September 15, 2003
PATENTS
Robot to Implant Hair Plugs Faster
By TERESA RIORDAN


HAIR implants are not exactly brain surgery. Yet a Houston neurosurgeon, Philip Gildenberg, hopes to revolutionize the baldness industry with his invention: a robot that he says will one day implant hair plugs faster and more precisely than a human can.

A full-scale hair-implant procedure is now a daylong, labor-intensive affair. First a strip of scalp is sliced off the lower back of the head. Then a team of four to six technicians, working under microscopes, divide the strip into 1,000 to 2,000 individual "follicular units," each of which contains from one to four hair follicles.

A doctor makes tiny slices in the scalp and inserts hair units one by one. The process can take up to eight hours.

"It is stressful, tedious, repetitive motion," Dr. Gildenberg said. "Which makes it the perfect job for a robot."

Until he retired two years ago to devote his time to inventing, Dr. Gildenberg was a leading practitioner of stereotactic neurosurgery, which relies on three-dimensional mapping to guide the surgeon. Next week he will be giving the keynote speech at the opening of a stereotactic surgery display at the Duke University Medical Center Library.

Dr. Gildenberg's hair-implant robot relies on stereotactic technology. Moreover, he says, the robotic techniques used for hair implant surgery would not be vastly different from brain surgery.

"It is similar to inserting an electrode into the brain to treat Parkinson's disease," said Dr. Gildenberg — who at 68 has a full head of hair and, for the record, has never had a hair implant. "But instead of the one or two electrodes, you are inserting 1,500 to 2,000 follicular implants."

The robotic arm that Dr. Gildenberg plans to use in his prototype (which is being built) is made by Kuka, a German company whose robots got their 15 minutes of fame in the recent James Bond movie "Die Another Day." A big Kuka robot grasps Halle Berry while little Kuka robots bombard her with lasers.

Before the implant procedure would take place, the robotic arm, which has two videocameras mounted on it, each at a different angle, would take a three-dimensional image of the patient's head. Then the doctor and patient would look at the image in the computer and decide where to make the implants.

"Most people think of R2D2 when they hear the word robot," Dr. Gildenberg said. "But this robot doesn't look anything at all like a person." Rather, it is a flexible robotic arm that is anchored to a table and can be programmed with an ordinary PC.

During the implant procedure, the robotic arm would extract the follicular units, either from a hair strip or directly from the scalp. Holding in its "hand" a canister of about 50 hollow needles, the robotic arm would punch one needle at a time into the skin, extracting the cores of the hair follicles. Once the canister was full, a technician would put it temporarily in a nutrient solution and replace it with a new canister, until enough canisters had been filled to begin implanting.

The robot would then implant the hair by inserting it into the scalp with the same needle it used to extract the hair (and thus eliminating the slicing step now required). Its videocameras would monitor the position of the head while it implanted the follicles, which it does by following a map programmed into the PC showing where the part should go as well as the boundaries of the new hairline.

Dr. Gildenberg predicts that robots will cut surgery time in half. "We are hoping to revolutionize hair transplant surgery, quite frankly," he said.

Hair implants now cost $2,000 and up, and the robotic implant will initially cost the same, Dr. Gildenberg said. He said that as more doctors acquired the machines, competition would drive the price down. "But the big attraction is that it will be so much easier for the patient and it will be state-of-the-art technology."

He has formed a company, Restoration Robotics, to develop the robot. His advisers include Dr. Walter Unger, a hair-implant pioneer and author of "Hair Transplantation," a standard reference text for transplant surgeons. In July, Dr. Gildenberg received patent No. 6,585,746.

Dr. Gildenberg says he thinks his robotic arm could perform other medical procedures as well — removing unwanted hair, for example. But he said the cosmetically focused robot would lay the ground for not-yet-invented life-saving techniques.

"Robotic surgery," he said, "is still in its infancy."

NYTIMES.COM