Kidney Stone Dissolution By Tetherless, Enzyme-Loaded, Soft Magnetic Miniature Robots.

Kidney stones are some of the most common urinary diseases, affecting 12% of the population. The high prevalence and recurrence of this disease urges the development of more targeted and effective treatment with lower side effects and less invasiveness avoiding recurrence and prolonged drug administration. Particularly for recurring stone formers, the current methods of persistent drug treatment and repetitive surgeries for stone removal are unsatisfying solutions that bring a huge burden to the patients and healthcare systems. For these reasons, a delivery strategy that provides drug administration at the disease site through active, wireless transport is urgently needed to improve urinary tract disease treatment. A wireless treatment of kidney stones is proposed with the help of flexible, magnetically steered, enzymatically active robots. These robots are designed to navigate in the urinary tract and locally dissolve the stones by action of embedded urease. The robots are made of millimeter-sized, gelatin-based polymer strips with embedded micromagnets and encapsulated urease which constantly converts urea to increase urinary pH. This study demonstrates enhanced stone dissolution and the robots' magnetic navigation through the different parts of a 3D printed human urinary tract model. A clinical ultrasound system allows real-time localization of the robots. This research proposes a less invasive and more targeted strategy for medical interventions in the urinary tract with potential to circumvent surgery in case of uric acid kidney stones, which is relevant especially in the light of high prevalence and recurrence of kidney stones.