The Sternberg Clinic is one of the very few surgical practices in the United States that specializes in the care of pilonidal disease. Here, Dr. Sternberg cares for the full spectrum of pilonidal disease – from primary pilonidal disease (for patients who have never had surgery) to the most difficult of pilonidal wounds that develop after one or many failed operations. Dr. Sternberg performs the Cleft Lift procedure for patients requiring surgery for pilonidal disease; his success rate is remarkable as he has a nearly 100% cure rate. Dr. Sternberg has been performing the cleft lift procedure for approximately 21 years and has over 1500 cases of experience. Since 2007, he has performed over 1000 cleft lift procedures and has only had 7 patients requiring repeat lifts (0.76% recurrence rate). All 7 of these patients had 1 or several prior unsuccessful operations by other surgeons. Those 7 patients had successful second operations and are doing well to date.
Tips for interviewing a surgeon for your pilonidal disease:
Few surgeons truly have a desire or interest in taking care of pilonidal patients and many of their operations make the problem worse. Because these surgeons don’t perform the cleft lift procedure (or do so infrequently), the operation is technically difficult, anxiety provoking, and frustrating in that their patients have poor results and frequently recur with more extensive pilonidal problems. In turn, the recovery is very difficult for patients as their wounds are left open or often open unintentionally and may unfortunately recur worse than before.
Not everyone should be performing the cleft lift. It is technically demanding, requires good three-dimensional planning, and adequate patience to meticulously perform the operation. So if the surgeon you’re consulting with doesn’t seem confident about the procedure or admits to performing it infrequently, consider another surgeon.
Red flags to be aware of:
Some red flags that should encourage you to do more research:
- If the surgeon performs traditional surgery (open procedures or excisions with midline closures) and reserves the cleft lift for recurrences. The CL shouldn’t be reserved for recurrences, and actually isn’t any more extreme or invasive than a typical excisional procedure.
- If the surgeon wants to biopsy a draining sinus. There is no point in doing this because the biopsy does not fix the underlying problem, the sinus is simply a sign of a deeper cause and the procedure itself usually indicates that the physician doesn’t understand the problem sufficiently.
- If the surgeon advises only removing the top draining sinus hole and leaving the lower holes/pits in place. The source of pilonidal disease is the lower holes/midline pits. The top draining sinus is the result of the disease, and if it is removed, it will just come back in a bigger and angrier form.
- If the surgeon admits to lacking experience with the procedure but would like to try it in your case. Don’t take a chance with experimentation. The best way for a surgeon to learn how to perform the CL is in a mentorship experience.
- If the surgeon recommends another flap procedure instead of the cleft lift procedure. While some flap procedures work (e.g. the Modified Limberg Flap) for pilonidal disease, they are less reliable, often more invasive, are more disfiguring, and require a longer recovery period.
After many years performing major abdominal operations including open and laparoscopic resections for colon cancer, rectal cancer, Crohn’s disease, and Ulcerative colitis, I have chosen to concentrate my efforts in a few highly specialized areas of surgery where I feel I can make the greatest positive impact on patients.
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