US Guided Si.La.D. A new technique for minimally invasive pilonidal disease treatment, using ultrasound guided laser ablation

Background: The destruction of the pilonidal sinus with a radial laser probe has been suggested as a safe procedure with good results and low morbidity. Nevertheless, the drawbacks of this technique are: a blind technique, if the sinus has some ramifications or a non-linear development, we cannot be sure for their destruction. Methods: 17 patients (12 men, 5 women) were operated with US guided laser destruction - US guided Si.La.D. Laser destruction of the pathological tissue (cavity, sinus) was performed using a 400 mu radial optical fiber, connected and locked to a radiopaque biopsy needle 14 G, using a 12 MHz linear probe, to introduce and real-time echo guide the fiber in order to achieve laser ablation with 120-140 J /cm of pathological tissue Results: No significant complications were recorded. Conclusion: Real-time echo guided laser ablation of pilonidal sinus and cavities proved to be safe and efficient, providing controlled emission of laser energy only to the pathological tissue, increasing the accuracy of identify the right track to deliver energy, decreasing the risk of traumatic progression of surgical instrument into healthy subcutaneous tissue, accidental progression of the disease and missing in the same time tracts that need to be ablate.