View Full Version : Is speed a good thing for ARTAS cases? Does it compromise quality?

Ken Anderson, MD
05-25-2016, 10:01 AM
Yesterday was a big day in our clinic. We completed 999 harvest attempts in 1 hour, which was a record for our clinic. We had an even better candidate today, and completed 949 harvest attempts in 46 minutes before the patient had to use the restroom. We started using our ARTAS robot in 2013, and currently our efficiency has never been better, particularly now with the new 8X update.

I posted a screenshot (see pic) of the computer screen as we passed 999 grafts on Facebook, and another hair restoration surgeon--one who does not offer FUE at all--made a comment about my post. His comment was, "Is it truly about setting "records"?- Or performing State of the Art, Natural Long-Lasting results? I wonder....."

I was doing a robot case this morning and I thought about this comment. This surgeon is very much correct, and I wanted to make a comment about it, because it seems even hair restoration surgeons themselves don't understand efficiency of robotic surgery vs. rushing a surgical procedure along for the sake finishing sooner.

The surgeon is absolutely correct: it isn't about setting records at all. It's about achieving objective efficiency with a very complex tool. The ARTAS system is not like a car wash where you just stick a patient in and *presto* out come the grafts and there you go. It's simply a tool. Like a paintbrush. No tool can guarantee good or even acceptable results, no more than any given paintbrush is going to result in the most beautiful paintings. It's the skill, talent, dedication and experience of the person using the tool. In this case it's an entire surgical team working in concert to provide the most optimal results for every single patient. I've been doing FUE surgery since 2003, and I've had an ARTAS system since 2013. We are certainly not new to FUE. To assume that achieving efficiency somehow automatically compromises anything "state-of-the-art" or "natural, long-lasting results" implies a greater concern about speed than quality. In the case of FUE, speed = quality (obviously, if we assume the same quality of grafts are being produced). It's not a NeoGraft or other hand held instrument where you can simply aim less and work faster. You can't rush the robot along, and the grafts are consistent because it's a robot. It's not going to aim less and work faster; it doesn't have a mode setting for that. It's the ARTAS Workflow that's critical. It's what happens in between the grids; the ARTAS will complete the grid as fast as it wants to, with guidance by me of course. When the grid is done, it's the knowledge and experience of the surgical team that will determine how quickly the next grid is initiated. There is absolutely zero compromise of any of the grafts, nor the quality of the work, and as we're using Planet Earth's only robotic hair transplant machine, it's most certainly state-of-the-art. Efficiency is key, however, especially for large cases. The grafts sitting in the Petri dishes are technically slowly perishing, and limiting their ischemia time is critical. In large cases, it becomes a workflow concern as without efficient workflow, the grafts will be left outside the body and "in the dish" for significantly longer times, which will clearly reflect in the survival rate and overall final appearance of the patient. I think a lot of people, apparently even some practicing hair restoration surgeons, assume speed would compromise quality. This is a different paradigm, however, and efficient graft harvesting indicates an experienced surgical team, not a rushed, compromised procedure.

In the picture below is a screenshot of the ARTAS User Interface monitor on the wall of my Operating Theatre. The letters point out three important things:
A: time record of 01:02:20 (one hour, two minutes, and twenty seconds)
B: 999 harvest attempts
C: happy, smiling surgeon (me in the reflection, holding up my camera to take the photo)

http://img.photobucket.com/albums/v241/otosurgeon/999%20ARTAS%20Hair%20Transplant%20Anderson%20Cente r%20for%20Hair%20FB.jpg (http://smg.photobucket.com/user/otosurgeon/media/999%20ARTAS%20Hair%20Transplant%20Anderson%20Cente r%20for%20Hair%20FB.jpg.html)

Gabe Zingaretti, PhD
05-25-2016, 11:08 AM
I think this is a great summary and a solid point of view that I strongly agree with. ARTAS is for a hair surgeon what Maya/3DS max are for Computer Graphics. An artist is an artist and a tool is a tool. ARTAS 8x is a different tool than ARTAS 4x (released in 2011). You will be amazed on what it can do in the hands of a capable surgeon...all with a smile :)

Gregory Turowski, MD
05-26-2016, 09:56 PM
Speed is important because it testifies to the experience and quality of the hair team work
here is our record:

Ken Anderson, MD
06-22-2016, 10:01 AM
Today was a great day at our center. We set the new world record for ARTAS efficiency at 1,239 grafts harvested in 1 hour and zero seconds. We hit 1,300 at 1:02:15. Very proud of our team!