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Robotic Harvesting of Follicular Units

New research on robotic hair transplants conducted at Restoration Robotics, Inc., Mountain View, CA, USA and the Berman Skin Institute, Palo Alto, CA, USA, was presented by Miquen G. Canales, MD and David Berman, MD at the 2008 meeting of the ISHRS. Robotic procedures are currently being used in the areas of prostate surgery and cardiology.  They are now being tested in hair transplantation.  Follicular unit extraction, where hair is moved as individual naturally occurring groups of 1 to 4 hairs, is a highly repetitive and tedious procedure which lends itself to the use of robotics. The development of an image-guided robotic system for follicular unit extraction (FUE) has entered a clinical trial testing phase.  The prototype robotic device is an image guided system composed of a robotic arm, needle punch mechanism, disposable proprietary dermal punches, video imaging system, disposable cartridges, and a user interface.  Its extraction technique consists of a double punch arrangement with an inner (18g) punch and outer (16g) punch. The inner punch has cutting capabilities and the outer punch has a blunt edge used for dissection.  Automating some of the technical skills required in the labor intensive hair transplant procedure is the next logical step in its evolution.  The “potential” advantages of using robotic technology to harvest donor hair in the hair transplant procedure include:

  1. increasing the accuracy of graft harvesting

  2. increasing graft survivalreducing the time for the procedure

  3. potentially decreasing the cost of the procedure

Initial testing, presented at the International Society of Hair Restoration Surgery (ISHRS) meeting in 2007, discussed the safety aspects and feasibility of a robotic device in aiding follicular unit extraction, a type of follicular unit hair transplantation where the follicular unit grafts are extracted one-by-one from the donor area, instead of from a donor strip.  The prototype device had a transection rate of 30%. 

At the 2008 ISHRS meeting, using a more advanced device, graft survivability and transection rates were again examined. The preliminary new results showed at transection rate of 6-15%, significantly better than the year prior, but still not low enough for general use. Modifications of the robotic instrument will continue in order to further reduce transection rates and increase the consistency of the results when used in a broad spectrum of patients.

 

Robotics in Hair Transplantation

Restoration Robotics, Mountain View, CA, has announced that they have developed a robot which can remove and implant hair follicles during a hair transplant procedure. It is designed specifically to facilitate a type of hair restoration procedure called Follicular Unit Extraction, first described in the medical literature by Rassman and Bernstein in 2002.

Restoration Robotics was founded by Dr. Frederick H. Moll, CEO of Hansen Medical, a publicly traded robotics company for invasive cardiac care instruments, and board member of Mako Surgical, an orthopedics robotic company, is considered a leader in the field of robotics.

The company claims that the robot can perform the removal of follicles individually at a rate of up to 1000 per hour through the use of 1-mm hollow needles. The removal is aided by the use of a suction apparatus. The robotic device is then guided by cameras and 3-D imaging softwar.

The technology is still in its developmental stages and clinical trials are ongoing. This robotic device is not yet available for general use.

 



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