Objectives: The debate these days: What is the best FUE technique? There is:
* Manual: 1 doctor (1 or 2 hands/or 2 doctors)
* Assisted: Motorized, Automated, and Robotic.
There are no significant studies comparing the different techniques.
Motorized techniques: Its main function is to rotate the punch.
Automated system that combines suction and extraction and also implantation
Robotic Extraction-Implantation.
The objectives are to evaluate, in a pilot study, the differences between the different extraction-implantation methods of follicular units with FUE technique.
Introduction: In the recent years, follicular unit extraction (FUE) technique has become the most used by professionals because patients prefer it. This technique does not leave visible scars and is less “aggressive”.
Methods of harvesting with fue are:
* Manual
* Motorized
* Automatized
* Robot assisted
There is an important debate about whether the extraction must be manual, automated, or robotized.
In order to minimize the errors that fatigue causes due to long-term processes, different motorized systems and, recently, automated or robotic procedures have been implemented.
Materials / method: Male patients between 30 and 55 years of age with baldness patterns III to V of Hamilton.
In order to extract follicular units with manual FUE technique, use punches blunts. When motorized, use the micromotor with straight handpiece. When robotized use Artas robot 9x. For every technique, I use punchs 0.9 and 1 mm.
6.25 cm2 adjacent areas were studied, with almost identical density and follicular units with an 1.9 mms extraction spacing.
The extraction time, number of incisions per area, total and partial transection and healing, robotic incision and implantation were studied.
Results: Preliminary results indicate that these devices are an ally for the Surgeon-Dermatologist.
In order to minimize the errors that cause fatigue due to long-term processes, different motorized systems and robotic must be used.
The extraction time is slower in manual and motorized with a single surgeon than in robotic, but is faster if two surgeons are involved.
Robotic has the best transection rate.
In all three techniques the healing was excellent without visible scars, preserving the natural appearance of the donor area.
Robotic implementation is slower than manual.
Conclusion: It is a pilot study and therefore with statistical limitations that only aims to guide the conduct of a larger study in terms of number of patients and variables.
The robotic aid seems to provide better extraction results, in terms of transection rate, than the manual and motorized techniques; and also it's faster than manual, being similar in terms of time when comparing to motorized, and the healing evolution is similar for all of them.
However, it has disadvantages: High purchase price, maintenance, update and cost per process.
Robotic incision and implantation don't overcome the manual
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