miniaturized sensors and actuators. Such microrobots can be tethered (e.g., smart microcatheters, microendoscopes) or untethered (e.g., cell-based drug delivery systems). Active motion and multiple functionalities, distinguishing microrobots from mere passive carriers and conventional nanomedicines, can be achieved through external control with physical fields such as magnetism or ultrasound. Here we give an overview of the key challenges in the field of assisted reproduction and how these new technologies could, in the future, enable assisted fertilization in vivo and enhance embryo implantation. As a case study, we describe a potential intervention in the case of recurrent embryo implantation failure, which involves the non-invasive delivery of an early embryo back to the fertilization site using magnetically-controlled microrobots. As the embryo will be in contact with the secretory oviduct fluid, it can develop under natural conditions and in synchrony with the endometrium preparation. We discuss the potential microrobot designs, including a proper selection of materials and processes, envisioning their translation from bench to animal studies and human medicine. Finally, we highlight regulatory and ethical considerations for bringing this technology to the clinic.

Self-vectoring electromagnetic soft robots with high operational dimensionality

Soft robots capable of flexible deformations and agile locomotion similar to biological systems are highly desirable for promising applications, including safe human-robot interactions and biomedical engineering. Their achievable degree of freedom and motional deftness are limited by the actuation modes and controllable dimensions of constituent soft actuators. Here, we report self-vectoring electromagnetic soft robots (SESRs) to offer new operational dimensionality via actively and instantly adjusting and synthesizing the interior electromagnetic vectors (EVs) in every flux actuator sub-domain of the robots. As a result, we can achieve high-dimensional operation with fewer actuators and control signals than other actuation methods. We also demonstrate complex and rapid 3D shape morphing, bioinspired multimodal locomotion, as well as fast switches among different locomotion modes all in passive magnetic fields. The intrinsic fast (re)programmability of SESRs, along with the active and selective actuation through self-vectoring control, significantly increases the operational dimensionality and possibilities for soft robots.

Unlocking the promise of mRNA therapeutics

The extraordinary success of mRNA vaccines against coronavirus disease 2019 (COVID-19) has renewed interest in mRNA as a means of delivering therapeutic proteins. Early clinical trials of mRNA therapeutics include studies of paracrine vascular endothelial growth factor (VEGF) mRNA for heart failure and of CRISPR-Cas9 mRNA for a congenital liver-specific storage disease. However, a series of challenges remains to be addressed before mRNA can be established as a general therapeutic modality with broad relevance to both rare and common diseases. An array of new technologies is being developed to surmount these challenges, including approaches to optimize mRNA cargos, lipid carriers with inherent tissue tropism and in vivo percutaneous delivery systems. The judicious integration of these advances may unlock the promise of biologically targeted mRNA therapeutics, beyond vaccines and other immunostimulatory agents, for the treatment of diverse clinical indications.

Multicomponent and multifunctional integrated miniature soft robots

Miniature soft robots with elaborate structures and programmable physical properties could conduct micromanipulation with high precision as well as access confined and tortuous spaces, which promise benefits in medical tasks and environmental monitoring. To improve the functionalities and adaptability of miniature soft robots, a variety of integrated design and fabrication strategies have been proposed for the development of miniaturized soft robotic systems integrated with multicomponents and multifunctionalities. Combining the latest advancement in fabrication technologies, intelligent materials and active control methods enable these integrated robotic systems to adapt to increasingly complex application scenarios including precision medicine, intelligent electronics, and environmental and proprioceptive sensing. Herein, this review delivers an overview of various integration strategies applicable for miniature soft robotic systems, including semiconductor and microelectronic techniques, modular assembly based on self-healing and welding, modular assembly based on bonding agents, laser machining techniques, template assisted methods with modular material design, and 3D printing techniques. Emerging applications of the integrated miniature soft robots and perspectives for the future design of small-scale intelligent robots are discussed.

Heat-Mitigated Design and Lorentz Force-Based Steering of an MRI-Driven Microcatheter toward Minimally Invasive Surgery

Catheters integrated with microcoils for electromagnetic steering under the high, uniform magnetic field within magnetic resonance (MR) scanners (3-7 Tesla) have enabled an alternative approach for active catheter operations. Achieving larger ranges of tip motion for Lorentz force-based steering have previously been dependent on using high power coupled with active cooling, bulkier catheter designs, or introducing additional microcoil sets along the catheter. This work proposes an alternative approach using a heat-mitigated design and actuation strategy for a magnetic resonance imaging (MRI)-driven microcatheter. A quad-configuration microcoil (QCM) design is introduced, allowing miniaturization of existing MRI-driven, Lorentz force-based catheters down to 1-mm diameters with minimal power consumption (0.44 W). Heating concerns are experimentally validated using noninvasive MRI thermometry. The Cosserat model is implemented within an MR scanner and results demonstrate a desired tip range up to 110° with 4° error. The QCM is used to validate the proposed model and power-optimized steering algorithm using an MRI-compatible neurovascular phantom and ex vivo kidney tissue. The power-optimized tip orientation controller conserves as much as 25% power regardless of the catheter's initial orientation. These results demonstrate the implementation of an MRI-driven, electromagnetic catheter steering platform for minimally invasive surgical applications without the need for camera feedback or manual advancement via guidewires. The incorporation of such system in clinics using the proposed design and actuation strategy can further improve the safety and reliability of future MRI-driven active catheter operations.