Video-Assisted Laser Ablation of Pilonidal Sinus by Dr Kalyan Kar

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Description
VALAPS, or Video-Assisted Laser Ablation of Pilonidal Sinus, is a minimally invasive surgical procedure used to treat pilonidal sinuses. A pilonidal sinus is a small hole or tunnel that develops in the skin, typically near the tailbone in the crease of the buttocks. They are more common in men and individuals who sit for long hours. Pilonidal sinuses are caused when hairs get trapped in the skin, leading to inflammation and potential infection, forming an abscess or discharging pus through the tunnel. 
 
How VALAPS surgery works
The procedure involves these key steps: 
  1. Videoscope insertion: A thin camera (endoscope) is inserted into the sinus tract to provide a clear view.
  2. Cleaning and debris removal: The surgeon, guided by the videoscope, uses sharp curettage to meticulously remove hair and infected tissue from the sinus tract.
  3. Laser ablation: A specialized laser fiber is then used to burn and seal the sinus tract from the inside, destroying the diseased tissue. This is often done in a fan-shaped manner to ensure all areas are treated. 
 
Benefits of VALAPS over traditional methods
VALAPS offers several advantages over traditional, more invasive surgical approaches: 
  • Minimally invasive: No large cuts or extensive stitching, resulting in tiny wounds and minimal scarring.
  • Reduced pain: Patients experience significantly less pain compared to traditional surgeries.
  • Faster recovery: Most individuals can return to work within 3-5 days.
  • Lower risk of infection: The thorough cleaning and sealing of the sinus reduce the chances of post-operative infection.
  • Better cosmetic results: Minimally invasive approach results in less noticeable scarring.
  • Lower recurrence rates: Direct visualization ensures complete removal of the problem areas, reducing the likelihood of the condition returning. 
 
Recovery
Recovery from VALAPS surgery is generally quicker than traditional methods: 
  • Initial healing: Most patients heal within 3 to 4 weeks.
  • Return to work: Many can return to work within 3–5 days.
  • Wound care: Requires regular, simple dressings, but not always daily.
  • Precautions: It’s important to avoid prolonged sitting, sweating, friction, and strenuous activities during the initial recovery phase. 
 
Potential complications
While VALAPS is considered safe and effective, some potential complications, although less frequent than traditional surgery, may include: 
  • Infection: Although the risk is lower than with open surgery, it remains a possibility.
  • Bleeding: Bleeding at the surgical site can occur.
  • Pain: Pain is expected but can typically be managed with prescribed medication.
  • Scarring: While minimal, some scarring may be present.
  • Recurrence: While the risk is low, there’s a chance of the pilonidal sinus returning, especially if post-operative care instructions are not followed diligently. 
 
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