Bernstein Medical Center for Hair Restoration - ISHRS 25th Annual Meeting

ISHRS 25th Annual Meeting

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Dr. Bernstein Presenting at ISHRS 2017Dr. Bernstein speaking at the ISHRS in Prague, Czech Republic

Dr. Bernstein gave a presentation on “What’s New in Robotic FUE” at the 25th Annual Conference of the International Society of Hair Restoration (ISHRS) on Friday, October 6, 2017, in Prague, Czech Republic. He discussed the exciting new capabilities of the most recent upgrade to the ARTAS Robotic System, ARTAS 9x. The upgrades increase the speed and accuracy of the procedure while utilizing artificial intelligence to fine-tune the movements of the robotic arm.

Increased Speed

ARTAS 9x is 20% faster than the prior version, with each dissection cycle lasting less than 2 seconds. The robot can now harvest up to 1,300 grafts per hour. ARTAS 9x makes robotic hair transplants faster by enabling graft dissection and extraction to be performed simultaneously. Prior versions of the robot’s optical system used a red LED light. However, this proved to be too harsh for the human eye. ARTAS 9x solves this issue by using a white LED light, allowing grafts to be extracted while the robot dissects grafts in the scalp. Also, ARTAS 9x uses a yellow tensioner, rather than a white one, eliminating the need for two manual commands and increasing the speed of the procedure.

Increased Accuracy

ARTAS 9x has increased the accuracy of the procedure by allowing the option of smaller needles (0.8mm in addition to 0.9mm and 1.0mm). The 0.8mm needle minimizes distortion of the skin during harvesting and this improves the accuracy of the graft extraction process.

Artificial Intelligence

The ARTAS 9x uses artificial intelligence to maximize consistency in Robotic FUE procedures. It uses real-time information on the positioning of the robot and the patient to direct the robotic arm to automatically retract — but not shut down — if it detects a potential positioning issue. This increases efficiency and decreases the length of the procedure.

Artificial intelligence is also used to determine if there are any empty recipient sites on the scalp during harvesting, meaning that a graft was missed. The robot alerts the physician to this information so he/she can then adjust the algorithm to increase the efficiency of the procedure.

The software system that runs ARTAS 9x can now detect scars or areas of the scalp with few or no hairs and skip over these areas during harvesting. This saves time by blocking harvesting in areas that might result in a harvested area appearing too thin.

Other Functionality Improvements

ISHRS 25th Annual Conference ProgramISHRS 25th Annual Conference Program

There are a number of other improvements to the robotic system incorporated into ARTAS 9x. These include a smaller robotic head, an improved site-making headrest, a new harvesting halo, a robotic arm extender, and more. These modifications increase the functionality of the ARTAS Robotic Hair Transplant System and aid the physician to deliver optimal outcomes for the patient.

ARTAS Robotic Hair Transplants at Bernstein Medical

Bernstein Medical was one of the first hair restoration practices in the world to use the ARTAS robot to perform FUE, a procedure pioneered by Dr. Bernstein and his colleague Dr. William Rassman. In 2013, Bernstein Medical was named an ARTAS Clinical Center of Excellence.

As a medical adviser to Restoration Robotics, Dr. Bernstein works to improve its hardware and software systems in collaboration with the robot’s engineers and developers. Bernstein Medical is a beta-test site for the ARTAS robot with numerous advances being developed and tested in our NYC hair transplant facility.

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Dr. Bernstein at ISHRS 2015 Annual Scientific MeetingDr. Bernstein at the 2015 ISHRS Annual Scientific Meeting

Small, simple modifications in the sequence of the major steps in a Follicular Unit Extraction (FUE) hair transplant procedure will be beneficial to healing and growth following the procedure, says renowned hair restoration surgeon Dr. Robert M. Bernstein. Presenting at the 23rd Annual Scientific Meeting of the International Society of Hair Restoration Surgery (ISHRS) in Chicago, Illinois, Dr. Bernstein detailed how making recipient site incisions before harvesting follicular unit grafts can improve the outcome of an FUE procedure.

For years, it was standard operating procedure in an FUE hair transplant to first harvest follicular units, then create recipient sites in the balding areas and place the extracted units into these sites. This practice persisted despite the fact that hair restoration physicians had known for years that prolonged periods of time outside the body decreased survival of follicular unit grafts. With the widespread adoption of FUE, and the long time needed for the extraction phase of the procedure, Dr. Bernstein looked for ways to streamline the process.

Dr. Bernstein Presenting at ISHRS 2015Dr. Bernstein Presenting at ISHRS 2015

By making the requisite number of recipient sites before harvesting, the grafts can be placed as soon as they are extracted. This reduces the critical period of time that grafts are out of the body. Sites created before harvesting have more time to begin healing, and so they exhibit less bleeding. This results in fewer grafts that “pop” out of the recipient site during placement. Mechanical trauma to grafts that need re-positioning after popping is also reduced. Allowing time for recipient sites to begin healing might also provide a more fertile bed for newly implanted grafts to take root. Additionally, pre-making sites provides time for crusts to form on the surface of the wound. Removing these crusts before placement decreases post-operative inflammation and promotes wound healing.

Dr. Bernstein proposed that in some large FUE sessions, in which large numbers of follicular units are transplanted, the surgeon might deliberately delay extraction to allow pre-made recipient sites additional time to heal by creating recipient sites the day before harvesting.

In sum, Dr. Bernstein provided the audience of hair restoration surgeons with a practical modification of the traditional FUE procedure that could impact the outcome of every hair transplant. Given the growth in the number of FUE hair transplants being performed (now about 50% of all hair transplant procedures) and the international platform provided by the ISHRS Annual Scientific Meeting, this small procedural adjustment could have a significant benefit for thousands of hair restoration patients around the world.

Read these publications by Dr. Bernstein on recipient site creation:

Pre-Making Recipient Sites to Increase Graft Survival in Manual and Robotic FUE Procedures (2012)
Robotic Recipient Site Creation in Hair Transplantation (2014)

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