Pilonidal sinus at the natal cleft (area between the buttocks) is a very common condition in young people. It is often referred to as ‘Jeep’s bottom’ as it used to occur in soldiers in World War II as they ride in jeeps for long periods. Today it occurs in students, IT professionals and people who sit for long hours.

‘Pilo’ means ‘hair’ and nidus means ‘nest’ basically meaning nest of hair. The glands at the natal cleft have wide mouths which suck in hair and debris which collects to form a chronic inflammatory process which then becomes infected on and off to cause discharge and pain recurrently.

Pilonidal sinus and abscesses cause many people to suffer and take antibiotics repeatedly disturbing their quality of life.

The popular method of treatment was to incise the abscess and drain the pus, this gives instant relief. Excision of the pilonidal sinus is also commonly performed but leads to a big wound which needs to heal by secondary intention. Suturing such a wound can cause repeated sinuses/ infection.

Plastic surgery techniques such as rotation flaps are being done frequently for large sinuses after excision but there is considerable morbidity.

EPSiT is a minimally invasive procedure to treat pilonidal sinus at the natal cleft. The procedure involves using a specialised miniature camera to enter the pilonidal sinus and cavity and clear all the debris and pus under vision. Then under vision the wall of the sinus and cavity is destroyed using a minute electric current. Since the wound is small it begins to heal faster than an excision wound and pain is considerably less. Incase it’s a complex sinus, a remnant sinus discovered later can be easily addressed under local anaesthesia.

EPSiT reduces morbidity significantly and helps faster healing allowing the person to return back to his or her vocation earlier.