Comparison of Monopolar and Bipolar Electrocautery Excision Techniques in Pilonidal Sinus Disease: A Retrospective Clinical Study


Bipolar electrocautery, Monopolar electrocautery, Pilonidal sinus disease


How to Cite

Doğan, S., Öndeş, B. ., Kutluer, N. ., Sözen, S., Gençtürk , M. ., Erdem, H. ., Aksu, A., & Aydın, A. (2023). Comparison of Monopolar and Bipolar Electrocautery Excision Techniques in Pilonidal Sinus Disease: A Retrospective Clinical Study. Iranian Red Crescent Medical Journal, 25(3).


Background: There is no standard method for the treatment of pilonidal sinus disease (PSD). Today, many different treatment methods are attempted. Some of the leading methods are surgical procedures with different flap techniques and less invasive methods, such as crystallized phenol, laser pilonidoplasty, radiofrequency excision, and monopolar electrocautery excision.

Objectives: This study aimed to compare the monopolar and bipolar electrocautery excision techniques that we performed in our clinic for PSD.

Methods: Patients who received pilonidal sinus treatment in our clinic between January 2018 and January 2021 were analyzed retrospectively. The exclusion criteria were diabetes mellitus, renal failure, immunosuppression, and children (<16 years of age). The study included a total of 36 patients who met the criteria. Data were retrospectively obtained from hospital archive records (operative notes, discharge summary, and outpatient dressing records). The patients were then divided into two groups, namely monopolar electrocautery excision (group 1) and bipolar electrocautery excision (group 2).

Results: The mean age of 36 patients included in the study was 22.9 years. There was no difference between the two groups in terms of predisposing factors (gender, obesity, hirsutism, and smoking). There was also no statistical difference in terms of mean healing time and recurrence rate. Monopolar and bipolar electrocautery excisions lasted 32.2±8.9 and 38.8±7.8 minutes, respectively (P<0.05). Accordingly, the operative time was significantly different between the groups, and it was shorter in the monopolar electrocautery excision group. Furthermore, the bipolar electrocautery group showed shorter wound infection duration, compared to the monopolar electrocautery excision group (P<0.05).

Conclusion: Both excision techniques were similar in terms of wound healing, hospital stay, and recurrence rates. The operative times were longer in bipolar cautery; however, the wound infection was less.


Lee PJ, Raniga S, Biyani DK, Watson AJM, Faragher İG, Frizelle FA. Sacroccoccygeal pilonidal disease. ColonDis. 2008:10(7):639-50. doi:10.1111/j.1463-1318.2008.01509.x.

Harries RL, Alqallaf A, Torkington J, Harding KG. Management of sacrococcygeal pilonidal sinus disease. Int Wound J. 2019;16(2):370-8. doi:10.1111/iwj.13042 [PubMed:30440104]

Steele SR, Perry WB, Mills S, Buie WD. Practice parameters for the management of pilonidaldisease. DisColonRectum. 2013:56(9):1021-7. doi:10.1097/DCR.0b013e31829d2616. [PubMed:23929010]

Karydakis GE. Easy and successful treatment of a pilonidal sinus after explanation of causative process. Aust N Z J Surg. 1992:62:385-9. doi:10.1111/j.1445-2197.1992.tb07208.x. [PubMed:1575660]

Halleran DR, Onwuka AJ, Lawrence AE, Fischer BC, Deans KJ, Minneci PC. Laser hair depilation in the treatment of pilonidal disease: a systematic review. Surg infect. 2018;19(6):566-72. doi:10.1089/sur.2018.099. [PubMed:30095368]

Velotti N, Manigrasso M, Di Lauro K, Araimo E, Calculli F, Vertaldi S, et al. Minimal invasive pilonidal sinus treatment: a narrative review. Open Med. 2019:14:532-6. doi:10.1515/med-2019-0059. [PubMed:31428682]

Erciyes University Biomedical Engineering Department Calibration of Medical Devices Laboratory, Experiment No:6 Electrocoterial Device Calibration. https://biomed.erciyes.

Eryılmaz R,Şahin M,Alimoğlu O,Yıldız MK.Predisposing factors in the formation of chronic pilonidal sinus. Turkish J Surg. 2003:19(1):49-53.

Yang YP, Yu LY, Wang YZ, Shi J, Li JN, Shang FJ, et al. Comparative analysis on the effect of Z-plasty versus conventional simple excision for the treatment of sacrococcygeal pilonidal sinus: a retrospective randomised clinical study. Int Wound J. 2020;17(3):555-61. doi:10.1111/iwj.13315. [PubMed:31975537]

Palesty JA. Zahir KS. Dudrick SJ, Ferri S, Tripodi G. Nd:YAG laser surgery for excision of pilonidal cysts:a comparison with traditional techniques. Lasers Surg Med. 2000:26(4):380-5. doi:10.1002/(SICI)1096-9101(2000)26:4%3C380::AID-LSM6%3E3.0.CO;2-X.

Gupta PJ. Radiofrequency sinus excision: better alternative to marsupialization technique in sacrococcygeal pilonidal sinus disease. J Natl Med Assoc. 2005:97(7):998-1002. [PubMed:16080670]

Gupta PJ. Pilonidal sinotomy with radiofrequency. J Coll Physicians Surg Pak. 2003:13(9):540-1. [PubMed:12971883]

Minneci PC, Halleran DR, Lawrence AE, Fischer BA, Cooper JN, Deans KJ. Laser hair depilation for the prevention of disease recurrence in adolescents and young adults with pilonidal disease: study protocol for a randomized controlled trial. Trials. 2018:19:1-8. doi:10.1186/s13063-018-2987-7.

Dupuis A, Christou N, Teterycz D, Balaphas A, Robert-Yap J, Zufferey G, et al. Sacro-coxxygial hygiene, a key factor

in the outcome of pilonidal sinus surgical treatment? BMC Surg. 2021;21(1):197. doi:10.1186/s12893-021-01204-4. [PubMed:33865363]

Rogers P, Platell C, Levitt M. Minimal tissue excision in the treatment of pilonidal sinus disease: results from a

single surgical unit. ANZ J Surg. 2020;90(4):529-32. doi:10.1111/ans.155677. [PubMed:31930671]

Onder A, Girgin S, Kapan M, Toker M, Arikanoglu Z, Palanci Y, et al. Pilonidal sinus disease: risk factors for postoperative complications and recurrence. İNT Surg. 2012;97:224-9. doi:10.9738/CC86.1

Pfenninger JL, DeWitt DE. Radio frequency surgery. PPCP. 1994;1:91-101.

İgors İ, Andreas O. The management of pilonidal

sinus. Dtsch Arztebl İnt. 2019:116(1-2):12-21. doi: 10.3238/arztebl.2019.0012. [PubMed:30782310]

Segre D, Pozzo M, Perinotti R, Roche B, İtalian Society of Colorectal Surgery. The treatment of pilonidal disease: guidelines of the İtalian Society of Colorectal Surgery (SİCCR). Tech Coloproctol. 2015:19:607-13. doi:10.1007/s10151-015-1369-3. [PubMed:26377583]

Petersen S. Pilonidal sinus disease: what is the best treatment option? Zentralbl Chir. 2019:144(4):341-8. doi:10.1055/a-0901-7945.

Gohar MM, Ali RF, Ismail KA, Ismail TA, Nosair NA. Assessment of the effect of platelet rich plasma on the healing of operated sacrococcygeal pilonidal sinus by lay-open technique: a randomized clinical trial. BMC Surg. 2020;20(1):212. doi:10.1186/s12893-020-00865-x. [PubMed:32962673].