Modified Hybrid Approach for the Management of Pilonidal Sinus Disease: Combination of Laser Sinus Tract Ablation with Multiple Ksharasutra Application(CLAKS Technique)

Abstract

Pilonidal sinus disease (PSD) is a chronic and recurrent condition predominantly affecting patient. Conventional surgical techniques are associated with high recurrence rates, prolonged healing time, and postoperative discomfort. Minimally invasive approaches such as laser sinus ablation offer less pain and faster recovery but remain limited by recurrence risk. Ksharasutra therapy, a traditional Ayurvedic para-surgical procedure, provides effective tract excision and healing but requires prolonged weekly sittings, especially in long sinus tracts.We propose a new idea of Hybrid surgical technique(CLAKS Technique) combining laser ablation for primary sinus tract destruction with multiple Ksharasutra placement in segmented tracts. By dividing long tracts into smaller segments and applying multiple threads resulting in reduced healing time, faster cutting of tract and minimised recurrence risk with minimal post operative complications.This case report details the management of  pilonidal sinus of a  25 year old male patient using the hybrid surgical technique, a minimally invasive advanced approach. Imaging studies confirmed the presence of fluid filled sinus tracts with abscess formation. This case highlights the effectiveness of Hybrid technique in treating complex pilonidal disease and underscores its potential  as a preferred treatment modality in similar cases.