The surgical approach to chronic pilonidal disease has been significantly changed by minimally invasive and targeted procedures, with the aim to minimize costs and favoring less dressings, faster recovery, and prompt return to work or to school activity. Less invasive procedures are gaining wide acceptance as first approach. We present a single-center experience with the Gips technique, also called Israeli technique or trephine technique, and a brief review of the literature, focusing on minimally invasive procedures