Strano, Michael S.

Autonomous robotic-assisted surgery (RAS) has emerged as a promising objective in biomedical technology, further enhanced by miniaturization toward microrobotic-assisted surgery (μ-RAS). This reduction in scale promises minimally invasive, partially or fully automated surgical procedures, with the potential to reduce patient recovery times, lower medical costs, and enable previously unavailable procedural options. This perspective highlights the specific advances in RAS that potentially map to the microscale (μ-RAS), organized across five surgical domains: endovascular, endoluminal, laparoscopic, ophthalmic, and orthopedic. We examine both clinical demands and technological advances in surgical robotics and identify the key innovations required for progress across these surgical fields. Our contribution is distinct in combining the perspectives of both surgical experts and bioengineering innovators, outlining a roadmap for the advancement and eventual integration of autonomous RAS and μ-RAS into mainstream surgical practice.

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly desmoplastic cancer with limited treatment options. There is an urgent need for tools that monitor therapeutic responses in real time. Drugs such as gemcitabine and irinotecan elicit their therapeutic effect in cancer cells by producing hydrogen peroxide (H2O2). In this study, specific DNA-wrapped single-walled carbon nanotubes (SWCNT), which precisely monitor H2O2, were used to determine the therapeutic response of PDAC cells in vitro and tumors in vivo. Drug therapeutic efficacy was evaluated in vitro by monitoring H2O2 differences in situ using reversible alteration of Raman G-bands from the nanotubes. Implantation of the DNA–SWCNT probe inside the PDAC tumor resulted in approximately 50% reduction of Raman G-band intensity when treated with gemcitabine versus the pretreated tumor; the Raman G-band intensity reversed to its pretreatment level upon treatment withdrawal. In summary, using highly specific and sensitive DNA-SWCNT nanosensors, which can determine dynamic alteration of hydrogen peroxide in tumor, can evaluate the effectiveness of chemotherapeutics. Significance: A novel biosensor is used to detect intratumoral hydrogen peroxide, allowing real-time monitoring of responses to chemotherapeutic drugs.

Abstract Colloidal dispersion of single-walled carbon nanotubes (SWCNTs) is often the first processing step to many of their unique applications. However, dispersed SWCNTs often exist in kinetically trapped states where aggregation can be of concern. Recent work revealed prominent DNA–SWCNT aggregation following intravascular injection. In this study, we performed detailed analysis of DNA–SWCNT aggregate formation, structure, and composition in the context of endothelial cell condition media. Interestingly, we found that aggregates formed within condition media from cells that have undergone a stress response differ in size and organization from that of the control. We also found that temperature increases also promote DNA–SWCNT associations. A mathematical model was developed to describe the kinetics of SWCNT extraction from solution. Through orthogonal optical analysis and imaging modalities, we verified that proteins form the bulk of the aggregate structure and dictate aggregate assembly at multiple levels of organization. Finally, physiochemical analysis indicated preferential extraction of low-abundance hydrophobic and charged proteins. The formed aggregates also remain relatively stable in solution, making them potential macroscopic indicators of solution content.