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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Updated: Aug 24, 2025

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
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Endoscopic approach to complex or recurrent pilonidal sinus: A retrospective analysis.

Francesco Maione1, Anna D'Amore1, Marco Milone1

  • 1Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.

International Wound Journal
|October 22, 2022
PubMed
Summary

The minimally invasive endoscopic approach for pilonidal sinus is not ideal for complex or recurrent cases with off-midline pits. Distance from the midline significantly influences recurrence rates, suggesting a need for specialized classifications.

Keywords:
complexendoscopicpilonidalrecurrencesinus

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Procedures
  • Pilonidal Sinus Disease Management

Background:

  • Pilonidal sinus is a chronic condition affecting the sacrococcygeal area.
  • Optimal treatment for complex or recurrent pilonidal sinus remains debated.
  • Minimally invasive endoscopic techniques are being explored for pilonidal sinus treatment.

Purpose of the Study:

  • To evaluate the efficacy of the minimally invasive endoscopic approach for complex or recurrent pilonidal sinus.
  • To identify factors influencing recurrence rates after endoscopic treatment.

Main Methods:

  • Prospective study of 38 patients with complex or recurrent sacrococcygeal pilonidal sinus from January 2015 to December 2020.
  • Treatment involved Video-Assisted Ablation of Pilonidal Sinus (VAAPS).
  • Annual follow-up with physical examination to assess recurrence.

Main Results:

  • Recurrence rates at 1, 3, and 5 years were 28.9%, 22.2%, and 38.1%, respectively.
  • Patients with recurrence had a significantly greater mean distance from the most lateral orifice to the midline.
  • Multivariate analysis identified the distance from the midline as a key factor influencing recurrence.

Conclusions:

  • The endoscopic approach may not be the primary choice for complex or recurrent pilonidal sinus disease with off-midline pits.
  • A distinct classification system for such cases is needed to guide surgical approach selection.
  • Further research is warranted to optimize treatment strategies for challenging pilonidal sinus cases.