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For most people the phrase “medical robot” probably brings to mind the ground-breaking da Vinci surgical system that has revolutionized minimally-invasive surgery. Either that or the 2-1B droid from Star Wars: the Empire Strikes Back if you’re a sci-fi nerd.
But some of the most exciting progress in medical robotics is actually taking place at the micro and nano-scales. A recent review study in the journal Science Robotics highlights that materials and biomedical science have started to come together to create a new breed of miniature robots able to deliver drugs, carry out precision surgery and dramatically improve diagnostics.
“Designing miniaturized and versatile robots of a few micrometers or less would allow access throughout the whole human body, leading to new procedures down to the cellular level and offering localized diagnosis and treatment with greater precision and efficiency,” the authors write.
Designing devices on this scale has some major challenges, though—first and foremost, movement. Micro and nano-scale machines operate in low-Reynolds number environments, which essentially means inertia plays almost no role. At this scale they are also subject to Brownian motion—constant bombardment by the atoms or molecules that make up the gas or liquid they are in and causes them to move erratically.
This means that traditional swimming and navigation strategies that would be used in macro-scale robots often don’t work, and so novel approaches have to be devised, often inspired by the micro-organisms that share this environment. At the same time, conventional approaches to powering devices like batteries can’t be scaled down to this level, so researchers instead have to rely on chemically-powered motors using fuels found in the environment, or external power sources like magnetic fields or ultrasound.
But despite the onerous constraints, the authors highlight that scientists have managed to demonstrate a host of miniature robots that are able to navigate through complex biological environments to remove biopsy samples, deliver drugs and diagnose disease. Here are four areas where these tiny devices are proving to be promising approaches to medical problems.
Targeted drug delivery
Nanotechnologists working on drug delivery is nothing new, but most existing solutions rely on the body’s natural circulatory system to get medicine where it needs to go. By using miniature robots, though, it’s possible to get drugs to their destination faster and more accurately, which can make them more effective and also reduce side effects from powerful drugs.
A popular strategy for propelling these vehicles are chemical nanomotors—tiny particles whose make-up causes them to break down a chemical fuel to create bubbles that propel them forward. Often the fuel has to be added along with the nanomotor, and the review notes that most of these studies have happened in the test tube rather than in living organisms.
But recently, in vivo experiments have started to become more common, with promising results including synthetic motors powered by biological fluids such as gastric acid or water. Many of these solutions also degrade to non-toxic substances, removing the problem of having to retrieve them after they’ve fulfilled their purpose.
There have also been in vivo demonstrations of delivery devices powered using external sources such as magnetic fields or ultrasound. In one particularly impressive study, researchers co-opted bacteria that naturally swim along magnetic field lines and towards low oxygen concentrations to act as robots. They attached drug-containing droplets to the bacteria and used magnetic fields to guide them to the oxygen-depleted regions of tumors usually highly resistant to therapies.
Precision surgery
While huge progress has been made to reduce the invasiveness of surgery, nanorobots hold the promise of operations whose only superficial wound is the puncture hole from an injection. They will also be able to operate in hard-to-reach locations and carry out procedures at scale as low as the cellular level.
One promising class of miniature robots are “microgrippers,” which are able to capture and retrieve tissues and cells. Tethered versions of these tools controlled by mechanical or electrical signals have been around for a while, but they are still comparatively large. Now, advances in materials science have opened up the possibility of an untethered version. These devices rely on self-folding capabilities to close around the target tissue and can be triggered by a variety of environmental cues such as temperature or pH.
Magnetically-controlled microrobots also show great promise for surgical procedures due to the ability of magnetic fields to penetrate thick tissue. Researchers demonstrated the ability to carry out surgery inside a living rabbit’s eye using such a device.
Ultrasound can also be used to trigger so-called “microbullets” that reach speeds of six meters per second by vaporizing biocompatible fuel, allowing them to penetrate deep into diseased tissue. Finally, “nanodrillers” can use chemical fuels to power a corkscrew motion that lets them drill and embed themselves into tissues.
Sensing and detoxification
Put a nanomotor in the presence of the correct fuel, and it will keep on moving. This continual motion makes them particularly useful for speeding up both the detection of specific compounds in a solution and the removal of toxins from an environment.
Attach a bioreceptor to a constantly moving nanomotor, and it will collide with its target molecule far faster than if it was simply floating free, essentially creating a self-mixing solution. These devices can even be powerful enough to both detect and transport target cells, while others are small enough to operate inside cells.
