Pilonidal Cyst - Pit Picking
Pain-free, minimally invasive surgery for Pilonidal Cyst (Coccyx fistula) with small wounds
| Sinus Pilonidalis Pit Picking Check |
| Operation time: 10-15 minutes |
| Hospital stay: No |
| Open wound: Yes, but significantly smaller than with conventional surgery |
| Incapacity to work: 3-5 days |
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General anethesia: Generally no, but depends on the findings |
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Costs: Costs are covered by all insurance companies |
Pit picking - small cuts, small wounds, little pain
There are various treatment options for coccyx fistula. What they have in common is that only surgical treatment has been available to date. Conservative treatment, even with antibiotics, is not possible. The surgical method depends very much on the severity of the findings and the experience of the surgical practice.
How is the pit picking operation performed?
Pit picking involves removing small hair channels from the skin using a 3-4 mm punch. These are presumably the entry points for hair into the subcutaneous fatty tissue, which leads to the dreaded chronic inflammation.
The operation therefore always involves the complete removal of these hairs, as otherwise the inflammation will recur, which is known as recurrence. The surgeon must therefore have a lot of experience and the procedure should be performed very thoroughly in a center with a lot of experience.
However, pit picking always involves removing the abscess cavity under the pits in which the hair has been deposited. The cavity, including the wall and the hair, must be completely removed. This radical removal of the fistula structures in the case of larger findings is called a sinusectomy. The surgical approach is always slightly lateral in order to leave as small a wound as possible in the midline, which heals poorly.
The operation is performed under local anesthesia in our practice and patients can leave our practice after approx. 30-40 minutes. There is nothing to consider during preparation. Eating and drinking before the operation is even encouraged.
What happens after the pit picking operation?
After the procedure, the very small wounds remain open so that the wound secretions can drain off, allowing the wound to clean itself. Although it is also possible to close the sutures, there is always a residual risk of re-inflammation with pus formation and the wounds close within 1-2 weeks without sutures, so we prefer open wound healing as a safe option.
It is important to know that the disease can recur (recurrence) and the risk of this is around 20-25%. The classic generous excision of the lesion is still the “gold standard” in pilonidal sinus surgery, as there are fewer recurrences.
However, the healing process after large excisions is very protracted and can take up to 6 months, which means that patients and their relatives, who have to help with bandaging, are pushed to their physical and psychological limits.
Pit picking with sinusectomy should therefore always be considered as a treatment option if the findings are suitable, even if the recurrence rate is higher.
“We have been successfully performing the pit picking operation in our center every day for over 10 years”
This is a typical skin punch with which the pit picking operation is performed.
The opening is usually 3-4 mm in diameter and the channels are punched out in their entirety, which is painless.
The existing abscess cavity is cleaned via the resulting canal, hair is removed and finally rinsed.
The wound is usually healed after 2-6 weeks.
You are welcome to book an appointment with our doctors.
We look forward to hearing from you.