Endoscopic pilonidal sinus treatment (E.P.Si.T.): a minimally invasive approach

Abstract

Introduction The pilonidal cyst is a chronic inflammatory process that occurs frequently in the sacrococcygeal region. It is more common in males with a ratio of 3:1 and usually presents itself in the third decade of life. The treatment is mainly surgical with various forms. The search for new technologies as well as for a minimally invasive treatment has become of utmost importance in surgical routines. The technique E.P.Si.T. (endoscopic treatment of pilonidal cyst) developed by Meneiro has been quite interesting in the treatment of pilonidal cysts. Surgical technique Anesthetized the patient in the supine position. Identified the drainage hole of the cyst, and began with the passage of fistuloscope studying the path of the cyst. Performs following the removal of all the tissue inside as the hair followed by cauterization of the path. Removed all devitalized tissue and enlargement of the opening of the cyst.

Brazilian and Argentinean Multicentric Study in the Surgical Minimally Invasive Treatment of Pilonidal Cyst

“…Among the several treatments for the pilonidal cyst, the EPSiT technique presents itself as a safe alternative; however, its use depends on specific equipment, which may limit it 13 . Milone et al (2014) 14 described a similar procedure using a hysteroscope for performing the video-assisted operation.…”

“…The cyst is then opened with the aid of jet of these liquids in order to identify hairs and eliminate damaged tissues. The hairs present in the tract are removed with the aid of the forceps and the granular tissue is treated by means of the monopolar electrode 13 . All granular tissue is destroyed and removed, the hairs removed, and then the tract is cleaned and left open cavity to facilitate drainage (Figures 1C and 1D).…”

“…In addition, other less invasive techniques such as curettage of the cavity with application of phenol 4 or even the use of laser are commonly used 2 , 8 , 16 . Less invasive techniques are an alternative to methods of surgical excision, presenting advantages such as less postoperative pain, early return of the patient to his activities and reduced scarring 13 .…”

Comparative analysis on the effect of Z‐plasty versus conventional simple excision for the treatment of sacrococcygeal pilonidal sinus: A retrospective randomised clinical study

“…Although it is still argued whether it is congenital generation or acquired, it is widely accepted that keratin plugs, hair remnants as foreign bodies could be found inside the sinus . Considering these foreign bodies' existence, observation to SPS often starts from local infection at the sacrococcygeal site, and it would end with fistula formation if no in‐time proper treatment approach is used.…”

Estudo Multicêntrico Brasileiro e Argentino no Tratamento Cirúrgico do Cisto Pilonidal por Técnica Minimamente Invasiva

“…Results: Of the 67 patients, 67% (n=45) were male and 33% (n=22) female, with a mean age of 25 years (17-45). Surgical time in average was 40 min (20-120) and mean healing time of four weeks (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Surgical complications were presented in 7% cases (n=5) and recurrences in 9% (n=6).…”