Laser ablation for pilonidal sinus disease

We describe a standardised 14-step technique for pilonidal sinus tract ablation using a radial 1470-nm diode laser. The protocol incorporates systematic tract identification, methylene blue staining, pit excision and sequential curettage, followed by a dual curettage-dual ablation cycle with ice-cold saline cooling. Laser ablation is a safe, minimally invasive, day-case procedure offering rapid recovery, minimal post-operative pain and acceptable recurrence rates.