Background: The treatment of pilonidal sinus disease still remains challenging. Despite many non-surgical and surgical methods, no consensus emerged for the best treatment. We describe a new innovative technique consisting in the destruction of the pilonidal cyst with a radial laser probe (FILACTM, Biolitec, Germany). The energy delivered causes the destruction of the sinus epithelium and the simultaneous obliteration of the tract.
Method: In December 2015, we retrospectively studied the data of our 40 first patients operated with this technique between September 2014 and September 2015. The mean follow-up period was 234 days (92-316). There were 33 men and 7 women. The mean age of the patients was 25.2 years (15-46).
Results: The success rate was 87.5% (35 patients/40). Recurrence rate was 2.9% (1 patient/35). Hospital stay was 1 day for all the patients with no re-hospitalisation during the follow-up. The mean duration of soiling before healing was 18.6 days (2-35). The mean duration of pain-killers intake was 4.9 days (0-14). Four patients presented complications: 2 hematomas (5%) and 2 abscesses (5%), all medically treated.
Conclusion: The destruction of a pilonidal cyst with a laser probe is a safe, simple and minimally invasive technique. The success rate is good. Hospital stay is short, pain is light and complications are few as well as the number of patients needing post-operative care, allowing a rapid return to work or school. This technique could be proposed as a first-line treatment to the majority of patients with a pilonidal sinus disease.
Keywords: Pilonidal sinus; laser; minimal invasive surgery; pilonidal cyst; sacrococcygeal sinus.