Name of the Procedure:

Excision of Tumor, Soft Tissue of Upper Arm or Elbow Area, Subfascial (e.g., Intramuscular); Less Than 5 cm

Summary

This surgical procedure involves removing a tumor from the soft tissues located in the upper arm or elbow area, performed beneath the fascia (a layer of connective tissue) and within the muscle (if applicable). The tumor being removed is less than 5 centimeters in size.

Purpose

The procedure is aimed at removing benign or malignant tumors from the soft tissues in the upper arm or elbow to alleviate symptoms, prevent the spread of cancer (if malignant), and ensure proper function and range of motion in the arm.

Indications

• Presence of a palpable mass in the upper arm or elbow region.
• Pain or discomfort in the affected area.
• Impaired mobility or function of the arm.
• Suspected malignancy based on imaging or biopsy results.
• Rapidly growing or changing tumor.

Preparation

• Patients may be advised to fast for 6-8 hours before the procedure.
• Adjustments to medication (e.g., stopping blood thinners) may be necessary.
• Pre-operative imaging studies like MRI or CT scans.
• Blood tests and physical examination.

Procedure Description

1. The patient is given appropriate anesthesia (general or local, depending on the case).
2. An incision is made over the tumor site.
3. The fascia and muscle layers are carefully dissected to reach the tumor.
4. The tumor is excised with minimal disruption to surrounding tissues.
5. The incision is closed with sutures.
6. The excised tissue is sent for pathological examination.

Tools and equipment used may include scalpels, retractors, forceps, and an electrocautery device. Anesthesia is typically administered and monitored by an anesthesiologist.

Duration

The procedure usually takes about 1 to 2 hours, depending on the complexity and exact location of the tumor.

Setting

This procedure is generally performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic or general surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist
• Surgical technologist

Risks and Complications

Common risks:

• Infection
• Bleeding
• Scarring Rare risks:
• Nerve damage
• Muscle weakness
• Recurrence of the tumor

Benefits

• Removal of the tumor, eliminating or reducing symptoms.
• Preventing potential spread of malignant tumors.
• Restoration or preservation of arm function and mobility. Benefits are typically realized within a few weeks post-surgery as the wound heals and function improves.

Recovery

• Patients may need to keep the arm elevated and immobilized initially.
• Pain management with prescribed medications.
• Instructions on wound care and activity restrictions.
• Physical therapy may be recommended to restore full function.
• Full recovery may take several weeks, with follow-up appointments to monitor healing and pathology results.

Alternatives

• Observation and regular monitoring for small, asymptomatic benign tumors.
• Radiation therapy, particularly for malignant tumors.
• Chemotherapy, if the tumor is part of a systemic malignancy. Each alternative has its own set of pros and cons, such as prolonged monitoring versus the immediate resolution of symptoms through surgery.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be discomfort, swelling, and bruising in the affected area, managed with pain medications and careful wound care. As recovery progresses, pain should diminish, and mobility should gradually return with appropriate physical therapy.