Endoscopic technique? fibrin glue?

Discussion in 'Pilonidal Discussions' started by Melbourne_Mum, Jan 3, 2016.

  1. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi,
    My daughter (18) has a pilonidal abscess (it recently receded a little) but is uncomfortable to sit etc. We have been searching for the least invasive technique for treatment. Has anyone had an endoscopic surgery or biopsy punch? How about the use of fibrin glue to fill the tunnel and seal it up? It looks like the modified Karydakis is favoured but it's still quite invasive so as it's not a massive abscess yet or with several pits we are trying to find some way to fix it without resorting to that procedure.
    We have 3 surgeons lined up to speak to but I am hoping to find some success stories following an endoscopic/biopsy punch/fibrin glue surgery.
    Thank you!
    Melbourne, Australia
     
  2. LILLY

    LILLY Very Helpful

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    Have you contacted Dr. LP Cheah in Melbourne about pit picking and modified Karydakis? As far as the other techniques there is a current thread in the UK forum and some more information in the surgeons hall of fame forum regarding surgeons in Italy.
     
  3. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi Lilly,
    I do have an appointment to see Dr Cheah but I am also looking for an endoscopic surgeon for a less invasive option. I see Dr Cheah has great success with the modified Karydakis though. I have an appointment with a surgeon who does the endoscopic technique this week so I will report back once I have seen both. Thank you. I will look at the Italian threads.
     
  4. LILLY

    LILLY Very Helpful

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    Yes report back because people are always looking for options and the more information we have the better.
     
  5. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi, so we got to surgeon no.3 and chose him. Mr Alex Wong, colo-rectal surgeon who did a modified Karydakis cleft lift. He does a lot of robotic surgery and endoscopies etc - but he said you can't do an endoscopy on this area. (The nurses said he's even performed a successful colon resection through a belly button!) Anyway, he said he'd done more than 200 pilonidal surgeries and he was very knowledgable. The surgeon and anaesthetist were really nice and it has seemed to go well. She is in quite a bit of pain - day 5 so we will wait before posting on the Hall of Fame, but so far, it looks good and she may just be a slow healer. We never got to see Dr Cheah in the end because she was so tired of going to surgeon appointments and really liked Mr Wong.
    Apparently Mr Malcolm Steel - colorectal surgeon is also excellent and has performed 100's of these ops.
     
  6. Dermot Kelly

    Dermot Kelly New Member

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    Hi Melbourne_Mum, I am just after noticing your post. I received surgery in Rome (Italy) from Prof. Basso, back in 2014. A great success! He performed on me the so called "Israeli" biopsy punch procedure, where he cored out the fistula and its multiple openings... All I can say, after travelling all the way from the UK, it was well worth the while! Speedy recovery, painless surgery, affordable fees. Also, a pleasant professional working with a pleasant team. No language barrier whatsoever. Of course Australia is far away from Europe and the UK, but you could well balance pros and cons, in terms of quality of life after surgery, costs for loss of your days, etc. During my stay, Prof. Basso had a patient travelling from China and one from Canada. In any case, in Australia or elsewhere, my advice for your daughter is to go for a minimally invasive operation.
     
  7. Melbourne_Mum

    Melbourne_Mum New Member

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    I wish we could have travelled there Dermot. Dr Basso wrote back to me and I was considering it but worried it might be too risky if there were issues and we got stuck there (although 'stuck in Italy' sound like an oxymoron - nice place to be stuck).
    Anyway we are heading into week 10 of recovery from modified Karydakis - wound has opened up a little more but granulation is taking place so probably another 3-4 weeks says the surgeon. :(
     
  8. Brendan321

    Brendan321 New Member

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    Hi Melbourne_Mum, I hope your daughter's recovery was fast ... I had pilonidal minimally invasive surgery with Prof. Basso in Italy three weeks ago, and it has been a great success. We flew over from the United Kingdom (only 2 hours away by plane), no language barriers whatsoever, plenty of information prior to surgery, reasonable tax deductable costs ... I am writing full story elsewhere. In any case, I am sure your daughter's pilonidal is now gone and just a distant and bad memory ...
     
  9. Nick Tseganlis

    Nick Tseganlis New Member

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    Hi Melbourne mum! I have recently had the same procedure as your daughter also from alex Wong and also my stitches at the bottom have come apart and some pus, how long did it take for your daughter to recover thanks Nick
     
  10. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi Nick ​
    Thanks for writing! I hope we can be of help. My daughter is now completely healed but it took 3 ops and significant trauma - 7 months at home!
    Ok so your first port of call is to Alex Wong again for some strong antibiotics. If there is pus there is an infection. You should go urgently. Call asap and see if you can go today. Don't leave it over the weekend. If you can't get in call 13SICK to get a doctor at home for antibiotics to take in the meantime.
    See what Alex suggests. He recut and re stitched my daughter but it opened again once the stitches were out so 3rd op was to leave it open. This is the scariest but it did heal up eventually.
    I would also highly recommend you go see
    a specialist wound nurse called Jan Rice at the Ashburton Medical Centre. 03 9885 4494 She is amazing. If the wound is going to be left open - or there is a small part that won't close go see her. You need a referral so get one from Alex or another GP.
    We ended up packing the small open incision with Sorbact gel dressing - a bacteria binding gel dressing. I must say that the thing that really helped in the end as she basically had recurring infections for 6 months was an antibiotic cream called Mupirocin. Available on prescription. It basically stops the top of the incision from reinfecting.
    It's such a tricky disease to treat and some people heal really well and others don't. I don't think it's the doc - he was very caring. I'd still recommend him.
    All the best and call him now.
    Heather
     
  11. Nick Tseganlis

    Nick Tseganlis New Member

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    Jeeze your poor daughter, that sounds absaloutely horrific . I spoke to him yesterday and he said that the only thing to do for now is to take antibiotics till I see him next Thursday as I'm scheduled to get my stitches, though I can see once they are out its all going to be a big mess! From what I can see of the wound there is no good progress and its only looking g worse. I have no pain or anything. Thanks so much for your advice I will definitely look into the wound nurse if Alex can't give me any help, im so upset this whole pilondial thing is driving me insane! I'm due to go overseas in 8 weeks with my partner and praying that I will be ok to go! Thank you so much for your help its much appreciated!!
     
  12. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi Nick
    One of the threads said that surgeons know surgery but wound nurses know wounds and I wish I'd taken her to Jan earlier. Even if just for a consult - can't hurt. The sooner you get on to the treatment the better off you are going away in 8 weeks. She only works one day a week there so quite hard to get an appointment. She has seen hundreds of pilonidal surgeries so will give you good advice. All the best for a quick resolution and a great holiday. Feel free to write back if you want any more input.
    Heather
     
  13. Nick Tseganlis

    Nick Tseganlis New Member

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    Thank you so much heather! I will let you know what what the surgeon says next Thursday
     

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