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Laser ablation: a unique and beneficial therapeutic option for pilonidal sinus? And the potential for further innovation—a review

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Abstract

Laser has revolutionized the medical field, broadening the diagnostic and therapeutic spectrum, with diode (630–980 nm) and Nd:YAG (1064 nm) lasers being the common choices in ablation procedures. Laser ablation in pilonidal sinus disease is a new minimally invasive technique with good treatment efficacy, low post-op morbidity, and shorter recovery periods following employment. This review study aimed to provide information on the use of lasers in pilonidal sinus disease and their effectiveness compared to other conventional methods. The articles considered were obtained by performing a literature search in PubMed, Cochrane, and Google Scholar, and 44 articles were included in this study. Techniques like sinus laser-assisted closure (SiLaC), sinus laser therapy (SiLaT), pilonidal sinus laser treatment (PiLaT), and laser-assisted endoscopic pilonidal sinus treatment (LEPSiT) were included and reviewed. Diode laser was most commonly used, with local anesthesia preferred over spinal or general anesthesia. The highest healing rate was observed with Nd:YAG laser and the SiLaT technique. Recurrence was low, particularly in patients who underwent multiple procedures. On reviewing the published literature, laser ablation procedures showed lower morbidity and post-op complications. Patient satisfaction was higher, and the overall cost was found to be lower with minimally invasive techniques. Long-term prospective studies comparing lasers with other surgical techniques would help us ascertain the future treatment modality of pilonidal sinus disease.

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Authors and Affiliations

  1. NRI Institute of Medical Sciences, Visakhapatnam, India

    Rohit Ganduboina

  2. K S Hegde Medical Academy, Mangaluru, India

    Arjun Sreekumar

  3. Kyiv Medical University, Kyiv, Ukraine

    Palak Dutta

  4. Soochow University, Suzhou, China

    Ananya Dhawan & Yashaank Kumar

  5. Dubai Medical College for Girls, Dubai, UAE

    Arshiya Adhnon

  6. Medical College Baroda, Vadodara, India

    Atman Soni

  7. Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Vacoas-Phoenix, Mauritius

    Arya Sudarsan

  8. Bharati Vidyapeeth Medical College, Pune, India

    Ahana Basu

  9. Staten Island University Hospital-Northwell Health, New York, NY, USA

    Indraneil Mukherjee

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Contributions

Conceptualization: Rohit Ganduboina. Methodology: Rohit Ganduboina, Arjun Sreekumar, and Palak Dutta. Validation: Rohit Ganduboina, Arjun Sreekumar, Palak Dutta, Ananya Dhawan, Arshiya Adhnon, Atman Soni, Arya Sudarsan, Ahana Basu, Yashaank Kumar, and Indraneil Mukherjee. Formal analysis, investigation, and data curation: Rohit Ganduboina. Writing—original draft: Rohit Ganduboina, Arjun Sreekumar, Palak Dutta, Arshiya Adhnon, Atman Soni, Arya Sudarsan, and Ahana Basu. Visualization: Rohit Ganduboina, Arjun Sreekumar, Palak Dutta, Arshiya Adhnon, and Indraneil Mukherjee. Writing—review and editing: Ananya Dhawan and Indraneil Mukherjee. Editing: Yashaank Kumar. Supervision and project administration: Indraneil Mukherjee.

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Ganduboina, R., Sreekumar, A., Dutta, P. et al. Laser ablation: a unique and beneficial therapeutic option for pilonidal sinus? And the potential for further innovation—a review. Lasers Med Sci 38, 124 (2023). https://doi.org/10.1007/s10103-023-03788-0

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