ARTAS & SAFE System Donor Extractions & Healing Comparison

[Bigmac]

I watched the Artas on a patient, i payed particular attention to the punch and scorring of the grafts.

Once the 1mm punch made the incision, it retracts and then the outer diamater punch slides in opening the extraction hole wider by stretching the skin, not cutting it further. The skin then shrinks back to the 1mm ininitial hole.

I like the approach SMG are taking with the Artas by conducting their own patient study and posting the transparent pictures.

 

[garmin333]

Sorry Janna but I fail to see the logic.
You state that you have no problems with your manual FUE.
On the other hand you are now offering a new kind of treatment that has virtually no proven record? I mean, where can I find at least 10 fully outgrown results of this ARTAS machine?
Do you really intend to offer a treatment performed by a robot that uses larger punches?
Why do you offer your patients a robotic solution, I mean I would prefer to have skilled technicians over a robot which may still have some problems (and yes they always have some, I know since I program software for the airplane industry).

 

[janna]

We're offering both robotic and manual. It's not one service over the other. There are advantages and disadvantages with both. There are few reasons as to why we've incorporated the Artas to our practice. One is that we currently have one person who can extract grafts well. What if he's sick or wants to take days off? The FUE procedure is getting more and more popular so "fatigue" was another consideration.

Dr. Shapiro has seen in many instances the quality of the grafts extracted from the Artas. They are similar to what the grafts look like when extracted manually at our clinic. The Artas has made great improvements in last year alone. We know the improvements will be ongoing. The Artas isn't some thing that you turn on and it's automatic for everything. Each aspect of it is controlled and we can evaluate the quality of the grafts after every punch if we want to. If the quality of the grafts look good, then we know yield will be good.

The punch size at our clinic isn't going to be bigger with the Artas. We'll be using the .9mm punch sizes.

Both FUE and Strip procedures are SURGICAL that require a dedicated and skilled physician. FUE is not a "treatment" like some clinics try to believe. Shapiro Medical has these skilled and trusted physicians who are constantly trying to improve their results. We don't keep trying because our current technique is poor. The hair restoration physicians are a small community that share info, studies, and knowledge with each other that they can implement into their practice.

Essentially, the Artas is just another punch tool and how its used will depend on the team running it. One clinic's results with the Artas isn't necessarily the same results achieved at another clinic, which holds true for any procedure.

 

[mattj]

There does seem to be the misconception that ARTAS is something you can just switch on and then go for a round of golf. Thanks Jana for getting to that point.

 

[topccat29]

The point is there are different opinions and those opinions should be stated and welcomed by all. I see it differently as some young kid will not be getting the best outcome possible and sure I could say screw let them learn the hard way like I did but then the HT industry wins. How can anyone with good conscience say that not as good is good enough?

 

[janna]

Who's saying you can't give your opinion? Where does it say it's not welcome? On the other hand, I don't have to embrace or agree with your opinions any more than you have to embrace mine. You call out what you don't believe in - so do I.

 

[topccat29]

Janna it was a rhetorical question but thanks for replying anyway. I have always had good things to say about you, hairtech and the clinic to anyone I have spoken to and yes we can disagree.

 

[hairtech]

Well... um guys/gals... This type of debate is fun and helps all the ghost readers out there... and believe me there are hundreds of readers who are looking for their own research purposes... this banter helps them. Keep it up.

 

[ejj]

agreed Hairtech , healthy debate is good for all

regards

ejj

 

[garmin333]

Janna,
A good debate is indeed a healthy way of communicating.
However you are dodging my questions.

Please clarify:
Who decides whether the patient is offered ARTAS? Is it the patient?

What happens if the patient is set up for ARTAS, but the machine is unable to figure out the extractions and produces cut off grafts. Is the surgeon sitting next to the machine at all times and makes the call??

Please take your time to answer questions.

 

[janna]

garmin333 wrote:

Janna,
A good debate is indeed a healthy way of communicating.
However you are dodging my questions.

