A novel minimally invasive technique for epidermoid cyst removal using needle-hole extraction and radio frequency unit

Objectives: This study aims to reduce the incision size and enhance patient outcomes while maintaining the integrity of the cyst capsule. The goal of this technique is to transform the standard of care by integrating patient comfort, esthetic results, and procedural efficiency over traditional approaches. Material and Methods: One hundred patients with clinically diagnosed epidermoid cysts underwent this novel procedure, utilizing a custom-designed tool, the Pandey cyst removal device. First, a needle-sized incision was made, and the cyst contents were then evacuated. Finally, radiofrequency cautery was employed to destroy any residual epithelial lining. Minimal wound closure techniques were used, eliminating the need for sutures in almost all cases. Results: In 92 of 100 cases, the cyst wall and the capsule were removed completely intact. The patients experienced minimal discomfort during and after this procedure, with no serious complications. Importantly, the needle-hole technique resulted in aesthetically pleasing results, with no significant scarring reported. Conclusion: Our minimally invasive needle hole method for excising sebaceous cysts reduces the incision size to a needle hole, avoiding the necessity of sutures. We have also introduced the cost-effective novel instrument - “The Pandey’s cyst removal device” (patent approved), which can be reused after autoclaving. This simple technique is easy to perform and requires no extra training.