Current Advancements in The ARTAS Hair Transplant System - Dr. Craig Ziering

[Tron]

It’s not about being right or wrong, it’s about what is. In 99% of clinics Techs do all the implantation of the grafts, that’s common knowledge If you were not aware of that going in, then you didn’t do the appropriate amount of research. That’s their job. they are either paid hourly or on salary. When Techs are hired to do extractions, they are paid differently and a lot more money in general. If you feel the need to be right, that’s fine, I’m just attempting to give you the facts. Spreading misinformation does not help anyone. You may have had your ARTAS experience, but it’s clear that you don’t really understand how these doctors and clinics work. I doubt that you asked how much the technicians who were dabbing your blood and implanting your grafts were being paid, so your experience does not really relate to your assumptions about how much more or less doctors make, etc. It’s spelled out in that video I linked to and if you listen to The Bald Truth show, you would have a better understanding of it. They talk about this all the time.

I asked you a simple.....business.... question. All things being equal, which balance sheet would you rather own? Thats it.

[Delphi]

I asked you a simple.....business.... question. All things being equal, which balance sheet would you rather own? Thats it.

The point is that all things are not equal. If it were a simple question, then I would be able to give you a simple answer.

[Follicle734]

Delphi not to sound disrespectful but to sit there and try to discredit and comepare Da vinci to manual surgery just shows the level of your bias. 90% of surgery in that field is done robotically...FACT not opinion. Patients who don't have the procedure done robotically(da vinci) are simply getting a 2nd class outcome/surgical procedure. IS the Artas perfect yet no, but it's a work in progress that continues to improve over time. It takes time and effort to get close o perfection. But to ignore the fact of the importance of surgical robotics is ignorant. It's no coincidence that Tech giants like Google, and mega life science brands like Johnson & Johnson are pumping billions upon billions of dollars into the field of surgical robotics. I think if you do some actual homework on the sector and not allow outside opinions and pre determined biases to cloud your judgement, you may actually agree. Surgical robotics are going to continue to improve and dominate their respective markets, and those that don't embrace/adopt will eventually be left behind.

From what is being presented I would say that at this point the ARTAS does a good job extracting on patients who are candidates for larger punch sizes. Even with the smallest punches the robot uses the scaring is a bit larger than other instruments. (I’m assuming this based on the size of the holes left behind) I was a fan and I’m really into the technology, but the results seem to fall short except by the doctors who know what they are doing, which seem to be only a few. I disagree about it being more profitable for doctors to talk you out of the ARTAS. Since they can charge more it’s really a wash, unless the robot limits their ability to transplant more grafts in a single session, which might be the case, so if that is then it’s better for both the doctor and the patients to get more grafts in one session as long as it is a reasonable amount. They either talk the person out of it because they know the results will fall short for that particular patient or because it might be easier to perform a strip or FUE using other methods and offer the patient a “discount”.
I would love to see their financials, can you point me to where I can find them?

As far a robots performing life saving surgery today, from all the research I have done, if I was going to have urological surgery or some other life saving surgery, I’d far prefer to go to a true expert in laparoscopic surgery than a place that uses a robot. After 15 years in use, outcomes still seem to be better doing surgery by hand. and far less of a burden on the healthcare system.

An example is the da Vinci robot.
“This is a technology that is costing the healthcare system hundreds of millions of dollars and has been marketed as a miracle — and it’s not,” said Dr. John Santa, medical director at Consumer Reports Health. “It’s a fancier way of doing what we’ve always been able to do.”

Da Vinci was originally designed to do cardiovascular surgery, but it’s fallen out of favor for heart surgeries. Next it was picked up for gynecological surgeries. In 2013, the American College of Obstetricians and Gynecologists (ACOG) said it wasn’t the best, or even the second-best option, for noncancerous gynecological surgeries.

Here’s the whole article. I’ve read some very scary things about it.

http://www.healthline.com/health-new...ipoff-021215#1

[Delphi]

No disrespect taken. As far as showing my “level of bias,” I'm not a share holder in the company like you are, so I have no axe to grind and feel no bias either way. I’m just a guy voicing my opinion on what is being presented to the public by renowned experts and studies on the subject. I’m also a bit of a technology geek who has hair loss, so I was very excited about the prospect of robotics being used for hair transplant surgery.

