Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
Adv Healthc Mater. 2024 Nov;13(29):e2401407. doi: 10.1002/adhm.202401407. Epub 2024 Aug 5.
Untethered microrobots offer the possibility to perform medical interventions in anatomically complex and small regions in the body. Presently, it is necessary to access the upper urinary tract to diagnose and treat Upper Tract Urothelial Carcinoma (UTUC). Diagnostic and treatment challenges include ensuring adequate tissue sampling, accurately grading the disease, achieving completeness in endoscopic treatment, and consistently delivering medications to targeted sites. This work introduces microgrippers (µ-grippers) that are autonomously triggered by physiological temperature for biopsy in the upper urinary tract. The experiments demonstrated that µ-grippers can be deployed using standard ureteral catheters and maneuvered using an external magnetic field. The μ-grippers successfully biopsied tissue samples from ex vivo pig ureters, indicating that the thin-film bilayer springs' autonomous, physiologically triggered actuation exerts enough force to retrieve urinary tract tissue. The quality of these biopsy samples is sufficient for histopathological examination, including hematoxylin and eosin (H&E) and GATA3 immunohistochemical staining. Beyond biopsy applications, the µ-grippers' small size, wafer-scale fabrication, and multifunctionality suggest their potential for statistical sampling in the urinary tract. Experimental data and clinical reports underscore this potential through statistical simulations that compare the efficacy of µ-grippers with conventional tools, such as ureteroscopic forceps and baskets.
无缆微型机器人为在身体解剖结构复杂和狭小的区域进行医学干预提供了可能。目前，需要进入上尿路来诊断和治疗上尿路尿路上皮癌（UTUC）。诊断和治疗方面的挑战包括确保有足够的组织取样、准确分级疾病、在内镜治疗中达到完全性以及将药物持续递送到靶向部位。本工作介绍了可通过生理温度自动触发用于在上尿路进行活组织检查的微夹（µ-grippers）。实验表明，µ-grippers 可以使用标准输尿管导管进行部署，并可以通过外部磁场进行操纵。μ-grippers 成功地从离体猪输尿管采集了组织样本，这表明薄膜双层弹簧的自主、生理触发致动能够产生足够的力来取回尿路组织。这些活检样本的质量足以进行组织病理学检查，包括苏木精和伊红（H&E）和 GATA3 免疫组织化学染色。除了活检应用之外，µ-grippers 的小尺寸、晶圆级制造和多功能性表明它们在尿路中的统计采样方面具有潜力。通过与传统工具（如输尿管镜活检钳和篮子）的功效进行统计模拟的实验数据和临床报告强调了这一潜力。
