A new minimally invasive treatment of pilonidal sinus disease with the use of a diode laser: a prospective large series of patients.

Aim: Various surgical techniques are available for the management of pilonidal sinus, but there is still controversy concerning the optimal surgical approach. The aim of our study was to evaluate the safety, efficacy and clinical outcome of a laser procedure for the treatment of pilonidal sinus.

Method: Patients suffering from pilonidal sinus were operated on with sinus laser therapy (SiLaT) in our institute. SiLaT was applied under local anaesthesia after a small skin incision of 0.5-1 cm and careful cleaning of the sinus tracts with a curette. A radial fibre connected to a diode laser set at a wavelength of 1470 nm was then introduced into the tracts. The laser energy was delivered in continuous mode.

Results: Two-hundred and thirty-seven patients (183 male, median age 24 years, range 14-58) suffering from pilonidal sinus were operated on using the SiLaT laser procedure in our referral Institute and prospectively evaluated. A high healing rate was observed after the first session (90.3%, 214 of 237) with a median healing time of 47 days (range 30-70 days). A second treatment was offered for patients failing in the first session; this was successful in 78.3% (18/23). The duration of the procedure ranged between 20 and 30 min and had limited morbidity (wound infection in 7.2%, 17 of 237).

Conclusion: SiLaT proved to be a safe and effective procedure for treating patients suffering from pilonidal sinus. Clinical results showed low morbidity and recurrence rates comparable to the published literature for other modern techniques.