Endoscopic pilonidal sinus treatment (E.P.Si.T): a new minimally invasive technique for the treatment of sacrococcygeal pilonidal sinus

INTRODUCTION: The present study analyzed the results of a new video-assisted minimally invasive technique for the treatment of sacrococcygeal pilonidal disease (E.P.Si.T: endoscopic pilonidal sinus treatment). METHODS: From May 2013 to June 2015 a total of 85 consecutive patients (68M, 17F), mean age 27.5 years referred to our surgical department. 75 patients had a primary sacrococcygeal pilonidal sinus, 10 patients had a recurrent pilonidal sinus and all underwent to E.P.Si.T. A fistuloscope is introduced through the external opening and the sinus cavity is completely ablated under direct vision. Patients' postoperative complications, wound infection rate, recurrence rate, time until return to work and satisfaction score were recorded during follow-up or at the last interview. Clinical data were obtained at 7 days, 15 days, 30 days, 6 month and 12 months following surgery. RESULT: All patients were followed up. Mean operative time was 18 min (range 12-30 min). The mean hospital stay was 6,5h (range 5-9) and mean time to return to work was 5 days. Mean follow-up was 16,8 (range 4-29) months. Mean healing time was 32,7 days. There were no major complications and infection; 5 recurrences. Overall satisfactory rate 98%. CONCLUSION: The ideal surgical treatment for pilonidal sinus disease must be simple and effective. In our experience, E.P.Si.T can be performed as a day care surgery with early return to work. This technique is also associated with a low recurrence rate and postoperative morbidity rate and a good aesthetic result.