• Welcome to Hair loss Experiences hair loss forum.

    Free impartial hair loss advice, hair transplant advice, hair loss medications and hair loss news.
    You can contact us directly at [email protected] if you experience any problems.

The Artas can now do Automated Graft selection

bullitnut

bullitnut

4 awesome repairs with SMG
Intersting article about the improvements to the ARTAS.
Dr Bernstein has introduced robotic follicular unit graft selection using the ARTAS ® Robotic System at the 2015 ARTAS User Group Meeting in Newport Coast, CA. By automatically selecting follicular units with two or more hairs, the robot can harvest the number of donor hairs needed to achieve the greatest cosmetic benefit in the transplant while creating the least amount of wounding to the scalp.
using the ARTAS Robotic System. In adding this new capability to the robot, Dr. Bernstein and his colleagues at Restoration Robotics, Inc. have automated another important step in the Follicular Unit Extraction (FUE) procedure, a step that until now needed to be performed by hand. The goal of the new function is for the robot to automatically obtain the maximum number of donor hairs with the least amount of wounding and the greatest cosmetic benefit for the patient. Dr. Bernstein introduced the graft selection capability at the 2015 ARTAS User Group Meeting on February 7th, 2015 in Newport Coast, CA.
How Does it Work?
In robotic graft selection, the hair restoration surgeon programs the ARTAS robot to harvest follicular units which contain two or more hairs by selectively skipping over the 1-hair units. Using its advanced optical guidance system, the robot orients itself to the scalp by way of special markings on a tensioner, a plastic frame-like device that is positioned on the donor area. Once the robotic arm is in place, the software rapidly analyzes each graft and selects the appropriate ones for extraction. It then dissects these follicular units from the surrounding scalp tissue.
The Importance of Graft Selection in FUE
In FUE procedures, the surgeon wants to harvest as much donor hair as possible while leaving the fewest number of wounds. To minimize the number of wounds, the choice is clear: extract only the units that contain the largest amount of hair. However, smaller grafts of 1-hair are typically needed to create a natural-looking hairline and temples. By selecting and extracting larger grafts first, and then extracting smaller ones only as needed, surgeons can both minimize wounding and harvest an adequate number of follicular units of varying size so as to enhance the cosmetic benefit of the procedure. Smaller grafts can be generated by dividing the larger grafts without increasing the donor wounding.
ARTAS Robotic System: Graft Selection Capability
The ARTAS system, launched in 2011 by Restoration Robotics, Inc. (San Jose, CA), currently selects follicular units irrespective of their hair content. However, Dr Bernstein and the robot €™s software engineers have developed an algorithm that allows the surgeon more flexibility in how it selects grafts for extraction. If too few smaller units are extracted, the surgeon can either program a second pass to harvest some of the skipped over 1-hair FUs or the surgical team can dissect some of the larger units into smaller units using stereo-microscopic dissection. By enhancing the sensitivity of the graft selection software and allowing for one or two passes at extraction, the robot will be able to intelligently harvest follicular units based on the surgeon €™s, and ultimately the patient €™s, hair restoration needs.
Robotic Graft Selection Pilot Study Underway at Bernstein Medical
Bernstein Medical has completed an initial bilateral pilot study to determine the optimal configuration of the robot €™s new capability. The study looked at robotic harvesting when graft selection is disabled, enabled with one pass at extracting follicular units, and enabled with two passes. In the two pass setting, the robot first extracts only follicular units with two or more hairs, then goes back for a second pass to extract 1-hair grafts that were skipped in the first pass. Harvesting with graft selection disabled was the control for the study.
Results showed that with graft selection enabled, both the first pass and second pass at harvesting showed improvement over the control (10.6% and 7.7% respectively) in hairs extracted per harvest attempt.
While further data is needed to determine which setting is optimal given a patient €™s needs, the study serves as a proof of concept that the robot can increase the efficiency of the harvesting process by intelligently selecting grafts for extraction. The results also highlight the fact that different graft selection settings can be applied to suit a patient €™s cosmetic need. The surgeon can further improve the yield by splitting larger follicular units into smaller ones using stereo-microscopic dissection. With a combination of robotic graft selection and splitting follicular units as needed, the surgeon can yield more grafts with fewer harvest attempts and thus less donor wounding.
Dr. Bernstein will continue to collect data until the sample size is sufficient to produce statistically significant results. He intends to publish his findings this year.
Automating FUE & Improving the ARTAS Robot
With his work in robotic follicular unit selection, Dr. Bernstein continues to pioneer advancements in robotic hair transplantation by improving the ARTAS Robotic System €™s harvesting capabilities, making the entire procedure more compelling for patients. These techniques enhance robotic FUE hair transplants based on the hair loss characteristics of each individual patient.
 
