Resources for Medical Professionals
This website was originally intended for patients suffering from Pilonidal Disease, however, over the years it has also become a major resource for those in the medical profession seeking information. Please also check our Pilonidal Medical library for published studies.
This organization is committed to changing the incorrect perception that a Pilonidal needs deep and wide excision. Pilonidals are abscesses, not true cysts. Pathologists and surgeons on rare occasions find the sac is lined with epidermis, made up of cells from skin, but only cells from the outer layer of skin. That outer layer, which we call epidermis, contains no follicles. Pathologists find epidermis lines the sac only in rare late cases where epidermis has crept into a long-standing abscess in an attempt to heal it. They never find a sac lined with intact skin and follicles, only an occasional sac lined with epidermis.
With this in mind, deep and excision, as is commonly thought, is not the most effective treatment for Pilonidal. Newer techniques spare the need for extensive tissue removal and the potential for unhealed wounds. The skin and the tissue are not the problem to be solved by removal. The problem is depth of the gluteal fold and the pits in the midline that exist in an environment with no oxygen and full of anaerobic bacteria.
Below are resources to learn more advanced surgical techniques that preserve tissue and shorten healing times.
The Cleft Lift/Modified Karydakis has become the gold standard treatment for unhealed wounds.
Bascom’s Pit Picking concept has evolved into two newer techniques: Gips Procedure and EPSiT.
Cleft Lift Surgical Instruction Video
by Dr. John Bascom & Dr. Tom Bascom
Bascom’s Cleft Lift Presentation
Below are movies demonstrating the cleft lift surgery in and the techniques pioneered by Drs. John & Tom Bascom. Please note that these videos are narrated by the late Dr. John Bascom after he had suffered a stroke.
**Surgeons who are practicing these techniques should contact us so that we can put them on the list of Cleft Lift surgeons worldwide.
Modified Karydakis Surgical Instruction Video
by Dr. Paul Kitchen
Pilonidal surgical technique of Modified Karydakis Procedure (similar to Bascom Cleft Lift) by Dr. Paul Kitchen.
Like the Cleft Lift, one of the key components of the Modified Karydakis Procedure is making the natal cleft shallower and keeping the primary incision site off the midline where it can receive oxygen and heal. Dr. Paul Kitchen took Karydakis’ original work and modified it based on new information and techniques pioneers by Bascom. This surgical technique has been passed on to several other surgeons in Australia and worldwide.
Watch at Medtube: https://medtube.net/general-surgery/medical-videos/28356-modified-karydakis-pilonidal-surgery
Gips Procedure by Moshe Gips
This technique uses punches (trephines) to pick pits as Bascom had suggested
https://www.colonproctologia.com/?page_id=642
Endoscopic Pilonidal Sinus Treatment (EPSiT)
Taking the idea of pit picking one step further from punches, is the EPSiT procedure by Piercarlo Meinero (Italy). Ths technique uses a video assisted fistuloscope to find underlying sinus cavities and tracts that might be missed during pit picking.
http://www.piercarlomeinero.it/en/epsit.html
Watch at MEDtube: https://medtube.net/proctology/medical-videos/28124-epsit
This page last updated: May 9, 2021