I don’t think the 90% statistic you are pointing to equates to the quality of surgery being performed. I would say, however, that it is “opinion" that people who choose not to have robotic surgery are getting second class outcome/surgical procedures based on the current studies being published on the subject. Perhaps these studies and reports are bias, but I have no reason to believe that these reports are inaccurate.

What do you think of these reports and studies?

https://www.drugwatch.com/davinci-surgery/

https://www.wsj.com/articles/robotic-surgery-brings-higher-costs-more-complications-study-shows-1412715786

https://well.blogs.nytimes.com/2013/09/09/new-concerns-on-robotic-surgeries/?_r=0

http://www.medscape.com/viewarticle/810490

[PayDay]

No disrespect taken. As far as showing my “level of bias,” I'm not a share holder in the company like you are, so I have no axe to grind and feel no bias either way. I’m just a guy voicing my opinion on what is being presented to the public by renowned experts and studies on the subject. I’m also a bit of a technology geek who has hair loss, so I was very excited about the prospect of robotics being used for hair transplant surgery.

I don’t think the 90% statistic you are pointing to equates to the quality of surgery being performed. I would say, however, that it is “opinion" that people who choose not to have robotic surgery are getting second class outcome/surgical procedures based on the current studies being published on the subject. Perhaps these studies and reports are bias, but I have no reason to believe that these reports are inaccurate.

What do you think of these reports and studies?

https://www.drugwatch.com/davinci-surgery/

https://www.wsj.com/articles/robotic-surgery-brings-higher-costs-more-complications-study-shows-1412715786

https://well.blogs.nytimes.com/2013/09/09/new-concerns-on-robotic-surgeries/?_r=0

http://www.medscape.com/viewarticle/810490

I find it to be a bit curious that one of the owners of the ARTAS company seems so upset about some very valid questions too. Spencer Kobren seems to speak highly of the technology and that it keeps improving, but he’s been very consistent over the past couple of years in cautioning people to research the doctors and the clinics who buy all of these new machines and robots. Even last week he said the he believes robots should play a big role in the future of hair transplants, so I see that as a positive, but like I said in my last post, I don’t think it’s smart to just think the ARtas is some magical new way to have a better hair transplant. The technicians and doctor are still doing the work and even if the ARTAS can be a little more precise or faster, if the people in the clinic are not good, your hair transplant won’t be good. Like I pointed out if people who know what they are doing and actually own one are still using other methods like in this video with Dr. Arocha https://www.baldtruthtalk.com/thread...ant-DocuSeries there has to be a good reason. Dr. Ziering obviously believes in it too, but it does not seem like most of his hair transplants are done with the ARTAS. Why? This puts a big question mark in my mind. But like I said, Spencer seems to believe the technology keeps improving and I don’t think he would even discuss it if he didn’t believe it was at least as good as other methods for certain specific people. He mentioned something about certain advantages to the patient if the operation takes less time, but I forgot exactly what he said and the podcast has not been posted yet.

I think you make some very strong points about the De vinci robot Delphi and those article are not too favorable.

[Tron]

Well the robot that did my eye surgery 12 years ago (along with 42 other people that day), seemed to do a pretty solid job. Ive had perfect vision ever since. Ive probably had more robotic procedures than anybody in this post.

Either way I could give a chit what other people think about what a couple of hair transplant techs concerned about job security think. People should revisit this post in ten years to follow up to see how many of these Luddites are owners of self driving robotic cars.

[Follicle734]

I think its fair to have hesitancy anytime you incorporate new technology, but again the da vinci would not dominate 90% of its market if it was not the better option. Ofcourse theres going to be naysayers and ofcourse theres going to be negativity. The best HT docs in the world that crank out unreal results on a consistent basis are going to have unhappy patients from time to time that arent happy with the outcome. BY incorporating an improving technology, you bring in the possibility of standardizing a field that without technology is unable to be standardized. Patients pay a boat load of money for a procedure, dont they deserve the advantage, in time, to have the best potential for a favorable outcome. I dont think theres anyway that you can paint a picture that if the Artas continues to improve at its current pace that it wont be a best in class treatment option for qualified surgery candidates. There's no surgeon in the world, regardless of talent, that can harvest grafts hour after hour at sub micron level precision. Time will tell but my chips are on the table in favor of the technology, just like they were when the same voices were saying in 2000 that the da vinci was bogus, and today it s a 30 billion dollar company...id say i did ok on my investment...

