Bernstein Medical - Center for Hair Restoration - Robotic vs Manual Transection Rates
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Q: Is it true that manual FUE hair transplant procedures are better than robotic hair transplants because the physician can adjust and feel the follicle when extracting? — M.H. ~ Great Neck, N.Y.

A: The ARTAS robot is a physician controlled, computerized device that uses a three-dimensional optical system to isolate follicular units from the back of the scalp in a hair transplant. The robotic system assists the physician in the extraction of grafts with precision and speed. Although there is some advantage to having “human feel” for the tissue, this is far outweighed by the fact that repetitive procedures performed manually thousands of times lead to operator fatigue and result in increased transection and damage to grafts. With the ARTAS robotic system, the quality of the first and the last graft harvested will be the same.

Read about advantages of the ARTAS Robot over manual FUE procedures

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Dermatologic Surgery - December 2014A 2014 study in the journal Dermatologic Surgery measured follicular unit transection (follicle damage) during the extraction step of a robotic follicular unit extraction (R-FUE) procedure. The study found that robotic transection rates, using the ARTAS Robotic System, compared favorably with non-robotic (manual) FUE transection rates. ((Avram MR, Watkins SA. “Robotic follicular unit extraction in hair transplantation.” Dermatol Surg. 2014 Dec;40(12):1319-27))

The researchers found the average rate of transection over many robotic procedures to be 6.6%. This rate compared favorably to an average manual transection rate of 6.14% reported in a 2006 study ((Harris JA. “New methodology and instrumentation for follicular unit extraction: lower follicle transection rates and expanded patient candidacy.” Dermatol Surg. 2006;32:56–612.)) and was significantly lower than an average transection rate of 17.3% reported in 2008 study using manual techniques. ((Onda M, Igawa HH, Inoue K, Tanino R. “Novel technique of follicular unit extraction hair transplantation with a powered punching device.” Dermatol Surg. 2008;34:1683–8.))

While the study’s robotic FUE transection rates compared favorably to two reported manual transection rates, the authors stressed that more well-designed studies comparing robotic to manual FUE are needed.

The authors noted that “The main advantages of robotic FUE compared with the standard ellipse are its minimally invasive nature and the lack of a linear scar.”

This paper was reviewed by Dr. Bernstein. ((Bernstein RM. “Commentary on Robotic Follicular Unit Extraction in Hair Transplantation.” Dermatol Surg. 2015;41:279.))

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