Endoscopic Pilonidal Sinus Treatment (EPSiT)

What is a Pilonidal Sinus?

A pilonidal sinus is a small tunnel under the skin at the top of the buttocks, where they divide (the cleft). It does not always cause symptoms and only needs to be treated if infected. It may go unnoticed unless it becomes infected. When infected, it can cause pain and swelling and may lead to the formation of a pus-filled abscess.

What is Endoscopic Pilonidal Sinus Treatment (EPSiT)?

Endoscopic Pilonidal Sinus Treatment (EPSiT) is a minimally invasive surgery using a tiny camera (endoscope) to treat the sinus. The internal lining of the sinus is safely burnt (cauterised) and cleaned with a brush. Some people will need more than one EPSiT to completely heal the sinus. This procedure is often performed as a day-case procedure under a brief general, spinal anaesthetic (awake anaesthesia with a needle injection into the back for patients with significant heart or lung diseases) or under local anaesthesia in selected patients.

The benefits of EPSiT compared to traditional surgical

• The surgeon can see the sinus (tunnel) using a tiny camera. It helps to identify complex sinus with branching tunnels and abscesses
• The natal cleft is not affected
• Wounds are quite small and don’t need the insertion of packing material
• People have less pain after the procedure and can go back to work and daily life much faster

What are the side effects of the EPSiT procedure?

• Pain and minor bleeding are common side effects of EPSiT
• You might develop discharge from the sinus. If you also have a high temperature, you might need antibiotics to treat a wound infection.
• Fluid is used to wash the sinus tract during EPSiT and rarely (1 in 20 patients) this fluid escapes out of the sinus tract and causes swelling aound the natal cleft. This swelling usually goes away by itself after a few days.
• Most people have a small amount of bleeding from the wound. You may notice this more after your dressing has been changed. This is normal and nothing to worry about. It is a good idea to wear a small pad inside your pants to protect your clothes from any staining.