Laser pilonidotomy — a new approach in management of complex pilonidal sinus disease: an exploratory study

Abstract

Background The treatment of pilonidal sinus disease still remains challenging mainly because of multiple factors responsible for wound healing and its recurrence. With recent advances in surgical field, use of laser found to be an effective technique in the destruction of a pilonidal cyst. Laser Piolonidotomy is a new promising technique. Methodology An exploratory study was planned with the Aim, to evaluate a new technique for the excision of pilonidal sinus. Objectives were to investigate its effectiveness in terms of operation time, healing time, and the duration of hospitalization, resumption of normal activity the degree of postoperative complications and rate of recurrence and patient’s satisfaction. All the patients with pilonidal sinus were categorized and laser pilonidotomy was planned for patients satisfying inclusion criteria. Data collected in pre-structured, pre-tested proforma and analyzed using SPSS. Results Mean duration of Procedure was 33 min (SD = 11), mean duration of Hospital Stay was 12 h (SD = 3), resumption of normal activity within 4 days (SD = 2), mean duration for Complete Wound Healing by secondary intention 6 Weeks (SD = 1.25). Among complications, infection reported in 1.08%. The difference between the mean pre and post-operative VAS score was statistically highly significant (p < 0.0001). Recurrence rate was 3.24%. Success rate was 96.75% and Overall patient’s satisfaction was 97.84%. Conclusion Laser Pilonidotomy is effective in destruction of a pilonidal cyst with good success rate, fewer complications and with high patient’s satisfaction.

Laser treatment of pilonidal disease: a systematic review

“…The retreatment with PILAT is easily performed and successful [17,18,21]. However, the minimally invasive nature of this method has two disadvantages (compared to excisional procedures): deep tracts and abscesses may be missed, and no adequate specimen for pathohistological analysis can be obtained, although malignant degeneration of PD is extremely rare [42].…”

“…In 3 studies [16,17,21], a repeated PILAT was performed. Pappas and Christodoulou used one repeated laser treatment in 23 patients with a healing rate of 78.2%.…”

“…Table 3 demonstrates technical and intraoperative characteristics. In 8 studies [16-19, 22, 23], the procedure was performed using the diode laser device from Biolitec® (Biomedical Technology GmbH, Jena, Germany), while 2 studies did not specify the laser manufacturer [21,24]. Laser characteristics were as follows: 1470-nm wavelength and power of 12-15 W in 9 studies and 980-nm wavelength in one study [22].…”

“…Dessily et al treated 40 patients with a healing rate of 87.5%. The number of studies and patients treated with this laser is rising [16][17][18][19][20][21][22][23][24]. However, there is still no high-level evidence on short and long-term outcomes to bring evidence-based guidelines for the use of laser treatment in chronic PD.…”

Comparative Study between Excision of Pilonidal Sinus Via Lay Open Technique Versus Closed Technique and between Karydakis Technique Versus Limberg Technique: Meta Analysis

“…It can cause pain, sepsis, and reduced quality of life and has an impact on the individual's ability to attend work or education. Risk factors for the condition include male gender, young age, obesity, Mediterranean ethnicity, hairiness, deep natal cleft, and poor hygiene [2] .…”