11770 Excision of pilonidal cyst or sinus; simple

Name of the Procedure:

Excision of Pilonidal Cyst or Sinus; Simple

Summary

In layman's terms, the excision of a pilonidal cyst or sinus is a surgical procedure to remove a cyst or sinus near the tailbone that causes pain and infection. This "simple" version involves less extensive surgery, usually suitable for smaller or less complicated cysts.

Purpose

This procedure addresses pilonidal disease, a condition where a cyst or abscess forms near the tailbone due to ingrown hairs, infection, or prolonged sitting. The main goals are to relieve pain, eliminate infection, and prevent recurrence.

Indications

• Persistent pain or discomfort near the tailbone.
• Recurrent infections or abscesses in the area.
• Presence of a noticeable cyst or sinus tract.
• Failure of conservative treatments like antibiotics or drainage.
• Suitable for patients with small or uncomplicated cysts.

Preparation

• Patients may need to fast for several hours before the procedure.
• Medications such as blood thinners might need adjustment.
• Pre-operative assessments typically include a physical examination and possibly imaging tests like an ultrasound.

Procedure Description

1. Anesthesia: Local anesthesia to numb the area; general anesthesia may be used in some cases.
2. Incision: A small incision is made over the cyst or sinus.
3. Excision: The cyst or sinus is carefully removed along with any infected tissue.
4. Closure: Depending on the size and depth of the excision, the wound may be closed with sutures or left open to heal.
5. Dressing: A sterile dressing is applied to protect the area.

Tools and equipment: Surgical scalpel, forceps, sutures, sterile dressing materials.

Duration

Typically, the procedure takes about 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient surgical center or a hospital.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common risks: Bleeding, infection, pain at the surgical site.
• Rare risks: Recurrence of the cyst or sinus, delayed wound healing, allergic reaction to anesthesia.

Benefits

• Relief from pain and discomfort.
• Reduced risk of recurrent infections.
• Improved quality of life.
• Benefits can usually be realized within a few weeks post-surgery.

Recovery

• Post-procedure: Patients may experience mild to moderate pain, managed with prescribed pain medication.
• Wound care: Keep the area clean and dry, and follow the surgeon’s instructions for dressing changes.
• Activity: Limited physical activity for a few days; avoid prolonged sitting.
• Follow-up: Typically scheduled 1-2 weeks post-surgery to monitor healing.
• Full recovery: Usually occurs within 2-4 weeks.

Alternatives

• Conservative treatment: Antibiotics, sitz baths, and warm compresses.
• Incision and drainage: Temporary relief but may not prevent recurrence.
• Laser hair removal: Can reduce the risk of cyst formation but doesn't address existing cysts.
• Minimally invasive techniques: May offer quicker recovery but depend on the cyst's complexity.

Patient Experience

• During: Minimal to moderate discomfort due to local or general anesthesia.
• After: Mild to moderate pain, manageable with medication. Feeling of tightness or discomfort around the surgical site.
• Pain management: Prescribed pain relievers and non-prescription analgesics help manage discomfort. Some patients may use ice packs to reduce swelling.