Laser ablation of pilonidal sinus using 1470 diode laser

Abstract:

This video demonstrates a minimally invasive technique for the treatment of pilonidal sinus using a 1470 nm diode laser. The procedure includes tract irrigation, mechanical debridement, widening of the external opening, and laser ablation of the sinus tract. This approach allows effective obliteration of the tract with minimal bleeding and excellent postoperative recovery.

Case Description:

A32 ys old male patient presented with a pilonidal sinus located in the sacrococcygeal region. The procedure was performed under spinal anesthesia with the patient in the prone position.

Procedure:

The sinus tract was initially irrigated with hydrogen peroxide to clear debris and organic material. This was followed by antiseptic preparation using povidone-iodine, and subsequent irrigation with normal saline.

Mechanical debridement of the tract was performed using a curette to remove granulation tissue and epithelial lining. The tract was then irrigated again with normal saline.

The external opening was gently widened using a curette to facilitate insertion of the laser fiber and ensure adequate drainage postoperatively .

Laser ablation was performed using a 1470 nm diode laser at a power setting of 8 watts. The sinus tract measured approximately 3 cm in length and 5 mm in diameter. The laser fiber was gradually withdrawn while delivering uniform energy to achieve complete ablation of the tract lining.

Hemostasis was achieved effectively after minimal to mild bleeding. The cavity collapsed almost completely following laser application.

Operative Time:

Approximately 30 minutes

Outcome:

The patient tolerated the procedure well and was in excellent condition postoperatively, with effective hemostasis and near-complete closure of the cavity.

Keywords:

Pilonidal sinus, laser ablation, 1470 nm diode laser, minimally invasive surgery, sacrococcygeal region, sinus tract, curettage