Operation

Minimally invasive surgery for chronically infected pilonidal cysts

Minimally invasive surgery is always primarily suggested to avoid mutilating surgery in young persons with a benign pathology.

Indeed, the results of excision and primary closure of a pilonidal cyst in the buttock cleft result in a recurrence rate of 40-60% and wound loosening in more than 50% of cases.

Especially the healing of an open wound in the buttock cleft can take several months, with direct consequences on social life, school and work.

Technique

The surgery is performed with the patient in the prone position (face down – on the abdomen).

First, the pits (holes through which the hair moves into the cyst) are resected and the hair is removed from the cyst. Through these holes, the cyst wall is destroyed by curettage, and then the cavity is thoroughly flushed to remove all the infected tissue and remaining hair. Finally, the cavity is treated with radio-frequency or laser to destroy the cyst and infected remaining tissue. The remaining cavity can also be filled with a biological glue (Tissucol type).

This minimally invasive procedure can be repeated if necessary.

Postoperative infection

Incidence : 1,5 %

Post-operative bleeding

Incidence : 0,2 %

Postoperative recurrence

Immediate recurrence : 4.4%

Recurrence after 5 years:

Incidence : 10 – 20 %

Normal symptoms

• Pain in the buttock cleft is normal but should subside over time.
• Oozing of wound fluid during the first weeks should decreases with time.
• Postoperatively, it is normal to feel an induration at the level of the cyst upon injection of a biological glue.

Abnormal symptoms

You should contact your surgeon, GP or go to the emergency department :

• If the pain increases over time.
• If the fever does not subside.
• If discharge of purulent fluid increases over time.
• If blood loss increases over time.

If any of the symptoms seem abnormal, contact your doctor.

If this is not possible, you can contact avec your surgeon.

If you are unable to contact your GP or your surgeon, go to the emergency department at St Elizabeth Hospital in Uccle.

No effect on fecal continence or sexual function after pilonidal cyst treatment.