topccat29

topccat29

29 year HT veteran
So let me get this straight. You take a follicular unit that is larger then what you need using a larger punch and then you start dissecting it to make it smaller €¦ €¦ €¦ €¦ €¦ €¦that €™s amazing €¦ €¦ €¦ €¦..really it €™s amazing that someone would need do that extra step.

Makes me want to laugh a little bit.
 
bullitnut

bullitnut

4 awesome repairs with SMG
I'm confused?what do you mean taking larger than needed then disecting dude, to me it reads that they can take the 2/3 hair follicular units first to minimise the amount of wounding and then On a second pass they get the one hair Fu's needed for hairline/temple work.
 
janna

janna

Moderator
I think Dr. Bernstein is saying the Artas will select only the 2+ hair grafts instead of selecting single hairs, 2's, 3's & 4's like it has in the past. Since singles hairs are needed in the frontal hairlines for naturalness, some of the 2+ hair grafts will be dissected down by techs to single hairs. So, if the Artas robot harvested a 1000 2+ hair grafts but you need 400 singles, some of the 2+ hairs will be dissected down and you'll have 1400 grafts. The donor area will only have 1000 grafts taken out leaving less wounds. This technique is not new to fue performed by hand however.
 
topccat29

topccat29

29 year HT veteran
One only needs to look at the best fue work out there and they use a selection of punch sizes to accommodate the follicular unit. They do not use one larger size punch on each and every follicular unit then rationalize by stating that they are able to focus only on multihair grafts.

So yes they have less extractions larger in size. Most patients probably would opt for smaller extractions and more of them if it €™s has the potential to be less visible so why not explain all this €¦ €¦ €¦ €¦you know what I mean dude. It's like people only say what they want others to hear.

And yes I agree Janna I €™m sure some dissection goes on as there may be no choice for other reasons. I don't perform hair transplantation but common sense would probably apply.
 
Last edited:
C

Coopman

Valued member
In respect of using a larger punch size. There are a lot of guys whom have had Fue and have decided to buzz their heads and have SMP.

Maybe their HT did not meet their expectations, maybe they were never really a suitable candidate, maybe they progressed to a NW 6-7 and decided they just never have the required donor hair for adequate density.

But if you read some of the stories over at The His Hair Clinic forum, where people have shared their stories. You will find many people who have buzzed their heads and been shocked at their Fue scarring. I mean these are really big circular dots where the skin is paler than the surrounding area, where the graft was extracted. Im only guessing but I assume these were 1.0-1.1mm punch extractions, but I did not expect that level of scarring.
 
Last edited:
topccat29

topccat29

29 year HT veteran
I had one repair patient in particular that I have known a long time. About 10 years ago he told me €œThe bastard used a f**king 1.0 mm punch on my head. He lied to me and told me it was a .75 and now I have shotgun scarring all over my head € €¦ €¦ €¦ €¦ €¦ €¦ €¦maybe I take all this took personally and feel the need to speak for others when I read something that sounds like complete horseshit to me. BTW he was referring to a well known doctor in the States and not Bernstein to be a little bit clearer.


Please excuse my eagerness to always comment.

I agree with BM the more information one has regardless of if everyone's views are different the better. That is how one forms their own opinion.

Bernstein did send me his book so I'm not saying he's not a nice guy. But when it comes to cosmetic surgery I am firm on not settling for anything except what I believe is the best.
 
Last edited:
Bigmac

Bigmac

Administrator
Staff member
I appreciate Dr Bernstein posting information on the Artas as it gives an insight into what they think and believe are beneficial to the Ht industry. It also gives the general public a chance to give their opinions on the Artas and discuss its benefits or downfalls.

 
Top