Laser Cure of Pilonidal Cyst or Pilonidal Sinus
The minimally invasive laser solution of Pilonidal Cyst or Pilonidal Sinus
It’s called also Ingrown Hair Cyst or Tailbone Cyst or Coccygeal Fistula , seen mostly in younger patients with the chief complaint of pain in mid buttocks groove, accompanied at times with some swelling, redness and may be some foul smelling discharges. Pilonidal cyst (sinuses) can extend quickly under the skin and branch out to cover larger area than what its small surface opening(s) suggest. It needs to be treated as soon as it is discovered. We see this condition mostly in young adults, both men and women, 60-70% of the patients are hairy in that area which seems to complicate the issue with excessive amount of hair growth onto and inside these cysts. The development of PC is related to the micro-environment and bacterial growth in the skin pores and hair follicles of the one area in the body that rarely see air, this anaerobic surrounding seem to play a role, more so than our traditional old believe that it is a congenital deformity.
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The problem with pilonidal cyst is two fold: One; is the patient delay in seeking medical care, most patients come to us with multiple cyst openings, and two; The cyst expansion is insidious and tricky, it could look like a small little opening (s) on the surface, while it is several centimeters deep and branching in all directions under the surface.
The above facts explain the surgeon’s dilemma in treating pilonidal cyst, traditional surgery involves rather unusually large and deep round wound that takes several months to heal or complicated and extensive dissection All of the traditional old procedures were trying to remove (physically remove) the entire cyst walls and content, and by enlarging the round area removed, the surgeon hopes he/she did not miss any branch or portion of the cyst. Obviously these traditional surgeries of pilonidal cyst were not popular among patients, they involved long protracted recovery, daily extensive packing of the wound or repeated visits to the hospital or clinic and worse and they still carried 25-35% recurrence rate.
At our clinic, we adopted and refined a treatment that combine the benefits and healing power of Endo laser with the proven methods of traditional surgical experience, we call it the ‘’Aji’s procedure’’ since it was first used by our Director, Dr. Sarmad Aji, an American board certified laser surgeon with more than 1000 pilonidal laser cystectomy successful experiences.
The method involves no incision or wounds more than enlarging slightly the existing opening, then utilizing the Fistuloscope and Endo-laser to cauterize all cyst walls from within, ending up with tiny opening that requires very little daily postoperative care, with immediate return to work and daily activities, we do this under simple local anesthesia, in an office setting, in less than half an hour with patient up and running immediately after treatment.
Laser Assisted Endoscopic Pilonidal Sinus Treatment (LA-EPSiT) is an exclusive treatment of choice at our clinic for most of our Pilonidal Cyst patients, it is the combination of the Aji Procedure with the Endoscopic tools that makes it so effective and popular. 95% of patients enjoy a permanent cure after LA-EPSiT without missing one day of work or sport activities.
For those advanced and recurrent cases of Pilonidal cysts that we see at our center or referred to us by other physicians and General surgeons and especially those associated with deep natal cleft or defect, we perform a very effective Laser Assisted Modified Cleft Lift Repair ( LA-MCLR ), again, under simple local anesthesia with mild sedation, no open wounds or dressing changes, and excellent permanent cure rate (more than 98%).