2nd Mediterranean FUE workshop (Showdown Time)!

[HARIRI]

Vories, can you give us a brief about it?

 

I heard that Dr. Erdogan had the best FUE method (One step FUE) in that workshop compared to Feriduni who performed same day with him and other manual FUE docs. Is it true?

[Michael Vories, MD]

How would someone quantify something like this? I was impressed by all of the surgeons performing extractions. The speed was incredible for manual extractions, but the technology behind the ARTAS robot was fascinating. All of the grafts were placed using the Hans Lion Implanters, and I believe the use of these Implanters with the relatively fragile FUE grafts was the highlight of the conference. The HRT community focuses so much on just one aspect of the procedure, and I believe there will be a renewed focus in the near future on placing grafts. The extracting was great, but the Implanters, in my opinion, stole the show.

[Blake Bloxham]

Dr. Vories,

 

Thank you for the update! Like you said, I'm particularly interested in the increased speed with manual extraction and the Hans implanter pen method. Have they updated the Hans implanter, or is it simply increasing in popularity?

 

Also, like Hariri said, I'm interested to learn more about this "one step" manual extraction process.

[Michael Vories, MD]

I think the use of the Implanter pens is regional. In Asia, specifically South Korea, virtually all transplants use Implanter pens for placement. In the US, there is a long history of delegating placement of grafts to surgical assistants. This has a proven record of consistent results with FUT grafts, but fragile FUE grafts can be easily over manipulated with manual placement. Implanter pens, in which the dermal papilla is not touched by human hands, give better growth rates in my clinic. Of course this means the physician has to place the grafts, and this can be a real problem for physicians who do not wish to place their own grafts. It also limits the procedure to one patient per day per provider.

[james84]

I am becoming a big fan of the implanter pen, after watching this technique used quite a few times this week. I at first was very wary of this technique but i can certainly understand now, why some Docs prefer to use this method, especially FUE.

[Michael Vories, MD]

Recently Ellis Instruments, which is well known in the HRT industry, has picked up the Hans Implanter for US distribution. Hopefully more FUE clinics will be looking at obtaining them.

[HARIRI]

vories, any idea about the one step FUE that Dr. Erdogan performed in the workshop? Can you elaborate what is a one step FUE?

[Michael Vories, MD]

I really can't comment on this procedure. I was with Dr. Feriduni's group during that time. I did see the graft morphology and the grafts looked clean.

[Michael Vories, MD]

I can only imagine imagine that one step implies the grafts are scored and extracted at the same time (By the way- this is how NeoGraft extraction works). I am not really sure how much this differs from the way most manual FUE grafts are extracted, in which 25-50 grafts are scored, then extracted. Other than speed, I'm not sure what benefits this gives the surgeon or the patient.

[Mickey85]

I can only imagine imagine that one step implies the grafts are scored and extracted at the same time (By the way- this is how NeoGraft extraction works). I am not really sure how much this differs from the way most manual FUE grafts are extracted, in which 25-50 grafts are scored, then extracted. Other than speed, I'm not sure what benefits this gives the surgeon or the patient.

 

Less fatigue. Grafts out of the body for less time due to shortened surgery time.

[HARIRI]

Vories, Erdogan was in Feriduni's group? On Saturday May 25, Feriduni and Erdogan performed surgery in same time 11am to 7pm. Check the program...

 

program

[Michael Vories, MD]

Exactly. I chose to be with Feriduni's group, mostly because he was using a "no twist" technique with the CIT punch, so I missed out on the other procedure. Can't be in two places at the same time!

[Michael Vories, MD]

I know the program. I chose to be in the Feriduni group. Can't be in two places at the same time.

[HARIRI]

Since you were at Feriduni's group. What were the final outcomes of Feriduni's work? Any findings about his technique?

[Michael Vories, MD]

I thought is was outstanding. I am used to a motorized system, and part of that is my worry about obtaining tendonitis of some sort in my wrist with manuel extractions. Dr. Feriduni (and especially his assistant) used an extremely sharp CIT punch which required no twisting, just insertion. In fact, it resembled the action physicians use to make recipient sites. Very fast and very impressive.

[scar5]

Fantastic work all who posted here and have contributed generally to spreading the education about FUE, encouraging more surgeons to pursue it. I never thought I could see the day, but perhaps, just perhaps, the strip scar will wane, and balding guys won't have to roll the dice with it and the drugs needed to cover it.

 

On the matter of manual punches, I know long term problems with fingers is a real problem for docs, and it is imperative that reliable devices emerge. Interesting to read about implanters.

 

Thanks again.

[Michael Vories, MD]

I agree. While I was watching all the manual punches in use, I also wonder about how could these surgeons keep us this fine motor work. But then a good friend of mine is a concert pianist, and she can play as well at 65 as she could at 45. I think often these fine motor skills are one of the last things a person loses as they age.

[scar5]

Yes, the fine finger stuff, the dexterity needed can remain, even on a shaky hand or wrist. I look at my grandmothers shaky handwriting on Christmas cards for an example. The lines are full of unsteadiness and minor deviations, but the basic contours and proportions remain intact.

 

Still, I know the big FUE pioneer himself, in practice since 1989, has had problems, and I noticed that the last two FUEs I had, whilst performed by the same doctor (not the pioneer I refer to above), I suspected a change in the way he extracted the grafts. Now this could have been from using a different tool, whatever, but there was a distinct difference - from a spin and toggle to a cut and thrust.

 

Once again, I can't be sure, but I suspected that the doc was saving his hands, at the time.

[Injertocapilar.com]

Videos of the 2MFW:

Pre:

 

 

 

Post: