25111 Excision of ganglion, wrist (dorsal or volar); primary

Name of the Procedure:

Excision of Ganglion, Wrist (Dorsal or Volar); Primary

• Common Name: Ganglion Cyst Removal
• Medical Term: Ganglion Cyst Excision

Summary

Ganglion cyst removal involves surgically excising a fluid-filled sac that commonly develops on the wrist area, either on the dorsal (back) or volar (front) side. This procedure aims to alleviate discomfort, pain, and any functional limitations caused by the cyst.

Purpose

Medical Condition Addressed:

• Presence of a ganglion cyst on the wrist.

Goals:

• Eliminate pain and discomfort.
• Restore normal wrist function and mobility.
• Prevent recurrence of the cyst.

Indications

• Persistent pain or discomfort that hampers daily activities.
• Numbness or tingling caused by the cyst pressing on nearby nerves.
• Recurrent cysts after aspiration or non-surgical treatments.
• Aesthetic concerns if the cyst is visibly noticeable.

Preparation

Pre-Procedure Instructions:

• Fasting may be required if general anesthesia is used.
• Adjustments to medications, especially blood thinners, according to the doctor's advice.

Diagnostic Tests:

• Physical examination.
• Imaging studies such as ultrasound or MRI to identify the cyst's size and location.

Procedure Description

Steps:

1. The patient is positioned and the wrist area is thoroughly sterilized.
2. Local or general anesthesia is administered as required.
3. A small incision is made over the site of the cyst.
4. The cyst is carefully excised along with its stalk.
5. The incision is closed with sutures, and a sterile dressing is applied.

Tools and Equipment:

• Scalpel, scissors, forceps, and sutures.

Anesthesia:

• Local anesthesia for numbing the area or general anesthesia for complete sedation.

Duration

Typically takes about 30 to 60 minutes.

Setting

• Performed in an outpatient surgical center or hospital.

Personnel

• Orthopedic or hand surgeon.
• Surgical nurse.
• Anesthesiologist or anesthesia provider, if general anesthesia is used.

Risks and Complications

Common Risks:

• Infection at the incision site.
• Bleeding or hematoma formation.

Rare Risks:

• Nerve damage causing numbness or weakness.
• Recurrence of the ganglion cyst.
• Scarring or adhesion formation.

Management:

• Proper wound care and antibiotics for infection.
• Monitoring and follow-up for any neural complications.

Benefits

• Relief from pain and discomfort.
• Improved wrist function and mobility.
• Enhanced quality of life.

Recovery

Post-Procedure Care:

• Keep the incision site clean and dry.
• Follow prescribed pain management regimen.
• Attend follow-up appointments for suture removal and to monitor healing.

Recovery Time:

• Initial recovery in a few days.
• Full recovery and return to regular activities in 2-4 weeks.

Restrictions:

• Avoid heavy lifting or strenuous activities until clearance from the surgeon.

Alternatives

Non-Surgical Options:

• Aspiration (draining the cyst fluid with a needle).
• Bracing and activity modification.
• Corticosteroid injections.

Pros and Cons:

• Non-surgical options may provide temporary relief but have higher recurrence rates.
• Surgery offers a more definitive solution with lower recurrence but involves more recovery time.

Patient Experience

During the Procedure:

• Minimal discomfort if local anesthesia is used.
• Sedation and monitoring for those under general anesthesia.

After the Procedure:

• Mild to moderate pain manageable with prescribed medications.
• Swelling and bruising at the incision site.
• Gradual improvement in symptoms and return to normal wrist function.