Name of the Procedure:

Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); less than 5 cm

Summary

This procedure involves the surgical removal of a tumor located in the soft tissue beneath the fascia in the shoulder area. The tumor typically measures less than 5 centimeters in size and may be intramuscular.

Purpose

This surgery is performed to remove benign or malignant tumors, reduce pain, prevent tumor growth, and possibly improve shoulder function. The goal is to completely excise the tumor while preserving surrounding healthy tissue.

Indications

• Presence of a soft tissue tumor in the shoulder area
• Tumor size less than 5 cm
• Symptoms such as pain, swelling, or limited shoulder movement
• Suspicion of malignancy based on imaging and biopsy results

Preparation

• Pre-operative fasting (usually overnight)
• Medication adjustments as advised by the doctor
• Diagnostic imaging (MRI, CT scan) and possibly a biopsy
• Blood tests and pre-surgical assessment

Procedure Description

1. The patient is given either general or regional anesthesia.
2. An incision is made over the site of the tumor.
3. The surgeon carefully dissects through skin, subcutaneous tissue, and muscle to reach the tumor.
4. The tumor is identified and excised along with a margin of healthy tissue to ensure complete removal.
5. The incision is closed with sutures.
6. A drain may be placed to prevent fluid accumulation.

Duration

Typically, the procedure lasts about 1 to 2 hours.

Setting

This surgery is usually performed in a hospital operating room or a surgical center.

Personnel

• Surgeon
• Surgical assistant or nurse
• Anesthesiologist or nurse anesthetist
• Operating room nurses

Risks and Complications

• Infection
• Bleeding or hematoma
• Nerve or muscle damage
• Scarring
• Incomplete removal of the tumor
• Anesthesia-related risks

Benefits

• Removal of the tumor
• Relief from pain and other symptoms
• Prevention of tumor growth or spread
• Potential improvement in shoulder function

Recovery

• Post-operative pain management with medications
• Keeping the surgical site clean and dry
• Follow-up appointments to monitor healing
• Gradual return to normal activities as advised
• Complete recovery may take several weeks, with physical therapy potentially required

Alternatives

• Watchful waiting for small, benign tumors
• Radiation therapy or chemotherapy for malignant tumors
• Minimally invasive techniques like radiofrequency ablation
• Each alternative carries its own set of pros and cons, which should be discussed with the healthcare provider.

Patient Experience

• During the procedure: Patients will be under anesthesia and should not feel pain.
• After the procedure: Some pain and discomfort, managed with pain medications. May experience swelling or limited shoulder movement initially. Recovery care includes rest, wound care, and gradual resumption of activities.