In a similar way, self-propelled nanorobots can rapidly target and remove toxins in biological environments. Red blood cells have been shown to be excellent toxin-absorbing nanosponges, and so several approaches have combined red blood cells with nanomotors to create robots capable of absorbing and neutralizing harmful substances.
Future challenges
Despite the progress in the field, the review highlights a number of challenges that need to be addressed. First and foremost is the fact that many of the nanomotors being investigated rely on hydrogen peroxide as a fuel, which is not biocompatible.
While powering nanorobots using magnetic and ultrasound fields is feasible for surgical procedures, many promising applications require the devices to be able to act autonomously, without human intervention. Recent work on nanomotors that use enzymes to power themselves with chemicals found in bodily fluid like glucose or urea are promising, but still require considerable work.
Biological environments are unpredictable places with constantly-changing conditions, so the field needs considerable innovation in materials to create multifunctional, fault-tolerant robots that won’t malfunction outside of narrow comfort zones. Coupling synthetic nanodevices with biological materials is one promising approach to avoiding things like immune responses.
Scaling the production of these devices up to the numbers required for therapeutic purposes at reasonable cost is another challenge that needs to be overcome, with 3D nanoprinting one promising avenue.
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ARTIFICIAL INTELLIGENCE
Facebook Is Using Artificial Intelligence to Help Prevent SuicideAlex Kantrowitz | BuzzFeed"Today, Facebook is introducing an important piece of that technology—a suicide-prevention feature that uses AI to identify posts indicating suicidal or harmful thoughts. The AI scans the posts and their associated comments, compares them to others that merited intervention, and, in some cases, passes them along to its community team for review."
ROBOTICS
Cobalt Robotics Introduces a (Mostly) Autonomous Mobile Security RobotEvan Ackerman | IEEE Spectrum"It [Cobalt's robot] can navigate around pre-mapped areas in buildings, it can recognize people and read badges, and it has a pile of sensors (day-night cameras, lidar, microphone array, RFID and badge readers, and even smoke and CO2 detectors) that helps it to recognize potential security issues (unauthorized people, open doors and windows) and hazards (suspicious items, moved items, water leaks) and flag them for review."

SPACE
SpaceX Plans to Send 2 Tourists Around Moon in 2018Kenneth Chang | The New York Times"Seven space tourists have paid tens of millions of dollars to fly on Russian Soyuz rockets to visit the International Space Station, which is about 200 miles above the Earth’s surface. This would be a much more distant trip. The moon is about a quarter million miles away, and the trajectory would take the capsule 300,000 to 400,000 miles from Earth. No astronauts have ventured beyond low-Earth orbit since the last of NASA’s Apollo moon landings in 1972."
GADGETS
What's Causing the Sudden Boom in 360 Videos in Your Social Feeds?Elizabeth Woyke | MIT Technology Review"We experience the world in 360 degrees, surrounded by sights and sounds. Until recently, there were two main options for shooting photos and video that captured that context: use a rig to position multiple cameras at different angles with overlapping fields of view or pay at least $10,000 for a special camera."

SECURITY
White Hat Hackers Warn of Easy to Hack Household RobotsLorenzo Franceschi-Bicchierai | Vice MOTHERBOARD"Cesar Cerrudo and Lucas Apa said they looked into the security of the SoftBank Robotics' NAO and Pepper, the UBTECH Robotics' Alpha 1S and Alpha 2, the ROBOTIS' OP2 and THORMANG3, among others, and found more than 50 bugs in their ecosystem. These robots have so many vulnerabilities, Cerrudo said, that he wouldn't have them always on if he owned one."

SILICON VALLEY
As Uber Melts Down, Its CEO Says He 'Must Fundamentally Change'Adrienne LaFrance | The Atlantic"After a stunning month of scandals at Uber, Kalanick, its founder and CEO, sent an emotional and uncharacteristically apologetic memo to his employees Tuesday night. “This is the first time I’ve been willing to admit that I need leadership help,” Kalanick wrote. 'And I intend to get it.'"
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Are we ready for cyborgs? More specifically, people with implants that enhance beyond the superficially cosmetic and into the realms of evolved beings?
Jorge Pelegrín-Borondo (Universidad de La Rioja), Eva Reinares-Lara (Universidad Rey Juan Carlos) and Cristina Olarte-Pascual (Universidad de La Rioja), in cooperation with Professor Kiyoshi Murata, from Meiji University in Tokyo, believe society is ready for this melding of (hu)man and machine.
