Sinus laser-assisted closure – SiLaC: Early outcomes and influencing factors

Background: Pilonidal sinus disease (PSD) is a chronic condition of the sacrococcygeal region, commonly affecting young men, causing pain and reduced quality of life. Traditional operations such as open excision or flap procedures (Limberg, Karydakis) are effective but leave large scars, cause significant pain, and require long recovery times. Current practice favors minimally invasive techniques. Sinus Laser Closure (SiLaC) uses a 1470-nm laser fiber to ablate the epithelial lining and shrink the tract, thereby closing the sinus. Early studies report that SiLaC is safe, less painful, and promotes rapid healing (2–3 weeks) with low short-term recurrence; however, long-term data remain limited. Objective: To determine the preliminary outcomes of SiLaC at Hanoi Medical University Hospital, Vietnam. Methods: Consecutive patients who underwent SiLaC at Hanoi Medical University Hospital from February 2024 to June 2024 were included. This was a retrospective analysis of a prospectively maintained database. Results: Nine patients underwent laser sinus closure. Mean age was 19 ± 3.08 years (15–25); 6/9 (66.7%) were male and 3/9 (33.3%) female. Mean BMI was 28.51 ± 5.04 kg/m² (23.23–36.73). Prior pilonidal surgery was recorded in 3/9 (33.3%). Mean tract length was 39.55 ± 14.91 mm (19–62); a secondary tract was found in 1/9 (11.1%). Disease severity: simple 6/9 (66.7%), complex 3/9 (33.3%). Mean operative time was 30 minutes with no intraoperative complications. Postoperatively, all patients had mild pain with VAS <4 (9/9, 100%); no case had VAS >4. Mean length of stay was 1.11 ± 0.33 days. No postoperative complications were observed. Over a mean follow-up of 103.11 ± 73.26 days (29–234), primary wound healing occurred in 100% (9/9); time to complete healing was 20.22 ± 10.06 days (7–30). No recurrences were recorded during follow-up. Conclusion: SiLaC is a minimally invasive and safe technique with a high success rate, low complication rate, and minimal postoperative pain.