Adarsh Malagouda Patil
BACKGROUND A simple examination is generally sufficient to establish the diagnosis of a pilonidal sinus disease. The inner wall of the sinus is lined by stratified squamous epithelium and there are almost always free hairs, debris and granulation tissue in the pilonidal sinus. The techniques range from simple incision of the sinus with or without marsupialisation or radical excision of the cyst with the wound laying open and healing by second intention to closed methods with midline or off midline sutures like the Karidakis or Bascom procedures. MATERIALS AND METHODS We describe a new innovative technique consisting of the destruction of the pilonidal cyst (Picture 1) with a Neo V Laser Probe (Picture 6). Our study suggests that destroying the pilonidal sinus with a laser probe is a safe procedure with effective results. The energy delivered causes the destruction of the sinus epithelium and the simultaneous obliteration of the tract. RESULTS The success rate was 87.5% (35 patients/40). Recurrence rate was 2.9% (1/35). All the 40 patients treated by the laser technique between September 2014 and September 2015 took part in the study. None of them were lost of follow-up. The mean follow-up period was 234 days (range 92–316). CONCLUSION The procedure meets the characteristics of minimal invasive surgery, is easy to perform and reproducible. The main advantages are a shorter hospital stay, less post-operative pain and care and the final aesthetic aspect. The ideal treatment should heal the sinus tract and the overlying skin and prevent recurrence. This procedure is short and simple and does not require hospital stay. The main advantage of this procedure is reduced pain, post-operative care and the cost with the best aesthetic result which was achieved through this technique. This technique could be proposed as the first line treatment for the majority of the patients with a pilonidal sinus disease.
