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Excision of ganglion, wrist (dorsal or volar); recurrent

CPT4 code

Name of the Procedure:

Excision of ganglion, wrist (dorsal or volar); recurrent, also known as ganglion cyst removal surgery.

Summary

This surgical procedure involves the removal of a ganglion cyst from the wrist. The cyst may be located on either the dorsal (back) side or volar (palm) side of the wrist. This procedure is typically performed when the ganglion cyst has recurred after previous treatments.

Purpose

Excision of a ganglion cyst aims to relieve pain, restore wrist function, and remove the cyst to prevent further recurrence. This procedure addresses ganglion cysts that cause discomfort, interfere with wrist movement, or have returned after previous removal attempts.

Indications

  • Persistent wrist pain or discomfort due to a ganglion cyst.
  • Limited wrist mobility and function.
  • Recurrent cysts after previous treatment.
  • Cosmetic concerns.

Preparation

  • The patient may be advised to fast for several hours before the procedure.
  • Discontinue certain medications, such as blood thinners, as instructed by the surgeon.
  • Pre-operative assessments, such as blood tests or imaging studies (e.g., MRI or ultrasound) of the wrist, may be required.

Procedure Description

  1. The patient is positioned, and local or general anesthesia is administered.
  2. An antiseptic solution is applied to the wrist to prevent infection.
  3. The surgeon makes an incision over the site of the ganglion cyst.
  4. The cyst, along with its stalk, is carefully dissected and removed, ensuring complete excision to minimize recurrence.
  5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

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

Personnel

  • Orthopedic or hand surgeon.
  • Surgical nurse.
  • Anesthesiologist or nurse anesthetist (if general anesthesia is used).
  • Operating room technician.

Risks and Complications

  • Infection at the surgical site.
  • Bleeding or hematoma formation.
  • Nerve injury leading to numbness or weakness.
  • Recurrence of the ganglion cyst.
  • Scarring and adhesions.
  • Pain and stiffness in the wrist.

Benefits

  • Relief from pain and discomfort.
  • Improved wrist function and mobility.
  • Reduced likelihood of cyst recurrence.
  • Enhanced cosmetic appearance of the wrist.

Recovery

  • Keep the surgical site clean and dry.
  • Follow-up appointment within 1-2 weeks for suture removal and assessment.
  • Limit wrist movements initially to allow healing.
  • Gradually resume normal activities as advised.
  • Physical therapy may be recommended to restore strength and mobility.
  • Full recovery typically takes a few weeks to a few months.

Alternatives

  • Aspiration of the cyst with a needle, though recurrence is common.
  • Observation with no immediate treatment if the cyst is asymptomatic.
  • Use of splints or braces to alleviate symptoms without surgical intervention.

Patient Experience

During the procedure, the patient will not feel pain due to anesthesia. Post-operatively, some discomfort, swelling, and bruising can be expected. Pain is managed with prescribed medications. Patients should anticipate a period of restricted activity to ensure proper healing, followed by a gradual return to normal functions.


This markdown provides comprehensive information about the procedure while being easy to read and understand.

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