[Delphi]

I think its fair to have hesitancy anytime you incorporate new technology, but again the da vinci would not dominate 90% of its market if it was not the better option. Ofcourse theres going to be naysayers and ofcourse theres going to be negativity. The best HT docs in the world that crank out unreal results on a consistent basis are going to have unhappy patients from time to time that arent happy with the outcome. BY incorporating an improving technology, you bring in the possibility of standardizing a field that without technology is unable to be standardized. Patients pay a boat load of money for a procedure, dont they deserve the advantage, in time, to have the best potential for a favorable outcome. I dont think theres anyway that you can paint a picture that if the Artas continues to improve at its current pace that it wont be a best in class treatment option for qualified surgery candidates. There's no surgeon in the world, regardless of talent, that can harvest grafts hour after hour at sub micron level precision. Time will tell but my chips are on the table in favor of the technology, just like they were when the same voices were saying in 2000 that the da vinci was bogus, and today it s a 30 billion dollar company...id say i did ok on my investment...

So what you are saying is that even though the experts clearly state that the Da Vinci is more dangerous, less effective and more of a burden on our healthcare system that it’s a better option simply because it’s being used more. If this was a discussion on deceptive and unethical marketing as opposed to good medicine I can see your point. Your lack of empathy and arrogance is amazing. The fact that you represent the ARTAS company is even more upsetting, since your views are probably aligned with theirs.

[Follicle734]

Let's just clarify that. I don't represent the company. I personally am a large shareholder in the company based on my view that in the future it will be the standard of care in this field...that's where my relationship to the company stops. Secondly I don't think the top urologists in the world would all point their ethical compass in the wrong direction without thinking it was better for their patients. Sane thing is happening with hair restoration. The top echelon of doctors in this field, guys who literally helped right the book on hair restoration have backed the Artas. Ask yourself why?? It's less economical to the physician, it takes time to retrain the staff and adjust. The guys I'm referring too don't need the robot their practices are booked for life and they've decided to embrace the robot because they truly believe it's the future and in the best interest of the patient.

So what you are saying is that even though the experts clearly state that the Da Vinci is more dangerous, less effective and more of a burden on our healthcare system that it’s a better option simply because it’s being used more. If this was a discussion on deceptive and unethical marketing as opposed to good medicine I can see your point. Your lack of empathy and arrogance is amazing. The fact that you represent the ARTAS company is even more upsetting, since your views are probably aligned with theirs.

[Delphi]

Let's just clarify that. I don't represent the company. I personally am a large shareholder in the company based on my view that in the future it will be the standard of care in this field...that's where my relationship to the company stops. Secondly I don't think the top urologists in the world would all point their ethical compass in the wrong direction without thinking it was better for their patients. Sane thing is happening with hair restoration. The top echelon of doctors in this field, guys who literally helped right the book on hair restoration have backed the Artas. Ask yourself why?? It's less economical to the physician, it takes time to retrain the staff and adjust. The guys I'm referring too don't need the robot their practices are booked for life and they've decided to embrace the robot because they truly believe it's the future and in the best interest of the patient.

Actually it appears the guys “who helped write the book” on hair transplants have tried and rejected the ARTAS, at least that's what I read on the other forums.The best in the world like Dr. Hasson and Dr. Wong have rejected it. There are only a few well respected doctors who use it, like Dr. Bernstein and Dr. Ziering. As it was pointed out, these two doctors are experts in hair transplant surgery, so when they choose to use it they know what they are doing. I find that Spencer Kobren talks about it less and less and when he does he still talks about the importance of going to a doctor who is experienced, like Dr. Bernstein for instance. It also looks like most of the doctors don’t do very much talking about it anymore either and what I do see online lately has been negative. That probably does not have to do as much with the technology as it does with the doctors not knowing how to use it. I’m very interested in this technology and if you look at my posting history I was very excited each time there was a show posted about it. I’m sure it’s good, but when I see a large investor soliciting for investors on a hair loss message forum, it really makes me wonder. I would like to hear Spencer Kobren’s opinion on this, since it’s because of him that I thought the ARTAS had any credibility in the first place and I’m a little disappointed by this thread and by what I’ve been reading about it online lately. Has he changed his mind, does he know something that we don’t? What’s the deal Spencer?

