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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

In office

Laser Pilonidal Cyst Excision (PCLE)

A minimally invasive, in-office laser treatment that closes the pilonidal sinus tracts — most people are back to normal life the next day.

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Setting
In office
Anesthesia
Local anesthetic
Back to work
Most patients return to work, life and sport the next day
Pain relief
No prescription pain medication
Success rate
85-95%
Recurrence
3-15%

What it is

What is Laser Pilonidal Cyst Excision?

Laser Pilonidal Cyst Excision, also known as Laser Ablation of Pilonidal Sinus (the FiLaC or SiLaC procedure), is a minimally invasive surgical technique for treating pilonidal sinus disease. The procedure involves inserting a thin, flexible fiberoptic laser probe into the sinus tract. The laser emits energy in a 360-degree radial pattern, which vaporizes and ablates the epithelialized lining of the sinus tract and any associated granulation tissue. This process effectively destroys the pathological tissue and seals the tract from the inside, promoting healing with minimal damage to the surrounding healthy skin and tissue. It is performed as an outpatient procedure, often under local or regional anesthesia.

Am I a candidate?

Who is a Good Candidate for This Procedure?

Ideal candidates are patients with symptomatic, uncomplicated chronic or recurrent pilonidal sinus disease. Because it is minimally invasive, it is an excellent option for patients who wish to avoid a more extensive and painful excision with a longer recovery period. It is suitable for most patients, regardless of the length or shape of the sinus tract, and can be used for both primary and recurrent disease. Patients seeking a procedure with a quicker return to normal activities, less postoperative pain, and a better cosmetic outcome are good candidates.

How it's done

  1. 1Numbing — the area is numbed with local anesthetic. No general anesthesia, no hospital stay.
  2. 2Cleaning — the sinus tracts are cleared of hair and debris.
  3. 3Laser — a fine laser fiber is passed into each tract to close it from the inside.
  4. 4Home — you leave the same day with a small dressing and no open wound to pack.

What to expect

  1. Same day

    Home within a couple of hours.

  2. Next day

    Most patients are back to work, school, and normal activity.

  3. First week

    Light dressing care — no wound packing and no prescription pain medicine.

  4. Follow-up

    A quick visit to confirm healing.

Risks & considerations

What are the Risks?

Laser ablation is a very safe procedure with a low risk of complications. The minimally invasive nature of the procedure reduces many of the risks associated with traditional excision. Potential risks include:

  • Recurrence: The pilonidal sinus may recur if the sinus tract is not completely ablated. Recurrence rates are generally low but can be slightly higher than more extensive flap procedures.
  • Delayed Healing or Persistent Drainage: The small external openings may take several weeks to close completely and may have persistent drainage during this time.
  • Infection: The risk of infection is very low, as the laser energy sterilizes the tract during the procedure. However, a superficial wound infection can still occur.
  • Pain: Postoperative pain is typically mild and much less severe than with traditional excision, usually managed with over-the-counter pain relievers.
  • Bleeding/Hematoma: Minor bleeding is uncommon, and the risk of a significant hematoma is very low.

Sources

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