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Video

Session: Ongoing Videos for CME

VM104 - VALAPS Video Assisted Laser Ablation Pilonidal Sinus

Saturday, June 1, 2024
10:00 AM – 1:30 PM ET, USA
Location: Baltimore Convention Center, Hall BCD

    Video Presentation(s)

  • Kushal Mital (he/him/his)

    Honorary Surgeon
    Chattrapati Shivaji Maharaj Hospital
    Chatarpatti Shivaĵ Maharaj Hospital, Kalwa, Thane
    Thane, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: AIMS
To treat Pilonidal Sinus disease by Minimally Invasive technique using Endoscopic and Laser Ablation Techniques with minimal recurrence rates
OBJECTIVES
In Pilonidal sinus disease, we must avoid large disfiguring flaps. Excellent results are achieved by VALAPS.

Methods/Interventions: A total of 54 patients were undertaken for VALAPS, selection criteria ensured that no open sinus wounds were included in the study. There was no restriction on the chronicity and recurrence. The procedure was in three steps. Step 1 Trephining, Step 2 EPSiT, Step 3 LASER. All cases were subjected to Endoscopic Pilonidal Sinus treatment of entering. The Laser fiber ablation of the tract was done using Radial fiber with 10 CW on a 1470 diode machine, through the working channel of the Endoscope. Pit picking for midline pits. Follow-up dressings for 4-6 weeks.

Results/Outcomes: A total of 54 cases were subjected to VALAPS. Cases included pilonidal abscess, acute sinus tracts, chronic tracts, and secondary tracts off midline. All cases followed up till the wound healed. Mean operative time was 20 minutes (range 15 -24 minutes). The standard hospital stay was 24 hours. The median healing time was 18 days (14 -28 days). The mean return to work was 4 days (range 2-7 days). Two patients had early closure with the formation of abscesses. They were drained in OPD under local anesthesia, one had a recurrence and was managed by Laser ablation. Our series had a 97.2% success rate.

Conclusion/Discussion: VALAPS has given excellent results, even surpassing, EPSiT ( Endoscopic Pilonidal Sinus Treatment, 94.8%) or SiLaT (Sinus Laser Therapy 90.3% success rate). Our procedure was under vision with a success rate of 97.2% . Direct vision allowed the complete removal of hairs and hair follicles in the PDS tract. Using Laser fiber under vision, ensured that no skip areas were left behind. VALAPS is simple to do, the learning curve is negligible, the restricting factors being the cost of instrumentations.