Endoscopic Pilonidal Sinus Treatment (EPSiT) at Brighton Hospital

Endoscopic Pilonidal Sinus Treatment (EPSiT) is a new treatment performed at Brighton Nuffield hospital. It is less invasive surgery using a tiny camera to explore the sinus. The internal lining of sinus is safely burnt (cauterised) and cleaned with a brush. Some people will need more than once EPSiT for complete healing of 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 removal of sinus are:

• 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 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. around 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.