Please clarify:
Who decides whether the patient is offered ARTAS? Is it the patient?

What happens if the patient is set up for ARTAS, but the machine is unable to figure out the extractions and produces cut off grafts. Is the surgeon sitting next to the machine at all times and makes the call??

Please take your time to answer questions.

Hi Garmin,

I apologise if you feel I dodged your questions but your previous post was answered by me on Dec. 18, plus hairtech addressed you.

You have new question and rehashed questions so at the risk of being annoying to everyone who reads this post, I'll repeat myself and reword it since you asked so politely.

We did not, I repeat, we did not replace our FUE SAFE Harris system with the Artas robot. We simply added the Artas robot as another viable option for the patients to choose. Each patient decides which technique they want. We don't intend to give up the SAFE Harris technique. There are many instances where the human hands are better just as there will be instances where the robotic technique will be better. The robot will give more consistency across the board with each patient - whether its difficult or easy. Each individual patients have their own characteristics that make it a challenge to extract. But if for some unforeseen reason the Artas cannot extract proper grafts or the transection is high, we have the capability to switch to human hands. To be fair, if its difficult in human hands, we can also switch to the robotic technique. There is either a trained tech or physician or both at the Artas controls at all times. You don't ever set the robot and leave it to work by itself. It actually takes more manpower to run the robot controls than with the SAFE system. I'll also repeat again that we will NOT use a bigger punch with the Artas. We trained with the 1.0mm punch at the beginning because .9mm wasn't available but knew the .9mm punch size is on its way. We use the .9mm SAFE Harris punch and we will be using the .9mm Artas punches soon so we're NOT using a bigger punch. So no need for alarm.

We know each patient has the options to go anywhere for their procedures - Shapiro Medical Group or to any other clinic. Many patients decide on SMG because of our world renown physicians and surgical team with reputation for excellence in using the state of the art technique and for producing natural results for 20 years. SMG's reputation were for strip surgeries, and now, it includes FUE surgeries. Let's say by your logic that Dr. Shapiro never kept up with improvements and advancements in his technique over the years because we were producing solid results years ago. Why would he make any advancements when it's not broke, right? Fortunately, he has the drive to improve and has continued to be an industry leader despite already being a leader.

We are at the beginning stages of the Artas robotic technique so we don't have any results. You'd have to contact Restoration Robotics (company that makes Artas) or clinics who have had it longer than us to guide you in finding their results. It's true that the Artas doesn't have a "proven" track record with patient results online, yet here we are offering it. You ask "why", a fair question. We've only performed handful of patients so far with the Artas but you can see immediately after extractions that the robot can extract better grafts than any human hands who are beginners/inexperienced. Hands down after an hour we know full well which one will have more grafts and better quality grafts. The Artas extracts more like an expert. It stands to reason that in order for a person to become an expert at extracting, you'd have to practice and practice to become an expert, right? We wanted another expert hands for extracting, the Artas provides us with that. That's why we have the robot so that an inexperienced person doesn't have to practice on our patients who are expecting expert extractions. Hope this addresses all your questions. NO intent whatsoever to dodge any of your questions.

So, its your turn - hope you care to share your story and pics. What technique you've selected with which clinic and so on. We'd love to follow your hair loss journey.

 

[MPBsucks1234]

I personally would not want a machine working on my head but it is a viable alternative for those that are comfortable with the machines.

 

[hairtech]

I remember this posting from Harris topcat.

 

[topccat29]

Yes HT he seems to be pointing out just how much larger the surface area of the 1mm punch leaves almost to make a point. I now make the same point 7 years later and what has changed, nothing except maybe the thickness of one €™s pockets and how it can skew their perceptions and their views.

 

[topccat29]

So of course when I see something being stated to the contrary 7 years later it bothers me. It has nothing to do with any specific clinic and that is why no one should take my posting on this subject personal. How would one you guys that post to these forums like to have been one of the first patients using this system where the punches were even larger. Why do I somehow think that those patients were not given all the available information? If this does not bother you than something is very, very wrong. It €™s not okay to go along to get along too many destroyed lives out there.

