Next-generation medical nanorobotics: biohybrid systems, AI-guided navigation, and clinical translation challenges

Medical nanorobotics advances nanomedicine by integrating nanotechnology and intelligence into active platforms capable of performing active navigation, real-time monitoring, and controlled therapeutic payload release. This review discusses the design approaches for targeted drug delivery, compares nanorobots with other nanomaterials and traditional nanomedicine, and examines the translational, regulatory, and production challenges associated with their clinical implementation. This review evaluates the architecture of nanorobots, including sensors, actuators, payloads, propellers, power sources, and communication systems. It discusses propulsion mechanisms based on endogenous chemical/enzymatic and exogenous magnetic, electrical, light, and ultrasound stimuli. It also examines fabrication techniques such as roll-up/self-winding, Physical Vapor Deposition, laser direct writing/3D printing, two-photon lithography, template-assisted electrodeposition, self-assembly, and wet chemical synthesis. Compared with conventional nanomaterials, nanorobots have demonstrated enhanced targeting capability, adaptive behavior, and multifunctional operation in preclinical models through guided or semi-autonomous navigation and feedback-controlled drug release. Although promising applications have been reported for cancers, cardiovascular diseases, inflammatory disorders, neurological conditions, ophthalmic diseases, tissue engineering, and dentistry, most systems remain in the preclinical stage owing to challenges such as Brownian motion, limited energy availability, immune clearance, biocompatibility concerns, scalability issues and the lack of established regulatory frameworks. Overall, medical nanorobots represent a promising strategy for precision medicine and targeted drug delivery; however, overcoming biological, technological, manufacturing, and regulatory barriers is essential for successful clinical translation.