Ganglion Excision

This leaflet provides general information to help you understand surgery to remove a ganglion cyst.

This day-case procedure removes the cyst and its stalk to reduce recurrence.

At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.

The Anatomy of a Ganglion

A ganglion is a fluid-filled lump that arises from a joint or tendon, relying on several structures working together.

How a Ganglion Forms

Think of it as a small balloon of fluid:

• Fluid leaks from a joint or tendon sheath
• It collects in a small sac under the skin
• A stalk connects the sac to the joint

The Fluid

The sac contains a thick, jelly-like fluid, similar to the natural lubricant found inside your joints — it is not cancerous.

Where They Appear

• Back of the wrist (the most common)
• Palm side of the wrist
• Base of a finger, on the tendon sheath
• Often changing in size over time

Good to Know

• They are non-cancerous and harmless
• About half disappear on their own
• They often change in size or come and go
• Pain occurs only if a nerve is pressed

The Result

Most cause only a visible lump, but larger cysts can make it uncomfortable to bend the wrist or grip, and some press on a nearby nerve.

About the Operation

Ganglion surgery removes the cyst and its stalk to relieve symptoms and reduce the chance of it returning. It is a minor day-case operation, recommended when the lump is painful, presses on a nerve, limits movement, or keeps coming back.

Why It's Done

The operation aims to:

• Relieve pain and pressure from the cyst
• Restore comfortable wrist or finger movement
• Remove the stalk to lower the chance of return

The Procedure, Step by Step

The day-case operation, step by step:

• Anaesthetic: local or general anaesthetic
• Incision: a small cut is made over the cyst
• Removal: the cyst and its stalk are taken from the joint
• Closure: stitches and a splash-proof dressing

Before, During & After Surgery

Recovery & Results

Recovery is a partnership. The timeline below is a guide — I will adapt it to your healing and your goals — this shared decision-making process ensures you are fully informed and involved in your care.

Recovery Milestones

• Bandage: bulky dressing removed after 24–48 hours
• Hand use: gentle finger and hand use straight away
• Stitches: removed at about 14 days
• Good recovery: light use by 2 weeks, fuller by 6–8 weeks

Results

Most patients get good relief of symptoms. About 1 in 10 ganglions return, usually needing only observation, and removing the stalk lowers this risk.

After Surgery — The First Weeks

• Wound Care: keep the wound clean and dry; the bulky bandage comes off at 24–48 hours
• Pain Relief: start painkillers before the block wears off and take regularly for 24–48 hours
• Stitches: usually removed at about 14 days
• Scar Care: gentle scar massage with cream 2–3 times daily for 2–3 months

Risks & Complications

Uncommon, but possible

• Infection: rare; usually settles with dressings and antibiotics
• Scar Sensitivity: tenderness can last 2–3 months; massage with cream helps
• Recurrence: about 1 in 10 return, usually managed by observation
• CRPS: mild in about 1 in 10; a severe form is rare (about 2%)
• Wrist Stiffness: the joint lining can scar and stiffen a little

Return to Activity

This can be extremely variable and discuss with the surgeon. These are just guidelines.

• Desk work: 2–3 weeks
• Driving: when you can safely do an emergency stop, often 1–2 weeks
• Light manual work: 6–8 weeks
• Heavy manual work: 12–16 weeks

Avoid heavy lifting for 6–8 weeks.

Questions You May Wish to Ask

• When can I use my hand normally again?
• When can I drive and return to work?
• How much improvement can I expect?
• What are the signs of a problem?