The Spanish academics’ report "Assessing the acceptance of technological implants (the cyborg): Evidences and challenges" has just been released in the scientific journal Computers in Human Behavior. The report shows a significant proportion of those surveyed are comfortable with the coming cyborg modifications. The group are also collaborating with other academics across the world, including Professor Kiyoshi Murata, for a comparative cross-cultural study roundtable at the 2017 ETHICOMP conference this summer in Turin, Italy.
Quick background: There are already the accepted medical examples: Cochlear implants, pacemakers, cardioverter defibrillators, catheters and heart valves, as well as those that incorporate technology into the body through sensory prostheses: exoskeletons, neuroprostheses, and deep brain stimulation. Then there’s the underground biohacking and transhumanism movement, with Amal Graafstra and his double RFID implants as a notable exponent (you can see him in demo mode here).
Unsurprisingly, tech giants are also looking into the cyborg field, experimenting in the lab and registering intriguing patents: Motorola is investigating a neck implant to improve cellular reception and Nokia might be developing a tattoo that vibrates.
We spoke to the report’s three authors via email recently. In a series of conversations, they explained the theory behind the report, ethical and evolutionary implications of “insideables,” and whether they’d go under the knife to achieve cyborg elite status.
How did the term “insideables” come about? Was it to distinguish from “wearables,” which are attached to, but not part of, the body?
We initially called them T3ICs (Technological Implants to Increase Innate Capacities). However, we later learned of the work of Lucien Engelen, director of the REshape Center for Health(care) Innovation, who used the term “insideables.”
What sort of surgically-inserted objects count as insideables?
Insideables are electronic devices implanted in the human body that interact with the user to increase innate human capacities, such as mental agility, memory, or physical strength, or to give us new ones, such as the ability to control machines remotely.
But this is over and beyond the current medical field, right?
Yes. It is important to distinguish between insideables and medical implants. Unlike medical implants, insideables are not implanted for medical reasons (although they may enhance our health).
Needless to say, there are anthropological, philosophical, and ethical questions surrounding the implantation of electronic devices to improve capacities as opposed to for therapeutic (health) reasons.
In your study you refer to “Cyborg Theory.” Can you explain what that means?
In the field of computational theory of the mind and in cyborg theory (“cyborg” refers to a blend of the human and the mechanical), the human body is viewed as a machine. The integration of this technology in the body could be seen as an evolutionary leap for the species, whereby reasonable people will improve their capacities as much as technology allows.
The Ministry of Economy and Competitivity (Spain) funded your study. Does that mean Spain is vying to become the center of cyborg theory and insideables manufacturing?
Initially, we received funding from the Spanish Ministry of Economy and Competitiveness to conduct the research. Unfortunately, as a result of the Spanish economic crisis, our work is no longer being funded. However, we believe in it, so we are investing our own time and money. At the academic level, there is considerable interest in our work, and several of our papers have been published in high-impact journals, such as Computers in Human Behavior, Psychology and Marketing, and Frontiers in Psychology. From a social and economic standpoint, it has to be remembered that we are dealing with a line of new products with a potentially huge global market. Quite likely, this technology will usher in a level of change on a par with those generated by the advent of the internet or computers.
As authors of the report, if you could have any insideable implanted, what would you choose and why?
Jorge Pelegrín-Borondo (Universidad de La Rioja): I would implant one of the devices whose market acceptance we are currently studying: a memory implant, specifically, one adapted to learning languages. That would give me access to a vast quantity of information about words in other languages. Of course, information and knowledge (i.e. knowing how to apply that information) are two different things.
Cristina Olarte-Pascual (Universidad de La Rioja): I would also choose a memory implant. I would like to be able to revisit all sorts of memories and nice times regardless of where I am, without the need for an external device like a smartphone. I also think they open up new possibilities for communication and interaction with other people.
Eva Reinares-Lara (Universidad Rey Juan Carlos): Personally, I am on the same page as Apple co-founder Steve Wozniak, who has said that the intention to use technological implants on one’s children may be greater than the intention to use them on oneself. While he says he would like to “remain natural” himself, he says he would want his children to have them if, in a few years, the technology was giving other kids certain advantages.
Finally, your report highlights a potential divide between an “implanted elite” and the “masses without body mods.”
Yes, we believe these types of products could greatly exacerbate social differences. We could see the rise of a society consisting of an implanted elite alongside the non-implanted masses, who would be unable to achieve the same levels of development as their implanted counterparts. This will be the focus of our global comparative cross-cultural study roundtable for the 2017 ETHICOMP conference in June.
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