A limitation of both the two-step and three-step Follicular Unit Extraction (FUE) techniques is that when rotating traditional punch instruments manually, it is literally impossible to maintain a straight coring path. This results in poor alignment with the hair follicles and increased damage to the follicles due to transection. In longer harvesting sessions, the fingers and hand would fatigue due to extensive manual rotation of the coring instrument and this would also result in increased transection and decreased yield.
In addition, the punches that the surgeon used tended to clog with tissue debris during the procedure which required him to pause from time to time to clear the lumen. This not only wastes time, but occasionally damages the punch tip.
A final issue was the lack of control over the depth of penetration of the scalp causing the instrument to sometimes penetrate too deeply into the scalp, causing unnecessary bleeding, or to not core deep enough, thereby ineffectively freeing the grafts.
RotoCore is a new instrument that addresses the above inefficiencies through:
- Automatic rotation
- Ergonomic handle with grip
- Debris disposal window
- Penetration depth spacers
Follicular Unit Extraction
Automatic rotation of the punch tip occurs when downward pressure is placed on the RotoCore handle. When the pressure is released, the punch rotates back to its initial position. This obviates the need to manually rotate the device while coring out follicular units. The instrument’s simple and straightforward downward motion minimizes surgeon fatigue and decreases the potential of long-term disability, such as carpal-tunnel syndrome. Most importantly, it minimizes deviations from the coring path and thus decreases transection.
Unlike conventional punches, the length of the RotoCore punch is short which reduces the risk of debris clogging the lumen before exiting the debris disposal window. This opening is located near the junction of the shaft and hollow punch. As a result, the disposal process is quick and harmless to the punch tip.
The instrument is equipped with penetration depth spacers. At the start of the procedure, the physician can measures the scalp depth and determines how many depth spacers to place over the punch. The punch length can be adjusted from 2mm to 6mm in 1mm increments. The device’s ergonomic handle and tactile grip prevents the gloved hand from slipping when wet and decreases hand fatigue, particularly in long hair transplant sessions.
By: Dr. Robert M. Bernstein
Updated: 2015-05-22 | Published: 2009-07-23