In select patients, the more conservative “simple pilonidal cystectomy” may be offered as a first-line treatment at PTCNJ.
In the case of a focal, limited pilonidal cyst or sinus tract, a simple pilonidal cystectomy is a reasonable first-line approach. Borrowing from the fundamental concepts of the cleft-lift procedure, but limiting the cleft incision to a 3 x 1 cm ellipse, a simple pilonidal cystectomy may fully eradicate the disease. At PTCNJ, the simple pilonidal cystectomy is done in an ambulatory care center under intravenous sedation or general anesthesia. The resulting wound is closed in three suture layers over a small drain. The duration of surgery is approximately 45 minutes. The drain is removed either at home by a family member or friend, or in our Center, at approximately 4 days following surgery. Patients may return to full work or school activities in the first day following surgery, although stress to the operative site is avoided for 3 weeks.