P Th A.13 Video-assisted sinus surgery (VASS): New technique for treatment of surgical site sinus: A case series
Published Date: 01st September 2019
Publication Authors: Altaf K, Hajnik J, Patnam V, Rajaganeshan R
Introduction
Sinus formation after a procedure is a recognised complication. While most settle without requiring any treatment, many can continue to cause persistent symptoms. These have always been managed by exploration of the sinus tract under general anaesthetic, laying open, excision of the tract or debridement. Results post-surgery may not always be completely satisfactory. Video Assisted Anal Fistula Treatment (VAAFT) is a recently described technique for management of perianal fistulae, using endoscopic, minimally invasive approach. We modified this technique to incorporate surgical site sinuses as Video Assisted Sinus Surgery (VASS). Here, we describe our experience in our patient population and review individual cases.
Method(s)
Nine consecutive patients who were carefully selected to undergo VASS procedure were included. Their case notes, including radiology, were reviewed and details described. These patients had complex anterior abdominal wall, gluteal, perianal and retroperitoneal sinuses.
Result(s)
Nine patients with surgical site sinuses, unsuccessfully treated with traditional approach, were included in this case series, between 2015-2018. They were followed up for a range of 3-24 months (median 11.5 months). Symptom resolution was noted in all of them (two out of nine patients required more than one procedure). None of the patients developed any complications from the procedure.
Conclusion(s)
This is the first case series reported in literature, employing VASS for complex post-operative sinuses. Our initial experience with this novel technique is promising, effective and safe. It can be utilised as an alternative treatment for patients with complex sinuses refractory to traditional operative techniques.
Altaf, K; Hajnik; J; Patnam, V; Rajaganeshan, R. (2019). P Th A.13- Video-Assisted Sinus Surgery (VASS): New technique fortreatment of surgical site sinus: A case series. British Journal of Surgery. 106 (S5), 117.