The ARTAS System is a 21st-century technological innovation that was introduced into the hair treatment field in 2011 to treat male pattern baldness, or androgenetic alopecia. The system is sophisticated, utilizing computer assistance to harvest hair follicles during the actual process of hair replacement. ARTAS incorporates a number of elements in its operation, including an image-guided robotic arm and special imaging technologies that co-ordinate together for the purpose of implementing the "follicular unit extraction (FUE)" technique upon the recipient of the system.
The ARTAS System was developed by Restoration Robotics, Inc., a privately held medical device company co-founded by four recognized leaders in medical robotics and computer-assisted technology: Mohan Bodduluri, PhD, Don Caddes, PhD, Phillip Gildenberg, M.D., and Fred Moll, M.D.
Rigorous clinical trials were conducted to develop and validate the system and a 510(k) clearance for safety and efficacy from the Food and Drug Administration was handed down to Restoration Robotics in April, 2011.
Robotic FUE harvesting was presented at the annual conference meetings of the International Society of Hair Restoration Surgery (ISHRS) between 2008 and 2011 (inclusive), and it was at the final year's gathering that Dr. Miguel Canales, Medical Director at Restoration Robotics, presented on the development and efficacy of the ARTAS System.
Follicular Unit Extraction
FUE is a minimally invasive technique used in hair restoration procedures to extract individual follicular units from the scalp in preparation for transplantation. Hair restoration or transplantation is used to treat hair loss, a condition that affects 50 million men and 30 million women in the United States. The system, which was developed by Restoration Robotics, features an image-guided robotic arm, small dissection punches and an interactive computer interface.
Overall, the ARTAS System enables trained physicians to harvest follicles using FUE more rapidly and with significantly lower transection rates than with traditional methods. Transection rates using ARTAS are reported at 8%, as compared with 20-30% with manual FUE. The ARTAS procedure can be done in half the surgery time compared to manual FUE. In ideal patients, a peer reviewed manuscript by Rashid Rashid showed yield rates over 95%.  The system harvests follicular units in a random fashion so that any scaring related to the procedure can be well-hidden with the remaining hair. Patients receiving the ARTAS procedure can return to normal activities in one to two days, compared to weeks or months for strip harvesting procedures. The system has been recognized in the media  and by national awards such as the Gold Edison award in medicine.
The donor area, an area of permanent hair in the posterior scalp, is determined by the physician. Hair in the donor area is trimmed to make the follicles easier to identify and extract. The scalp is numbed using local anesthetics. The patient is seated in a semi prone position, and a skin tensioner is placed on the scalp. This tensioner improves precision and control of the dissection depths.
ARTAS uses multiple cameras to continuously capture video images of the patient's Donor Area. Through its image processing software algorithms, the ARTAS System identifies and computes different properties of the follicular units such as exit angles, orientations and density. Using this imaging information, the robotic arm maneuvers the small dermal punches to perform the follicular unit dissection in a precise fashion. The ARTAS System continuously monitors the location of the hair follicles and dynamically compensates for patient movement. The physician and technician operate the system by making adjustments to fine-tune the dissection. The follicles are harvested in random patterns specified by the physician, while leaving a natural-looking donor area behind. The follicular units are then transplanted into the patient’s recipient area using current manual techniques.
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- ARTAS System, www.artashair.com
- Dr. James Harris demonstrates the ARTAS procedure, TheBaldTruth.com
- International Society for Hair Restoration Surgery, www.ishrs.org
- American Hair Loss Association, www.americanhairloss.org