Modified open method [limited excision] for the treatment of pilonidal sinus

This study was done on 23 patients with pilonidal sinus disease [20 males and 3 females], with an age ranged between 16-35 years. Proper preoperative cleaning of the sinus track by a special fine brush had assessed much in proper delineation of the sinus track, any side tracks and the wall of the sac by the use of methylene blue dye, and this had assessed much the main objective of limiting the amount of excised soft tissues, that include all sinus track and the wall of the sac, thus shorten the time needed for proper healing, together with minimizing the incidence of recurrence. All patients had left the hospital 4 days after the operation. The discharge was markedly reduced within a week after the operation. Complete healing of the wound was established in 17 patients [74 percent] within 4-6 weeks, and in 3 patients [13 percent] within 7-8 weeks, and in the remaining 3 [13 percent] within 10-12 weeks. Recurrence had observed in one patient [4.3 percent]. Hygienic instructions, with depilation of hair from the region is considered as an important item to guard against recurrence, or formation of a new sinus

Lateral extension of inguinal incision for exploring intra-abdominal undescended testis, and the role of ultrasonography in the diagnosis

Twenty one cases, with clinically impalpable testis were studied in 15 patients [9 had unilateral, and 6 had bilateral undescended testis]. Their ages were ranged between 2- 31 years. All cases were subjected to ultrasonography, which had succeeded in localizing 14 cases [66.6 percent] in the inguinal canal; a finding which was confirmed at operation. Although ultrasonography had failed to localize those cases posed behind the internal ring and in the pelvic cavity, but it was succeeded in localizing other cases of impalpable ectopic testes, thus avoiding unnecessary exploration. Inguinal incision done opposite the inguinal canal for all cases showed that, 16 cases of undescended testis were located in the inguinal canal, and three cases behind the internal ring Limited lateral extension of the inguinal incision had resulted in proper exploration of the pelvic cavity and the lower part of the loin. Meticulous dissection of the tissue plane between the parietal peritoneum and pelvic fascia had resulted in delineating and finding the remaining two cases posed at the pelvic brim. This lateral extension obviates the unnecessary invasive investigations, as will as the intraperitoneal exploration with direct approach to the undescended testis