Video‐assisted ablation of pilonidal sinus (VAAPS) – video vignette

: Video assisted approach to chronic pilonidal sinus demonstrated to be a valid alternative for the definitive treatment of this disease. We present a case of 30-year old women, with a BMI of 26.5 kg/m, diagnosed with a chronic complex pilonidal sinus, without any other comorbidities.After performing local anesthesia and positioning the patient in a prone position with the hips slightly flexed, the external opening of the sinus is widened with a spreading clamp. An endoscope is inserted through the external opening (orifice), and the sinus cavity and its lateral tracks are identified. A mechanical adhesiolysis is performed with the grasping forceps and the hairs are removed. Then the sinus cavity is completely ablated with a 5-Fr bipolar electrode under continuous vision. Finally, a cleaning of the sinus cavity is performed with a Volkmann spoon and the residual cavity is irrigated with iodine-povidone. The postoperative period was uneventful and the patient was discharged after 6 hours.