Pilonidal Sinus Surgery with Mechanical Drilling Technique

Pilonidal sinus disease (PSD) is a common condition affecting young and middle-aged adults. Most commonly seen in men, it has significant economic implications and is associated with discomfort and inability to work. Men are thought to be at higher risk because of their more hirsute nature. The aim of this study was to evaluate the efficacy of “Mechanical drilling technique” as a new approach in pilonidal sinus disease treatment. From January 2017 to February 2019, 30 patients were treated for PSD in our center. All patients referred to our center with chronic pilonidal disease in the natal cleft were enrolled with no age or sex limitations and operation previously. After spinal anesthesia, all patients underwent operation in the prone position. Mechanical drilling was performed using drilling trephine apparatus number 368. Smaller pits were distracted using trephine number 859. Thirty patients were operated using this technique. The mean operating time was 15 min. Recurrence was observed in only one patient (3.33%). Wound healing time varied from 7 to 21 days. All patients were operated under spinal anesthesia and discharged after 4 h. The maximum cosmetic satisfaction rate was 90%. Mechanical drilling technique is an effective minimally invasive technique for the treatment of PSD with very low recurrence and comparable rate, and hospital stay compared with excision and primary closure techniques.