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In select patients, the cutting-edge endoscopic pilonidal sinus treatment (EPSiT) procedure may be offered as a first-line treatment at PTCNJ.

EPSIT: Below-skin view of a sinus
Below-skin view of a sinus
Endoscopic pilonidal sinus treatment or EPSiT is a minimally-invasive first-line approach for pilonidal patients wishing to avoid a larger incision. It is generally offered to patients with limited disease and an innately shallow natal cleft. Via one of several small incisions well to the side of the midline, a fiberoptic camera called an endoscope is inserted under the skin. The entire procedure is visualized with this endoscope. A long grasping instrument is next passed via one of these lateral incisions, again fully under the skin. With this instrument, thick subdermal hair shafts and associated inflammatory granulation tissue are bluntly extracted. Aggressive antiseptic irrigation is done. Finally, the tract remnants are thermally ablated with an electrocautery probe. The incisions are closed with dissolvable sutures. EPSIT is often combined with conventional pitpicking. At PTCNJ, EPSIT is done in our ambulatory care center under general anesthesia. The patient may return to full activities the day after the procedure.


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