Name of the Procedure:

Excision of tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater

Summary

This procedure involves surgically removing a tumor or abnormal blood vessel growth from the soft tissue beneath the skin of your hand or finger, especially when it is 1.5 cm in size or larger.

Purpose

The main purpose of this surgery is to remove abnormal growths that could be causing pain, functional impairment, or have the potential to become malignant. The goal is to alleviate symptoms, improve hand functionality, and reduce the risk of cancerous developments.

Indications

Indications for this procedure include:

• Presence of a palpable mass in the hand or finger
• Pain or discomfort in the affected area
• Impaired function or mobility of the hand or finger
• Suspicion of malignancy based on imaging or biopsy
• Growth or change in the size of the mass

Preparation

Pre-procedure instructions may include:

• Fasting for several hours before surgery
• Adjusting or temporarily stopping certain medications, especially blood thinners
• Undergoing preoperative blood tests and imaging studies (e.g., MRI, ultrasound) to determine the exact location and extent of the growth

Procedure Description

1. Anesthesia: Local anesthesia is commonly used to numb the hand or finger. In some cases, regional or general anesthesia might be considered.
2. Incision: A small incision is made over the site of the tumor or vascular malformation.
3. Excision: The abnormal growth is carefully dissected and removed from the surrounding tissues.
4. Closure: The incision is then closed with sutures, and a sterile dressing is applied.

Tools used include scalpels, surgical scissors, and forceps. In some cases, advanced imaging techniques may guide the surgeon during the procedure.

Duration

The procedure typically takes around 30 minutes to 1 hour, depending on the complexity and the size of the growth.

Setting

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

Personnel

The surgical team generally includes:

• A surgeon specializing in hand surgery or orthopedic surgery
• Surgical nurses
• An anesthesiologist or nurse anesthetist, if sedation or general anesthesia is used

Risks and Complications

Common risks include:

• Infection
• Bleeding or hematoma
• Scarring
• Nerve damage leading to temporary or permanent numbness or weakness
• Recurrence of the tumor or vascular malformation

Complications are rare, but managing them may involve additional medications, physical therapy, or further surgical intervention.

Benefits

Expected benefits include:

• Relief from pain or discomfort
• Improved hand function and mobility
• Reduced risk of malignancy
• Removal of the unsightly mass or swelling

Benefits are usually noticeable shortly after recovery from surgery.

Recovery

Post-procedure care involves:

• Keeping the surgical site clean and dry
• Following pain management protocols as prescribed
• Limiting the use of the affected hand and finger as instructed
• Scheduling follow-up appointments to monitor healing and remove sutures

Recovery time varies but generally lasts a few weeks. An early return to light activities is possible, with complete healing taking around 4-6 weeks.

Alternatives

Alternative treatments may include:

• Observation and regular monitoring if asymptomatic
• Medications for pain management
• Non-surgical options like needle aspiration if applicable

Each alternative comes with its own set of pros and cons, such as the risks of different interventions or the chance of recurrence.

Patient Experience

During the procedure, the patient will feel minimal discomfort due to anesthesia. Post-surgery, some pain and swelling are expected but can be managed with medications. Most patients can resume light activities within a few days and experience improved symptoms and functionality within weeks.