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PILONIDAL SINUS LASER SURGERY
Minimal Pain
No Stitch
No Scar
30 Min Procedure
PILONIDAL SINUS LASER SURGERY
Minimal Pain
No Stitch
No Scar
30 Min Procedure
What is Pilonidal Sinus?
A Pilonidal sinus also called Pilonidal cyst, Pilonidal abcess or Sacrococcygeal fistula is a cyst ( small sac ) or tunnel in the skin. It develops over the tailbone at the top of the cleft of the buttocks. The cyst usually contains hair and skin debris. More than one cyst may develop and these are linked by tunnels under the skin.
Causes Of Pilonidal Sinus?
- Excess hair growth
- Sitting for a prolonged period
- Unhygienic conditions
- Wearing tight-fitted clothes leads to excess sweat and dirt deposit
- Hormonal changes
- Hair puncture
What are the Symptoms & Signs of Pilonidal Sinus?
- Red, delicate swelling near the tailbone.
- Pain while sitting.
- A small dimple or large swollen area between your buttocks.
- Recurrent Purulent foul-smelling discharge from the sinus and (or) bloody discharge just above the cleft of buttock.
- May experience fever or fatigue during abscess formation
How Is The Condition Diagnosed?
Pilonidal sinus can be diagnosed by an experienced proctologist:
- Physical Examination:To diagnose pilonidal sinus, your doctor will first physically examine the affected area. They will look for signs of inflammation, such as redness, swelling, or tenderness. They may also look for signs of infection, such as the presence of pus or drainage.
- Imaging Tests:Your doctor may recommend imaging tests, such as an ultrasound or MRI, to get a better understanding of the severity of the condition or the chances of any other complications.
Prevention
To reduce the likelihood of pilonidal Synus, consider the following:
1. Maintain a regular hygiene routine.
2. Aim for a healthy weight and strive to keep it.
3. Avoid prolonged periods of sitting.
4. If you’ve experienced pilonidal cysts before, consider regular shaving of the affected area or using hair removal products as a precautionary measure to minimize the risk of a recurrence.
Treatment of Pilonidal sinus
1. WIDE EXCISION OF PILONIDAL SINUS
In this procedure the surgeon does a wide bore local excision of the skin containing the sinus tract. The resulting cavity is left open to heal and fill in naturally from the bottom upwards. The wound is kept covered with a dressing.
The disadvantage of wide excision is that the wound size is large and healing may take upto 3 months. The dressing needs to be changed daily making it a tedious process. However the procedure is safe with a recurrence rate of 10-15%.
2. LASER PILONIDOPLASTY ( LPP )
This is a minimally invasive procedure done using the Leonardo laser. This laser was first introduced in India at Healing Hands Clinic. In LPP, a small cut is made on the skin and all the pus is drained out. The entire sinus tract is then sealed with the laser fibre.
Advantages of LHP
- Patient is discharged within 24 hours and can return to routine work by the 5th day.
- Wound healing occurs in about 6-8 weeks and thus recovery is much faster as compared to conventional Wide excision.
- Recurrence rate is negligible.
3. EXCISION WITH PRIMARY CLOSURE
In this procedure, the abscess and sinus are surgically removed and the wound is closed with stitches/sutures. The stitch line is preferably off the midline, where the tension is less and chances of healing are better.
The advantage of this technique is that the healing is faster and takes about 4-6 weeks. The main drawback is that the infection rate is almost 20-25%. In case of such an infection a revision procedure is done and the wound is left for open healing anyways.
4. Z-PLASTY
In Z-plasty after removing the abscess and sinus, the surgeon loosens triangular flaps on each side of the midline to fill the cavity, with points of flap towards the head and foot. While closing the surgeon crosses the pointed flaps to cross the midline in a horizontal direction, thus converting an N-shaped incision to a Z-shaped closure.
Z-plasty is not a preferred choice of treatment because :
- The chances of recurrence are very high.
- Flap necrosis may occur in which case the dead portion of the flap also has to be removed.
- The post-operative pain and discomfort is very high.
5. CLEFT LIFT / MODIFIED KARYADAKIS / CLEFT CLOSURE
In this procedure the surgeon removes all the area of disease and makes sure the wound is healthy. The resultant defect, a football shaped ‘ellipse’ or cavity, lies parallel to the midline but to one side. The edges of the skin are then freed up a little and the wound is closed with multi-layered stitches. In cleft lift, the actual shape of the cleft is changed to be more shallow and allow for better healing. By almost flattening the cleft, the gathering of loose hair is less likely, and the less deep cleft does not favour the growth of anaerobic bacteria.
