GANGLION EXCISION

Ganglion Excision

Open Excision – A small 3 – 4 cm incision is placed over the ganglion (wrist/digit) and the pouch and the stalk are removed. The wound is then closed with dissolvable sutures tied on top of the skin. The wound is then dressed with butterfly sutures and a waterproof dressing. A bulky bandage is also applied after the surgery.
Arthroscopic Excision – A key hole surgery may be undertaken to remove the stalk of the ganglion and decompress the gangion. This is done through 3-4 small key holes on the back of the wrist. The keyholes are then closed with butterfly sutures and a waterproof dressing. A bulky bandage is also applied after the surgery. Not all ganglions are suitable for key hole removal.

If the lump is big enough or causes a problem then surgery may be considered.

No food for 6 hours, or drink for 2 hours, prior to surgery.
Please avoid smoking for 12 hours prior to surgery.
Please continue to take all your medication as advised by the preassessment team.

You will need to report to the main reception on arrival. You will be shown to your room where you will be checked in by the nurse and also see Prof. Singh and the anaesthetist. This will give you chance to ask any questions before surgery. You will also be given an approximate time of your procedure. Please read the instructions on ‘Preparing for Surgery’.

Scar:The scar on the wrist / digit will be firm to touch & tender for 2 – 3 months. This can be helped by massaging the area with moisturizing cream once the wound has healed.
Infection: Can occur after any operation. This would be treated with antibiotics. Its rare to have infection following ganglion surgery.
Nerve & Tendon Damage: The nerves and tendon running into the fingers can be damaged during the surgery and cause numbness or weakness in part of the finger. This is very uncommon after ganglion surgery.
Recurrence:As ganglion is a pouch from the normal joint lining, there is a risk of recurrence – about10%.
Bleeding: Can cause a collection of blood under the stitches which can cause wound problems. Tell the surgeon if you are on anticoagulants or aspirin
CRPS / Stiffness: About 5% (1 in 20) of people are sensitive to hand surgery and their hand may become swollen, painful and stiff after any operation. This problem cannot be predicted but will be watched for afterwards and treated with therapy.

The operation is most commonly performed under General Anaesthesia i.e you will be put to sleep. At the end of the surgery a nerve block is performed to give pain relief. The procedure can also be performed with awake anaesthesia – please discuss with your surgeon if you wish to consider.

The surgery is done as a day case and you should home within a few hours.

After hospital care:

Sling: After your surgery, you will be fitted with a Bradford sling, which is to be used for 48 – 72 hours or longer if required.
Wound care& Removal of Stitches:You will have butterfly stitches, a small sticky plaster dressing and back slab (half plaster) on top of your shoulder. The dissolvable will be trimmed around 12 -1 4 days either by the hand therapist or nurse.
Medication: The local anaesthetic lasts between 4 to 8 hours. Patients are encouraged to start taking painkillers before the pain starts i.e. on return home and for at least 24 hours from there.
Follow-up orthopaedic clinic: You will need to be reviewed in clinic after your operation. This is usually 2 – 6weeks after surgery.
Hand Therapy At the time of your surgery you will be referred to a therapist who will help your recovery.
Return to Work: Managerial or Supervisory: 1 – 2 weeks, Light Manual: 2 – 4 weeks (e.g. clerical, secretarial), Heavy Manual: 4 – 6 weeks (ground worker, HGV). Please discuss with your consultant / therapist if you have any queries.
Driving: Usually between 3 – 4 weeks after surgery, as long as the pain is under control. Please let your Motor Insurance Company aware of your procedure.