Name of the Procedure:

Excision of Soft Tissue Tumor, Forearm and/or Wrist Area, Subfascial (e.g., Intramuscular), 3 cm or Greater

Summary

This surgical procedure involves the removal of a tumor from the soft tissues located beneath the fascial layer in the forearm or wrist area. The tumor is intramuscular and measures 3 centimeters or greater.

Purpose

This procedure addresses the presence of benign or malignant tumors within the soft tissues of the forearm or wrist. The primary goal is to entirely remove the tumor to relieve symptoms, prevent further growth, and reduce the risk of malignancy.

Indications

• Noticeable lump or mass in the forearm or wrist
• Pain or discomfort in the area
• Restricted movement or mechanical symptoms
• Biopsy-confirmed soft tissue tumor
• Signs of tumor growth as noticed on imaging studies

Preparation

• Patients may need to fast for several hours before the surgery.
• Adjustments to medications, especially blood thinners, as per the healthcare provider's instructions.
• Pre-operative imaging tests like MRI or CT scans to locate and size the tumor accurately.
• Blood tests and possibly an ECG for baseline health assessment.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the tumor site.
3. Exposure: The surgeon dissects through the skin and subcutaneous tissues to reach the fascia.
4. Excision: The tumor is carefully excised along with a margin of normal tissue to ensure complete removal.
5. Closure: The area is thoroughly inspected for bleeding, and then the incision is closed with sutures or staples.
6. Dressing: A sterile bandage is applied to the wound site.

Duration

The procedure typically takes about 1 to 3 hours, depending on the tumor's size and complexity.

Setting

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

Personnel

• Orthopedic or general surgeon
• Surgical nurse
• Anesthesiologist
• Scrub technician

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve or muscle damage leading to weakness or numbness
• Recurrence of the tumor
• Adverse reaction to anesthesia
• Scarring

Benefits

• Relief from pain and discomfort
• Restoration of function and movement in the affected area
• Reduced risk of tumor malignancy or growth
• Peace of mind from knowing the tumor has been removed

Recovery

• Patients typically go home the same day or the next day.
• Keep the surgical site clean and dry.
• Pain management with prescribed medications.
• Gradual return to normal activities as advised by the surgeon.
• Follow-up appointments for wound check and removal of sutures, if necessary.

Alternatives

• Observation: Regular monitoring of tumor size and symptoms with periodic imaging.
• Radiation Therapy: For malignant tumors, to shrink the tumor before surgery or as an adjunctive treatment.
• Chemotherapy: Often in conjunction with other treatments for malignant tumors.
• Minimally Invasive Techniques: Such as laser therapy or radiofrequency ablation, depending on the tumor type.

Patient Experience

• Patients may feel anxious before the procedure but will be under anesthesia during surgery.
• Post-procedure pain is managed with medications.
• Some soreness and swelling at the surgical site are expected but will subside gradually.
• Physical therapy may be recommended to regain full function and strength.