Our View on Robotic Systems for Hair Transplants

27 Dec, 2022

Origin of Robotic hair transplants

Did you know that “ARTAS” was developed as the first physician-assisted robotic system in hair transplant by the same team behind Da Vinci system? Let us spare a few lines about The “Da Vinci” surgical system and you will appreciate why we are telling you this.

The “Da Vinci” surgical system (for various surgeries, but not hair transplant) is the most popular robotic system in the world, whose insect-like arms are operated by a Surgeon sitting at a control booth. When this system was introduced, most Surgeons felt threatened that robots will replace them. Of course, this never happened. And as they worked together, surgeons valued the precision and efficiency of robotics coupled with their own knowledge . There was another benefit. As physicians grew older and lost some dexterity, robots allowed them to operate with precision.

However, the team realized that hair transplant surgeries were very different as it is a unique combination of not only precision surgery but also an artisan’s approach and therefore needs higher physician supervision.

Evolution of roles of Robotic hair transplants

The earlier generations of ARTAS (Generations 3X to 9X) focused on extraction with every new model improving on speed. ARTAS iX is the next generation model which does implantation also.

ARTAS stands for ‘ART’ and ‘SCIENCE’ of robotic hair restoration. As per the CEO of US-based company “Restoration Robotics” that owns ARTAS, “ARTAS is a support technology, not a replacement technology. It is an important tool, but its success depends on the user of tool i.e. hair transplant Doctor.”

Reflecting back, ARTAS was devised keeping in mind that 80% doctors frequently use Assistants/ Technicians to place grafts. And that is why FUT is still popular technique in this world, even though it is archaic in many ways and causes linear scars. Due to this, many questions were raised. Do these Assistants have skill and training? Do they get tired during procedure? Do they care? How can we make this process more efficient?

Thus, a key role for ARTAS became to eliminate human fatigue for repetitive tasks subject to Doctor supervision.

ARTAS comes with a “Hair Studio” tool, which a consultant uses to walk around the patient with an iPad to render a 3D model in 40 seconds. A drawing is made on digital image to show how patient would look with a prescribed treatment plan. Using Hair Studio, company claims to have a 60% conversion rate. So ARTAS works very well as a marketing tool! But does it give the desired result to patients with precise angle, depth, density and natural look? That depends entirely on the doctor’s skill.

Constraints of Robotic Hair Transplants

ARTAS has many inherent limitations. Let us explain further.

  1. Unable to make judgement calls: ARTAS cannot make subjective calls on various aspects, where surgeon’s inputs are needed, including right diagnosis, treatment plan, punch size selection, hairline designing, correct depth, angle and direction for implant, and setting realistic patient expectations, to name a few.
  2. Compromised graft handling: In ARTAS, manual work is required to be done by Assistants. For example, Assistants pull out grafts from scalp, store them securely and load them into cartridges using forceps. The machine then pulls each graft from cartridge and implants it one at a time. This two-step process compromises graft handling and survival ratio.
  3. High Transection rates: Tests show a very high 30% transection rate, reduced to 10% only when a highly skilled Surgeon operates machine.
  4. Focus on speed over quality: In hair transplant, speed is not the ultimate goal of the patient, it is the most natural looking result with right density. But ARTAS practitioners do generate a social media buzz around speed.
  5. No impact on results: The results admittedly depend on the surgeon’s skill and ARTAS has no impact on it. Even from the ARTAS brochures, results look unnatural and of poor density.
  6. Extremely expensive: ARTAS iX price starts at $500,000. They also charge much higher costs for doing a hair transplant than any other clinic not adopting ARTAS. Obviously the other costs remain – Surgeon, Assistants, clinic costs etc. Then there is cost of future upgrades. Should the patients pay for such an expensive hair transplant treatment, and what benefits are they getting?

 Conclusion: Robotic hair transplants is a marketing tool to attract patients in the name of technology, but there is no true benefit to them.

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