 

[garmin333]

Here is my analysis Janna,
The ARTAS system does not provide ANY advantages in its current version over manual extractions.
Fatigue is not an issue if you work as a team, I really could not believe when this argument was used as an excuse (big no no if you ask me).
· - Experienced and dedicated FUE clinics do not seem to have problems with the problems you have stated.
· -In my opinion you are now subjecting patients to a robot that will make mistakes (someday something will go wrong).
· -Furthermore you have no outgrown patient reports.
· -On top of that the ARTAS system is unsuitable for difficult cases (it is stated on their own website).
· -Forget ARTAS if you have blond or white hair
· -It only works for people with straight hair
· -It cannot cherry pick the best grafts

My point is that ARTAS makes no sense at all. If ARTAS was able to do the hard cases, then you may have a point, but ARTAS is not suitable for difficult cases.
Look at the Belgian clinics, they seem light years ahead. They are able to extract white hairs, curly hair, have no fatigue issues (better physical condition??). Just go out and look for results from Bisanga, Feriduni, Prohairclinic, all world class FUE clinics with a record of excellent results.

 

[bullitnut]

garmin333 wrote:

Look at the Belgian clinics, they seem light years ahead. They are able to extract white hairs, curly hair, have no fatigue issues (better physical condition??). Just go out and look for results from Bisanga, Feriduni, Prohairclinic, all world class FUE clinics with a record of excellent results.

This is ludicrous IMO ......The Belgium clinics are all world class you mention i agree, but they are NOT light years ahead like you suggest and It's derogatory towards SMG to even suggest this as they have shown many world class FUE results on the forums.
It seems to me by your posts you have an agenda against them in particular, even though the ARTAS is used in many other world class clinics too.

 

[janna]

Bullitnut,

That's alright. To be fair, Shapiro Medical is the one who is showing any info on the Artas so it's understandable to get all the "concerns" addressed to us.

My reply to Garmin333 -

"Here is my analysis Janna,
The ARTAS system does not provide ANY advantages in its current version over manual extractions. " - Garmin333

Here lies the first problem because you're already behind on the "current version". Restoration Robotics has a hard time keeping up with their own advances on their website. I've mentioned the importance of this to them.

"Fatigue is not an issue if you work as a team, I really could not believe when this argument was used as an excuse (big no no if you ask me)." - Garmin333

What's your definition of "a team"? Are you a patient researching or part of a part of "a team" ? Have to ask since you dodged my question about you. I don't mind participating in debates as long as everyone is up front as to who they are.

Clinics I've spoken to and each clinic I've visited in Belgium had more than just one extractor. Aside from Dr. Bisanga who made all the initial punches but then his lead techs would take the grafts out. Why doesn't Dr. Bisanga take them all out too if he wasn't concerned with fatigue? He has made a choice and has a system in place to void fatigue. I mentioned that we have just the one extractor and we want to avoid fatigue in the future. Why is that a "no, no" to mention? I didn't say we have an extractor who is fatigued. Also, what if he's sick or wants to take a vacation? Now, whether to have one or more extractors is a choice made by individual clinics depending on comfort level of each clinic. We didn't want our patients practiced on unless they were aware of it. How many "team members" do you think should extract? If clinics are comfortable with whatever number of techs "learning" on patients until techs got the "experience", that's up to each clinic but it doesn't make them light years ahead, in my opinion. Dr. Feriduni will score and take some of the grafts out but he has 4 or 5 other techs who trained because he didn't want fatigue and didn't want to rely on only himself to take them out. Was this due to fatigue concerns? So there was a period in which these techs had to practice on their patients. This practice time is what we didn't want to do on our patients. It's a matter of preference.


Let's address your other points....

