
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 pilonidal cyst or sinus, in an innately shallow cleft, the simple pilonidal cystectomy is a reasonable first-line approach. Borrowing from the fundamental concepts of the cleft-lift procedure, but limiting the incision length to 9 cm, a simple pilonidal cystectomy may fully eradicate the disease. At PTCNJ, the simple pilonidal cystectomy is done in our ambulatory care center under intravenous sedation or general anesthesia. The resulting wound is closed in three absorbable suture layers over a small drain. The duration of surgery is approximately 45 minutes to one hour. The drain is removed either at home by a family member or friend, or in our Center, at approximately one week 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.