Model substantiation of surgical access in miniinvasive surgical treatment of pilonidal disease in children

Abstract

Background: Dissatisfaction with the results of treatment of pilonidal disease in children leads to the search for new ways to improve the methodology of its surgical treatment. Objective: To create a model for the spatial justification of the form and parameters of surgical access in the treatment of pilonidal disease in children in all forms of it. Materials and methods: On the basis of anatomical and spatial studies of sacral-coccygeal area in 50 patients with pilonidal disease, the prognostic factors of its course in children have been determined. Thanks to the data obtained, the main conceptual assumptions of the recommendation for the removal of the pathological lesion were identified. In all cases, the developed model of calculation of parameters and localization of operative access allowed to observe the minimally invasive direction of surgical treatment. Results: Based on the data obtained, the main conceptual assumptions and recommendations for the removal of the pilonidal cyst were identified. In all cases the developed model of calculation of parameters and localization of operative access allowed to observe the minimally invasive direction of surgical treatment. Depending on the location, size and location of the fistulas of the pilonidal cyst, a spatial model, based on the ratio of elliptical planes, allows to determine the necessary parameters of the surgical wound, which allows to maximally lateralize the surgical wound with a minimum area of soft tissue removed. Conclusions: The formation of contours, localization and parameters of intraoperative access in pilonidal disease in children, according to the developed model of spatial justification of the form and parameters of operative access, testifies to the feasibility of its elliptical shape, the parameters of which are determined by the location of the external openings of the fistulous passages in relation to the relation. The contour of the surgical wound in the form of an ellipse with well-defined geometric parameters of the calculated object allows to perform mini-invasive plastic surgery when removing the pilonidal cyst without additional formation of perianal skin and subcutaneous fat flap, which allows to reduce the number of postoperative lesions. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee (LEC) of all the institutions mentioned. Informed agreement was obtained from the parents of the children (or their guardians) for the research.The author declares that there is no conflict of interest.