Pilonidal Sinus Surgery with Vatsyayann's Technique

Pilonidal Sinus Surgery

Pilonidal  disease is a chronic infection of the skin and underlying tissue near the tailbone. This is a  very common disorder in both men and women in the age group 15-40. Most of the patients have heavier buttocks which result in the inward growth of body hair which become infectious

Common surgical options for treating sacrococcygeal Pilonidal disease have inherent problems of patient discomfort and inconvenience, prolonged hospitalization, delayed recovery, and loss of workdays. Dr. Suresh V. Sharma has developed a new technique in which the surgery is done under local anaesthesia and the hospital stay is just one day. The next day patient can resume normal work like going to office, studying or playing. In the `Vatsyayann' technique the patient walks in and out of the operating room on his or her feet. The surgery takes about one hour and the cost of removing a Single Pilonidal Sinus is USD 2000. For multiple pilonidal sinuses the cost may increase to USD 3000. 

Pilonidal Sinus SurgeryIn the conventional method being used by most of the surgeons a long incision is given on the skin and the area is cut open. After this the surgeon cleans the area of all hair follicles and excises the pilonidal sinus tract as seen in the picture. After this some of the surgeons leave the surgical site open so that the wound can heal over a period of 3-4 weeks. Some of the surgeons put stitches at the surgical site which changes the shape of the buttocks. In both the cases full recovery make take 4-6 weeks during which the patient cannot do normal routine work and has to spend a lot of time lying on the stomach. Sitting on a chair can be very taxing and painful. 

Dr Suresh Vatsyayann Technique for Pilonidal Sinus SurgeryThe surgical technique developed by Dr Vatsyayann was presented in the World Congress of Doctors held at Singapore in the year 2007. This technique is called `Tunnel Cleansing with Wet-to-Dry Gauze’. There are just one small incision of less than one cm at the sacrococcygeal midline where visible hair pits are seen or induration felt.  Another similar incision is made superiorly where there is discharge or indication of previous or future discharge. From the upper incision abscesses are drained and cleansed, the debris and the adherent dead and dying tissue scrubbed out with betadine impregnated gauze. Once the space is cleansed, artery forceps from the superior wound is passed through to come out from the lower wound. The gauze tip is held in the forceps and rotated while pulled out through the upper wound. Repeat this process 3-4 times and leave the final gauze in the tunnel so created with a tip coming out of both the ends. Patients are kept in the hospital for 24 hours after which the gauze is pulled out in a rotatory motion from the upper wound. Patients are taught to care for the wound at home. The patient can fly back home on the second day of the surgery.

Dr Suresh Vatsyayann doing Pilonidal Sinus SurgeryAs we see in this picture Dr. Suresh V Sharma is doing Axilla Pilonidal Surgery. Dr Suresh has treated more than 20 cases of chronic recurrent pilonidal  disease with this procedure under local anesthesia in our general practice setting.

 95% had no recurrence in 3 years. All went  back to work the second day of surgery. 50% needed dressing at the surgery twice and others no more than four times. Pain and discomfort other than while pulling out the gauze was reported to be minimal and tolerable. There was no case of secondary infection or cellulites reported or seen however all were given antibiotic one-day prior and to two days postoperative.

Vatsyayann’s technique is easy, has lower recurrence rate, is convenient, has less postoperative morbidity, saves hospital and community resources while avoiding loss of workdays. 

Dr. Suresh V Sharma has  long experience in doing the Pilonidal Surgery. Watch this video where Dr Suresh is explaining the surgical technique

Dr Suresh Vatsyayann is currently available at GNH Hospital Gurgaon India. For appointment with Dr Suresh Call :+91-9801333238

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