We hold a dialogue on perioperative perspectives in pilonidal disease to increase the value of perioperative outcome and patient satisfaction. Our review reveals that patients undergoing more extensive surgeries are better served by general or spinal anesthesia than by minimal approaches employing local anesthesia and the choice should be based on standard anesthesiological considerations such as neuraxial block time or recovery time after general anesthesia rather than the nature of pilonidal disease itself. To ensure sustainable outcome quality, surgeons, together with their anesthesiological partners must consider a wider perspective than the Operating Room and the recovery room, and should include dimensions of the other medical discipline in their decision making. This is best achieved with interprofessional dialogues