[Follicle734]

Maybe doctors don't like paying for quality, but in my previous posts you ignored the point on the actual technology. There isn't a doctor in the world that can operate and extract grafts for hours upon hours at with sub micron level precisions. I am curious to hear your thoughts as to how a surgeon can justify not offering his/her patient the most accurate and efficient way of harvesting grafts?? Please answer the question. How do you not see a benefit in harvesting grafts more accurately and faster keeping them out of the body for less time?

Actually it appears the guys “who helped write the book” on hair transplants have tried and rejected the ARTAS, at least that's what I read on the other forums.The best in the world like Dr. Hasson and Dr. Wong have rejected it. There are only a few well respected doctors who use it, like Dr. Bernstein and Dr. Ziering. As it was pointed out, these two doctors are experts in hair transplant surgery, so when they choose to use it they know what they are doing. I find that Spencer Kobren talks about it less and less and when he does he still talks about the importance of going to a doctor who is experienced, like Dr. Bernstein for instance. It also looks like most of the doctors don’t do very much talking about it anymore either and what I do see online lately has been negative. That probably does not have to do as much with the technology as it does with the doctors not knowing how to use it. I’m very interested in this technology and if you look at my posting history I was very excited each time there was a show posted about it. I’m sure it’s good, but when I see a large investor soliciting for investors on a hair loss message forum, it really makes me wonder. I would like to hear Spencer Kobren’s opinion on this, since it’s because of him that I thought the ARTAS had any credibility in the first place and I’m a little disappointed by this thread and by what I’ve been reading about it online lately. Has he changed his mind, does he know something that we don’t? What’s the deal Spencer?

[Delphi]

Maybe doctors don't like paying for quality, but in my previous posts you ignored the point on the actual technology. There isn't a doctor in the world that can operate and extract grafts for hours upon hours at with sub micron level precisions. I am curious to hear your thoughts as to how a surgeon can justify not offering his/her patient the most accurate and efficient way of harvesting grafts?? Please answer the question. How do you not see a benefit in harvesting grafts more accurately and faster keeping them out of the body for less time?

If we are going tit for tat you have not given me your thoughts on the below:

What do you think of these reports and studies?

https://www.drugwatch.com/davinci-surgery/

https://www.wsj.com/articles/robotic...ows-1412715786

https://well.blogs.nytimes.com/2013/...urgeries/?_r=0

http://www.medscape.com/viewarticle/810490

To answer your question, from what has been presented most doctors don’t do much more than 1000 to 1500 grafts per ARTAS hair transplant. If the robot works so quickly then we don’t really know if it’s "sub-micron precision" was even tested for "hours upon hours.” If it was then the ARTAS company should present the data. Currently your point is moot since there is no evidence that the ARTAS has performed well for hours upon hours. It’s just theoretical unless you have some evidence to present. By the way, who said I could not see the benefit of this type of technology? If the grafts are better, the precision is better and the outcomes are better than of course it would be better. No one is questioning that, but just regurgitating company marketing language does not prove anything. Let me be clear, I am all for this technology. I became interested in it after hearing Spencer Kobren talk about it and interview doctors like Dr. Bernstein and Dr. Ziering on his show. Before that I thought it was just a gimmick. I am now starting to question it’s real value based on the negative things I’ve been reading on other forums, the lack of discussion about it on Spencer’s show and this forum, even by the doctors who use it, and because of your solicitation for investors.

