27630 Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle

Name of the Procedure:

Excision of Lesion of Tendon Sheath or Capsule (e.g., Cyst or Ganglion), Leg and/or Ankle

Summary

This procedure involves surgically removing an abnormal lesion, such as a cyst or ganglion, from the tendon sheath or capsule in the leg or ankle. The goal is to alleviate pain, restore function, and prevent recurrence.

Purpose

The procedure addresses issues like cysts or ganglions that can cause pain, restrict movement, or lead to other complications in the leg or ankle. The expected outcome is the removal of the lesion, relief from symptoms, and improved function of the affected area.

Indications

• Presence of a painful cyst or ganglion.
• Restricted movement or function of the leg or ankle.
• Swelling or palpable lumps on the tendons.
• Discomfort that does not respond to non-surgical treatments.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Medication adjustments might be necessary, including stopping blood thinners.
• Diagnostic imaging, such as an MRI or ultrasound, may be done to assess the lesion.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered.
2. Incision: A small incision is made over the lesion site.
3. Excision: The cyst or ganglion is carefully dissected and removed from the tendon sheath or capsule.
4. Closure: The incision is closed with sutures or surgical glue.
5. Bandaging: A sterile bandage is applied to protect the area.

Duration

The procedure typically takes around 30-60 minutes, depending on the complexity.

Setting

The procedure can be performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Recurrence of the cyst or ganglion
• Damage to surrounding nerves or tissues
• Scarring

Benefits

• Relief from pain and discomfort
• Improved mobility and function of the leg or ankle
• Lower likelihood of lesion recurrence compared to non-surgical treatments

Recovery

• Patients might need to keep the leg elevated for a few days.
• Pain medication and antibiotics may be prescribed.
• Sutures are typically removed in 10-14 days.
• Full recovery may take 2-6 weeks, with potential physical therapy to regain strength and mobility.
• Avoid strenuous activities until cleared by the doctor.

Alternatives

• Aspiration: Draining the cyst with a needle, though recurrence is common.
• Non-surgical treatments: Bracing, anti-inflammatory medications, and physical therapy.
• Pros and Cons: Alternatives may be less invasive but are associated with higher recurrence rates compared to surgical excision.

Patient Experience

• During: Patients might feel pressure but not pain if under local anesthesia; if general anesthesia is used, they will be asleep.
• After: Some pain, swelling, and bruising are normal; pain management includes prescribed medication and rest. Comfort measures include ice packs and elevation.