The main advantage of the endoscopic technique is the possibility of performing the treatment of the pilonidal cyst with direct visualization, removing all its content to improve results.

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Benefits:

 - Treatment under direct vision

 - Small incisions

 - Early return to usual activities

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Disadvantage:

 - Cauterization is performed with a monopolar scalpel which may eventually leave untreated areas in the cyst.

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Relapse rate in 1 year: 3.9%

Relapse rate in 5 years: 24.3%

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The main advantage of the endoscopic technique is the possibility of performing the treatment of the cyst with direct visualization, removing all its content to improve results.

​

Benefits:

 - Treatment under direct vision

 - Small incisions

 - Early return to usual activities

​

Disadvantage:

 - Cauterization is performed with a monopolar scalpel which may eventually leave untreated areas in the cyst.

​

Relapse rate at 1 year:3.9%

Relapse rate in 5 years:24.3%

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A technique performed, a brush is placed in the path of the cyst to remove hair, soon after a probe with a diode laser at its tip is inserted to the cyst, and radial photothermoablation is started (360º), with a wavelength of 1470nm releasing 10- 15 watts per cycle. The fiber is withdrawn continuously and slowly, cauterizing the cyst and occluding its path.

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Benefits:

 - The laser acts on the circumference providing greater reliability in the radial treatment

 - Good aesthetic results 

 - Early return to usual activities

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Disadvantages:

 - Failure to directly visualize the cyst and its fistulas may eventually leave some orifice untreated.

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Relapse rate in 1 year: 2.9 - 9.7%

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There are no studies with a follow-up of more than 2 years.

Use of biological glues as fibrin sealant or thrombin matrix has several uses in pilonidal disease, as a minimally invasive technique is used after curettage of the cyst in order to occlude the holes and cause migration of cells that help to heal the site.

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In practice, the use of sealants is not widely used due to the cost and lack of large studies that show long-term results, as well as those that exist today show recurrence rates of the order of33% in single application.

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Its main advantage is the fact that it can be performed with local anesthesia.

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Probably the first minimally invasive technique created, it basically consists of curettage and infusion of the substance that aims to corrode the remains of the cyst.

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This outpatient technique was practically abandoned due to its high rates of long-term relapse (reaching 44% in 5 years).