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​Learn about the main surgical techniques for treating Pilonidal Disease.


The most used technique is this, known as “healing by secondary intention”, where the doctor removes all the tissue and leaves the wound open, being able to approximate the edges with stitches or not. Despite being widespread and providing satisfactory results, it has a long healing time and low recurrence rates.


This method is where the wound is sutured, that is, complete primary closure is performed with stitches and is recommended for active and young patients. There is controversy regarding this procedure, despite the rapid return to activities, recurrence rates are higher.


This is a technique used mainly in recurrent cases, that is, when the disease returns, after the incision, adjacent muscles are replaced in this region, cutting up the wound with the leftover skin. Aesthetically, it is quite unsatisfactory, on the other hand, the chances of recurrence are compared in the literature and research with the open method.


This technique is a natural application of VAAFT, developed for the treatment of perianal fistulas, to the treatment of pilonidal cysts. The technique consists of introducing the fistuloscope. This material is removed using foreign body grasping forceps and destroyed by cauterization. In this way, it is possible to clean all the contents of the cyst and cauterize its walls without opening it.


Laser surgery to remove a pilonidal cyst is performed under anesthesia and it is even possible for the patient to return home on the same day. The procedure is performed through a fiber (catheter) inserted into the openings of the pilonidal cyst. The specialist doctor, the coloproctologist, thoroughly cleans the area, removing hair and tissue. Then, with the circular beam laser fiber, it cauterizes and coagulates the cyst from the inside, promoting its closure. Pilonidal cysts can vary greatly in size. Some can be up to 10 centimeters long. Identifying the precise size is important to define the best technique for each case.

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