Endoscopic pilonidal sinus treatment (EPSiT): A modern answer to an age-old problem

Pilonidal Sinus Disease (PSD) is a cause of serious morbidity with varied clinical presentations. The management of the disease has seen sea-changes in the last few decades. Endoscopic pilonidal sinus treatment (EPSiT) involves the use of appropriately sized endoscope to delineate the anatomy of pilonidal sinus tract including any side branching tracts and ablating them using monopolar electrode under vision. Use of EPSiT in the Armed Forces settings has limited experience and we extended the use of EPSiT to ascertain its benefits in the manpower intensive military settings.

This prospective study included 43 patients. The procedure was performed using the technique described by Meinero et al. including diagnostic and operative phase. Intraoperative findings were recorded and patients were followed up for the duration of the study. Data analysis was performed using statistical software Statistical Package for Social Sciences.

Male to female ratio in this study was 3.3:1. 81.4% of the patients presented with primary disease whereas 18.6% had recurrent disease. The operative time ranged from 12-35 minutes. The mean length of the tract was found to be 7.6 ± 1.9 cm. A single, two and three fistulous openings were seen in 69.8%, 23.2% and 7% patients, respectively. Return to work was within a range of 2-7 days. Average visual analogue scale (VAS) score of patients on post operative day (POD) 1 was 2.72 ± 0.83. Complete wound healing was achieved within 21 days in 97.7% patients.

EPSiT an ideal procedure of choice among combatants where early return to work translates to operational readiness.