Is the Cleft-Lift a New Procedure?

Is the Cleft-Lift a New Procedure?

My surgeon said he never heard of it because it was a new, specialized procedure.

It depends on your definition of “new”. The cleft-lift is a procedure that has had several modifications, within the category of operations for pilonidal disease collectively called “off midline closures”:

• In 1973 Dr. George Karydakis, a Greek surgeon, published his experience with a successful operation to treat pilonidal disease with an off midline closure. We call his procedure the Karydakis Procedure, and it is very similar to the cleft-lift.
• Dr. John Bascom began writing about this in 1987 and has published numerous articles on the subject. He modified the Karydakis Procedure, and called his modification a “cleft-closure”, and later changed the name to “cleft-lift”. It is often referred to as the Bascom Cleft-Lift.
• Dr Immerman has been performing the Bascom Cleft-Lift since 1993, and now has an approximate overall 98% success rate with a single procedure. He has some slight modifications as well.
• This operation is not a “secret” and there are many, many scientific papers on the subject.
• A retrospective meta-analysis of 89,000 worldwide patients, followed for up to 20 years, was published in February 2018 which showed that the Bascom Cleft-Lift and Karydakis Procedures had the lowest recurrence rate. You can download and read that article here.

So these procedures have been in the surgical literature for well over 40 years, and are widely known by pilonidal surgeons throughout the world. When studying a board certification study course ten years ago (created by the American College of Surgeons) I came across a question on pilonidal disease where the correct answer to “which procedure has the lowest recurrence rate” : is the cleft-lift. (Indicating that it is the accepted answer to the question as recognized by the ACS.)

So, this is not a new procedure. It is not fringe science. It is not a gimmick. It is not “fake news”. This is one of the best ways to treat pilonidal disease in 2020. (Minimally invasive surgery is also an option, and I discuss that here.) Of course, it is “specialized” – as is every other operation we surgeons perform. If your surgeon has not heard of the cleft-lift procedure, I cannot explain why. You will have to draw your own conclusions.

So, this is not a new operation, but if you are struggling with pilonidal disease, it may give you a new life.