A Prospective Study of Outcome of Gips Procedure as Minimal Invasive Surgical Approach for Pilonidal Sinus

Abstract

Hina Gupta*, Avinash Gautam, Sumit Shukla and Ankur Maheshwari

Background: Pilonidal disease is a very common anorectal problem that most often arises in the hair follicles of the natal cleft of the sacrococcygeal area. Incidence of male being affected are more than female due to their hirsute nature. Pilonidal sinuses are also associated with obesity (37%), sedentary lifestyle (44%), local irritation or trauma. Pilonidal sinus can appear as acute abscess along with sinus tract formation. The management of pilonidal sinus is mostly surgical. The most commonly used procedures are simple incision, excision, plastic surgery techniques, minimally invasive sinusectomy, marsupialization, fistulotomy.

Materials and methods: A total of 30 patients, suffering from pilonidal sinus were enrolled in the study over a period of 18 months. A detailed history relating to the disease process and about socioeconomic, cultural and economic backgrounds of the patient was taken. Patients were operated with the minimally invasive GIPS procedure which combines the principles of a minimally invasive method proposed by Lord and Millar and the individual excision of midline openings proposed by Bascom, hence, named after them.

Results: In our study we observed that 83.3% patients were males with majority (50%) of them belonging to 21-40 years age group. Majority of the patients were driver by occupation (30%) and had co-morbidities of diabetes mellitus (14%) and hypertension (16.6%). Majority of them presented with chronic discharging sinus swelling (40%). Patients operated with GIPS procedure for the pilonidal sinus had healing rate of 70% after 2 weeks with minimal complications.

Conclusions: Patients operated with GIPS procedure had better outcome with quick recovery and healing. These patients had less post- operative pain and discomfort, early resumption of daily activities with least recurrence and complication rates. Hence, GIPS procedure, being a day care procedure represents a good option for the patients of pilonidal sinus.