[Follicle734]

My friend...when the technology continues to improve the scientific data will show the clear benefit...apple solicited investors a year ago for more than a billion dollars, and they are the most valuable company in the world not sure I see your correlation there. I was looking to help out a fellow poster so they could be fininacially rewarded for what I see here and what I saw 15 years ago when people were questioning 3 other surgical robotics companies which eventually dominated their markets. This is a robot that does hair transplants...unfortunately this is such a deceptive market with no trust and no standard...the doctors going against robotics have no benefit in promoting the robot because they don't care about their patients they just care about margins...Fact...there's a reason why Spencer associates himself with 63 doctors out of 10,000....unfortunately the industry is far to dishonest which is why I love the robot because once it's fully optimized it can offer the closest thing to standardization then anything else. At the end of the day the only point to discuss is that with the continued improvement of Artas technology the patient will be getting a better, standardized outcome then taking his chances with anything else...and I invite you to come with me to your nearest Artas physician and witness the precision, accuracy, speed and graft quality(still depends on docs expertise in trimming for appropriate placement). And I'll also be more then happy to introduce you to(not naming them on this forum) physicians who use other "devices" that have looked at Artas, if you gave the same doctor the same patient and used Artas versus X who would get the better outcome? 90% of the responses were Artas and these were docs who don't use the robot...so what does that tell you?

If we are going tit for tat you have not given me your thoughts on the below:

What do you think of these reports and studies?

https://www.drugwatch.com/davinci-surgery/

https://www.wsj.com/articles/robotic...ows-1412715786

https://well.blogs.nytimes.com/2013/...urgeries/?_r=0

http://www.medscape.com/viewarticle/810490

To answer your question, from what has been presented most doctors don’t do much more than 1000 to 1500 grafts per ARTAS hair transplant. If the robot works so quickly then we don’t really know if it’s "sub-micron precision" was even tested for "hours upon hours.” If it was then the ARTAS company should present the data. Currently your point is moot since there is no evidence that the ARTAS has performed well for hours upon hours. It’s just theoretical unless you have some evidence to present. By the way, who said I could not see the benefit of this type of technology? If the grafts are better, the precision is better and the outcomes are better than of course it would be better. No one is questioning that, but just regurgitating company marketing language does not prove anything. Let me be clear, I am all for this technology. I became interested in it after hearing Spencer Kobren talk about it and interview doctors like Dr. Bernstein and Dr. Ziering on his show. Before that I thought it was just a gimmick. I am now starting to question it’s real value based on the negative things I’ve been reading on other forums, the lack of discussion about it on Spencer’s show and this forum, even by the doctors who use it, and because of your solicitation for investors.

[Tron]

Delphi doesn't answer any direct questions, you're wasting your time. This thread is filled with his "I asked you first" b.s.

My theory is he/she is a Luddite hair transplant tech.

[Delphi]

My friend...when the technology continues to improve the scientific data will show the clear benefit...apple solicited investors a year ago for more than a billion dollars, and they are the most valuable company in the world not sure I see your correlation there. I was looking to help out a fellow poster so they could be fininacially rewarded for what I see here and what I saw 15 years ago when people were questioning 3 other surgical robotics companies which eventually dominated their markets. This is a robot that does hair transplants...unfortunately this is such a deceptive market with no trust and no standard...the doctors going against robotics have no benefit in promoting the robot because they don't care about their patients they just care about margins...Fact...there's a reason why Spencer associates himself with 63 doctors out of 10,000....unfortunately the industry is far to dishonest which is why I love the robot because once it's fully optimized it can offer the closest thing to standardization then anything else. At the end of the day the only point to discuss is that with the continued improvement of Artas technology the patient will be getting a better, standardized outcome then taking his chances with anything else...and I invite you to come with me to your nearest Artas physician and witness the precision, accuracy, speed and graft quality(still depends on docs expertise in trimming for appropriate placement). And I'll also be more then happy to introduce you to(not naming them on this forum) physicians who use other "devices" that have looked at Artas, if you gave the same doctor the same patient and used Artas versus X who would get the better outcome? 90% of the responses were Artas and these were docs who don't use the robot...so what does that tell you?

If you believe that this industry is any more dishonest than other field of medicine than you’re naive. If health insurance paid for ARTAS robotic hair transplants like it does for the De Vinci operations, doctors would be all over it just like hospitals and doctors were with the De Vinci. I believe you when you say it’s about margins, but when the money is coming out of a patient’s pocket, they are going to do their research and not just trust their doctor’s word or company marketing. If the patient’s research points to ARTAS being the best for the job and their pocketbooks, then that is the direction they will go. If the vast majority of online information points to other methods being better and less expensive than that's the direction the market will go.