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Laparoscopic, G.I. & colorectal surgery, Navi Mumbai, India

  Click to call +919833290590


Pilonidal Sinus Treatment with EPSIT & Flap

Pre-operative and post-operative care for Laparoscopic Hernia surgery

Pilonidal disease and sinus

Pilonidal disease and sinus

Pilonidal disease is a chronic infection of the skin in the region of the buttock crease. The condition results from a reaction to hairs embedded in the skin. The sinuses are infected tracts below the skin that connects to the surface with one or more small openings predominantly occur at the end of tail bone.

Although less common, a pilonidal sinus can also occur between fingers and in belly button area.

The exact reason of pilonidal sinus is not known. Ingrown hairs, hormonal changes, friction because of lot of sitting and infection may contribute to pilonidal sinus.
Pilonidal sinus is found more commonly in young adults and occurs most often in men.

Signs and symptoms of pilonidal sinus

A pilonidal sinus may be asymptomatic at first present as a small dimple or a small painless lump. Once it is infected, it may become a painful cyst and acute abscess. Once abscess ruptures patients may develop an opening/ pilonidal sinus.

Some patients have recurrent infections and inflammation of these sinus tracts if not treated.

  • Few symptoms
  • Pain, redness, and swelling
  • Blood or pus drainage
  • Protruding hair from the cyst
  • Fever & malaise in few

Diagnosis of Pilonidal Sinus

A medical history of symptoms and detailed physical examination is usually enough to diagnose pilonidal sinus.

Visual examination to check for signs of infection and blood test to check for increased white blood cells may be ordered. In rare cases, CT scan may be recommended.

Pilonidal sinus should be differentiated from other conditions such as a dermoid cyst.

Treatment of pilonidal sinus in Mumbai

Incision and drainage of Acute Abscess: 

In acute abscess formation, the Sinus tract is cut open and accumulated pus is drained out. This is a minor outdoor procedure under local anaesthesia so you will be able to return home on the same day or the day after. Daily dressing is required till healing occur.

For chronic sinus or recurrent infections of your pilonidal sinus, your surgeon will recommend surgery to remove the sinus with any of the following procedures:

Excision and Reconstruction with local advancement flap:

Treatment of pilonidal sinus in Mumbai

A section of skin along with infected sinus tract is removed by the surgeon. Direct suturing will cause excessive tension on the suture line and wound may breakdown causing a delayed wound healing or chronic wound sinus.
Wound is closed with the mobilization of a skin flap from the healthy skin of surrounding area. This helps in healing.

Advantage of local advancement Flap surgery:

  • Day care procedure,
  • Postoperative pain is very less
  • Fast recovery after surgery (usually within a week).

EPSIT (Endoscopic Pilonidal Sinus Treatment):

EPSIT is a new technique to treat pilonidal sinus which facilitate endoscopic visualization of inside of the sinus tract and ablation of tract by cautery through endoscope.

Advantages of EPSIT

Minimally invasive procedure
can be done under local anaesthesia
Day care procedure so same day return to home

Dr Nitish Jhawar is General, laparoscopic and colorectal surgeon with 17 years extensive experience in the field. He has fellowship of Association of Colorectal Surgeons of India (FACRSI) and Fellowship in colorectal surgeries from US.

He has received advance training in proctology and training EPSIT endoscopic treatment of pilonidal sinus from Berlin, Germany.

Post-Operative Care after pilonidal procedure

What to expect after the procedure?

Patients can go home same day
Pain Medications to control postoperative pain are prescribed.
Patient can lie on his back but should change position regularly.
Light physical activity and showering is allowed.
Full physical activity can generally be resumed after 2 weeks.
Patients are generally able to resume work after few days or in one week
No external stitches are present and there is no need to remove any suture.
Area is to be kept clean and dry.

After healing, the skin in the buttocks crease must be kept clean and free of hair.


What patient says about Dr. Nitish Jhawar

  • Person Image

    I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at M.... hospital, he .... asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Fortis staff was also very caring and good. I would mention fortis Vashi in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

  • I had surgery of my left hydrocele on 27th May 2017 by Dr Nitish Jhawar. An excellent experience of service I got particularly from Dr Jhawar. He is not only a qualified experienced doctor but also a splendid human being. Thanks a lot.

  • It was a Laparoscopic operation for the removal of Gall Bladder (stones). I had developed on and off pain in abdomen before the operation, after the operation feeling good, totally pain free. Thanks and respect for handling my case very well.

  • Person Image

    I met doctor Nitish for piles problem and wanted to undergo LASER procedure only, my operation is successful and I thank doctor for being a good human being and great surgeon.

  • Person Image

    I was suffering from piles since long time. For bleeding heavily I met Dr Nitish Jhawar and after meeting him decided to go for Stapler surgery for piles. I found him a doctor who listens to our problem and explains properly.

  • Person Image

    I got diagnosed about a year back but was avoiding operation for Hernia repair, Dr Nitish Jhawar explained me why surgery should be done and I chose surgery by laparoscopy method. I am happy with the doctor and the hospital.

  • Person Image

    I visited for Gall Bladder removal by Laparoscopy after searching for best laparoscopic surgeon. After meeting dr my fear for surgery was vanished and my surgery went well and recovery was smooth.

  • Person Image

    Honest doctor, expert in his field....can trust his words

  • Person Image

    Very good he describe everything in very pleasant manner about the problem which was very helpful to me to understand my disease.

  • Person Image

    Very nice. Doctor is very patient and gives you correct advice.

  • Person Image

    He is very erudite and smart at getting to the bottleneck of the problem. And before realized he had pinched away d growth bothering me near my anal area.

  • Person Image

    Dr. Jhawar is few of the best doctors in town. Extremely pleasant and comfortable experience