· " - Experienced and dedicated FUE clinics do not seem to have problems with the problems you have stated. -
· -In my opinion you are now subjecting patients to a robot that will make mistakes (someday something will go wrong). " - Garmin333

You are looking into the future as if you have a crystal ball. I stated each part of the Artas is controlled by experienced team of doctors and techs. I addressed this and most of your points already so I wish you'd take your time to read more carefully.

" -Furthermore you have no outgrown patient reports. " - Garmin333

- I'm aware of this as I mentioned this in my above post and our patients who we work on with the Artas are all aware of this fact. Before acquiring the robot, Dr. Shapiro saw the robot in action and saw the quality grafts it can extract. He was very impressed with it.

" -On top of that the ARTAS system is unsuitable for difficult cases (it is stated on their own website).
· -Forget ARTAS if you have blond or white hair
· -It only works for people with straight hair
· -It cannot cherry pick the best grafts

My point is that ARTAS makes no sense at all. If ARTAS was able to do the hard cases, then you may have a point, but ARTAS is not suitable for difficult cases.

Look at the Belgian clinics, they seem light years ahead. They are able to extract white hairs, curly hair, have no fatigue issues (better physical condition??). Just go out and look for results from Bisanga, Feriduni, Prohairclinic, all world class FUE clinics with a record of excellent results." - Garmin333

This is all one point so I'll address it as such... That's the old version and I can see why Artas didn't make sense to you. The Restoration Robotics are making constant improvements. Dr Harris, who has the most experience with the Artas, states white and curly hairs are extractable and good candidates with the Artas. And, you can cherry pick the best grafts.

Dr Feriduni and Dr Bisanga do a mix of strip and FUE procedures and they've shown fair number of excellent results for both types of surgeries. How many excellent cases are presented by Prohairclinic who does all FUE surgeries?

I didn't attempt to visit Prohairclinic in Belgium because I don't believe they have an establish doctor who participates in their surgeries. Maybe I'm wrong but their doctor is there as a legal means to use his license not for his trained expertise in the hair restoration field. Bart from Prohair can correct me on this if his physician has gone through extensive training in Hair Restoration but last time I inquired his new physician's experience, he dodged my question. I personally feel you need the physician to participate in the ongoing advancements in this field with other physicians. These advancements and pearls of the trade are shared with each other and it's invaluable. Myself and other non-physicians do not have the education and training like the physicians to take their place as head of a good surgical team. To say "team" without the doctor is not a true "surgical team". Because like it or not, FUE is surgery. To me, it's techs playing doctors and I think that's dangerous. No amount of talking is going to convince me that they are light years ahead of our clinic or clinics who opt to use different tools than what they use.

Artas is exactly that - a tool. How each clinic utilises this tool will vary from one clinic to another. There are just that many different controls and settings. I cannot speak for every clinic who acquired this tool since each clinic's use of it will vary. I can only speak on behalf of Shapiro Medical's use and experience with it. So, one clinic's result does not represent every other clinic.

 

[Sparky]

Bear in mind that Ron and Paul Shapiro have a great reputation, and shouldn't be tarred with the same brush than less experienced clincs who are planning to use Artas as a replacement for surgical skill.

 

[topccat29]

Speaking as a patient if I had to choose between a tech with skilled hands who has been doing it for years over a robot I would choose the tech. In fact I think the tech Larry Leonard who worked for Cole €™s office is better than 90% of the doctors out there.

It is also my opinion that medical training has absolutely zero to do with punching fue's, was that a special course they needed to take? Punching fue is no different than hitting a 100 mph fastball with a small wooden bat not everyone can do it. It is an eye, hand, and feel coordination skill and only a few can truly be great because they were born that way.

Why exactly is it okay for a doctor to supervise a robot but not a tech?

Extracting is my opinion is a slow tedious job which doesn't require as much skill as punching and some seem to be better equipped to perform this work and if that is a tech and the yield is 100% than it's not an issue.

Anyway all the best in the coming New Year.