US Guided Si.La.D. A new technique for minimally invasive pilonidal disease treatment, using ultrasound guided laser ablation.

Background: The destruction of the pilonidal sinus with a radial laser probe has been suggested as a safe procedure with good results and low morbidity. Nevertheless, the drawbacks of this technique are: a blind technique, if the sinus has some ramifications or a non-linear development, we cannot be sure for their destruction.Methods: 17 patients (12 men, 5 women) were operated with US guided laser destruction - US guided Si.La.D. Laser destruction of the pathological tissue (cavity, sinus) was performed using a 400 µ radial optical fiber, connected and locked to a radiopaque biopsy needle 14 G, using a 12 MHz linear probe, to introduce and real-time echo guide the fiber in order to achieve laser ablation with 120-140 J /cm of pathological tissueResults: No significant complications were recorded.Conclusion: Real-time echo guided laser ablation of pilonidal sinus and cavities proved to be safe and efficient, providing controlled emission of laser energy only to the pathological tissue, increasing the accuracy of identify the right track to deliver energy, decreasing the risk of traumatic progression of surgical instrument into healthy subcutaneous tissue, accidental progression of the disease and missing in the same time tracts that need to be ablate.

Anthropometric, hemodynamic, metabolic, and renal responses during 5 days of food and water deprivation.

BACKGROUND: Although there is considerable research in the field of fasting and fluid restriction, little is known about the impact of food and water deprivation (FWD) on body circumferences and vital parameters. METHODS: During 5 days of FWD in 10 healthy adults, hemodynamic, metabolic, and renal parameters, such as weight, 5 circumferences at neck, waist, hip, chest at axilla, chest at nipples, and 1 new oblique hip circumference were measured daily. For each circumference, new quotients of daily circumference-to-weight decrease were calculated. The set of employed parameters quantified and monitored dieting persons' compliance and efficacy of the method. RESULTS: The values of blood pressure, heart rate, hemoglobin oxygen saturation, glucose, K(+), Na(+), Cl(-), urea, creatinine, and serum osmolality proved to be stable. The mean creatinine clearance increased up to 167%. The mean daily weight decrease (1,390 ± 60 g) demonstrated the effectiveness of FWD in weight reduction. The daily decrease of all measured circumferences and the values of the corresponding circumference-to-weight decrease quotients reflected considerable volume decrease in all measured body parts per day and kg of weight loss during FWD. CONCLUSION: The intervention of 5 FWD days in 10 healthy adults was found to be safe, decreased weight and all measured circumferences, and improved renal function considerably.