6. LIMBERG FLAP / GLUTEAL FLAP
This procedure is done in patients who have extensive Pilonidal disease or who have disease affecting both sides of the buttock. The surgeon removes an oblong shaped plug containing the abscess, skin and fat, thus creating a cavity. To fill the cavity, a flap of skin and thick fat is mobilised from the buttock beside and below the cavity. The flap is swung into the centre and the edges are sutured.
Benefit of Laser Treatment for Pilonidal Sinus
| OPEN SURGERY | LASER SURGERY | |
|---|---|---|
Scar Stitches |
MULTIPLE |
MINIMAL |
Procedure |
PAINFUL |
MINIMAL PAIN |
Blood Loss |
HIGH |
LOW |
Infection |
HIGH |
LOW |
Recovery |
BEDREST |
FAST RECOVERY |
Hospital Duration |
LONG |
SHORT |
Technology |
OUT DATED |
ADVANCE |
What are the Benefits of Pilonidal Sinus Laser Surgery?
Pilonidal sinus laser surgery offers various benefits, including;
- Minimally invasive: Laser pilonidal sinus surgery is a minimally invasive procedure that involves less pain and bleeding.
- Outpatient procedure: The procedure is done on an outpatient basis, which means no overnight hospital stay is required.
- Fast recovery: Laser surgery has a shorter recovery time compared to traditional surgery.
- Lesser risks of infection: The risk of pilonidal sinus infection is lower with laser surgery due to lesser incisions made during the procedure.
- Lesser chances of recurrence: Laser surgery reduces the chances of recurrence compared to traditional surgery.
- No or less scarring: The procedure involves less scarring due to the smaller incisions made during surgery.
- High success rate: Laser surgery has a higher success rate for treating pilonidal sinus disease.
- Precise: Laser surgery is a more precise method of treating pilonidal sinus disease.
- Cost-effective: Laser surgery is a more cost-effective option as it requires fewer hospital resources and is less likely to require additional procedures.
What to Do After Pilonidal Sinus?
After undergoing pilonidal sinus surgery, it is important to make some lifestyle changes to make the treatment successful. Here are some common lifestyle changes you should follow after pilonidal sinus surgery;
- Keep the surgical area clean and dry: After surgery, it is important to keep the surgical area clean and dry to avoid infection. Take regular showers and gently clean the area with soap and water. Avoid using any harsh chemical-based soaps or scrubs in the area.
- Follow your doctor’s instructions: Your doctor will provide you with specific instructions on how to care for the surgical area, including how to change dressings and how often to clean the area. It is important to follow these instructions carefully to avoid complications.
- Avoid sitting for long periods: Sitting for extended periods can put pressure on the surgical area and slow down the healing process. If possible, avoid sitting for long periods and take short breaks to stand up and move around.
- Maintain a healthy diet: A healthy diet can help speed up the healing process after surgery. Make sure to eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein.
- Avoid strenuous activities: Strenuous activities can put pressure on the surgical area and slow down the healing process. Avoid activities such as heavy lifting, running, or jumping until your doctor gives you the okay to resume them.
- Quit smoking: Smoking can slow down the healing process and increase the risk of complications. If you smoke, it is important to quit before and after surgery.
By following these lifestyle changes, you can ensure a speedy recovery after pilonidal sinus treatment through surgery. Always remember to follow your doctor’s instructions and to contact them if you experience any complications or concerns.
FAQs Around Pilonidal Sinus Treatment
Sometimes pilonidal sinus goes away on its own, but there are high recurrence rates.
Most people need surgery to treat a pilonidal sinus completely. However, you can use medications and home remedies to manage symptoms.
You must seek immediate medical attention if you experience increased pain while sitting and notice a small dimple or large swollen sinus-like formation at the tailbone or between the buttocks. The sinus may also be oozing fluid with a foul smell.
Laser surgery is the best method for treating and excising a pilonidal sinus.
Sleeping on your front or side is the best way to sleep after the surgery, as this reduces the strain on your surgery wound. However, do not curl into a fetal position when sleeping on your side, as this would stretch your lower back.
