Brad Nelson, Editorial Board
ETH Zurich, Switzerland
The impact of robotics on medicine is undeniable. The success of Intuitive Surgical’s Da Vinci system has spurred a number of commercial ventures that have attracted large financial investments, such as Mako Surgical, Auris Medical, Medorobotics, and Mazor Robotics, and these efforts will continue their drive to improve health care in terms of both outcomes and costs. Recently, Google and Johnson & Johnson have teamed with the intention of creating next-generation medical robot systems. Although the clinical robotic systems used to date are assistive and lack any real autonomy, this will certainly change. As our understanding of how to use robotics in the clinic matures, we will continue to develop a deeper understanding of how to create more intelligent, more capable surgical robots. For example, future robots will enable procedures not yet possible, and some will begin taking over portions of the surgical procedure from the surgeon, such as is described in Shademan et al. (2016) and shown in Figure 1.
Figure 1. From “Supervised autonomous robotic soft tissue surgery,” Shademan et al., Sci. Transl. Med. 8, 337ra64 (2016).
As medical robotic systems become established in clinics around the world, one of the next paradigm shifts in the field will come from more precise, less invasive, targeted systems, an emerging area often referred to as micro- and nanorobotics. Micro- and nanorobots are small, motile devices that convert chemical or/and physical energy into mechanical actuation and have the potential to enable minimally invasive treatment and targeted drug/cell delivery with high precision. For active drug delivery strategies, these machines can locally concentrate therapeutic payload around pathologic sites to reduce the dose of administrated drugs and their systemic side effects. Micro- and nanorobots have numerous other applications for health care, especially for localized diagnostics and treatment in areas filled by bodily fluids. The field has made impressive strides over the past decade as researchers have created a variety of small devices capable of locomotion within liquid environments, such as those shown in Figure 2. Robust fabrication techniques have been developed, some devices have been functionalized for potential applications, and therapies are being actively considered; however, much remains to be done. Although excitement remains high for this field, a number of substantial challenges must be addressed head-on if continued progress toward clinical relevance is to be made—for example, the development of biodegradable and non-cytotoxic microrobots, the development of autonomous devices capable of self-directed targeting, catheter-based delivery of microrobots near the target, tracking and control of swarms of devices in vivo, and the pursuit of clinically relevant therapies.
Figure 2. (a) Origami-like 3D functional micromachines fabricated from a composite of hydrogel layers and magnetic nanoparticles. The micromachines possess many possible magnetization modes, which determine their motility when a magnetic field is applied. (b), (c) Time-lapse optical images of two different types of compound micromachines driven by rotating uniform magnetic fields [From “Soft micromachines with programmable motility and morphology,” Hwang et al., Nat. Commun. 7, 12263 (2016)].
Science Robotics encourages the submission of exceptionally high-quality manuscripts that move the field of medical robotics toward more intelligent, capable systems. The journal is particularly interested in highlighting in vivo and first-use-in-human efforts, as well as fundamental advances in micro- and nanorobotics.