Name of the Procedure:

Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger.

Summary

This procedure involves the surgical removal of abnormal growths or lesions, such as cysts or ganglions, from the tendon sheath or joint capsule in the hand or finger. It is commonly performed to relieve pain or restore function.

Purpose

The procedure addresses conditions where cysts, mucous cysts, or ganglions form on the tendon sheath or joint capsule in the hand or finger. The primary goals are to reduce pain, remove the lesion, and restore normal function and appearance.

Indications

• Persistent pain in the hand or finger due to a lesion.
• Swelling or a visible lump that affects hand or finger function.
• Lesions causing nerve compression or restricted movement.
• Recurrent cysts that don’t respond to non-surgical treatments.

Preparation

• Patients may need to fast for a few hours before the procedure.
• Blood tests or imaging studies, such as an MRI or ultrasound, may be required.
• Medication adjustments may be necessary, especially blood thinners.

Procedure Description

1. Anesthesia: Local or regional anesthesia is administered to numb the hand or finger.
2. Incision: A small incision is made over the lesion.
3. Excision: The lesion (cyst, mucous cyst, or ganglion) is carefully removed.
4. Closure: The incision is closed with sutures, and a dressing is applied.

Tools used may include scalpel, scissors, and sometimes a surgical elevator. The procedure is minimally invasive and is done with precision to avoid damage to surrounding tissues.

Duration

Typically, the procedure takes about 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient surgical center or a hospital.

Personnel

• Orthopedic surgeon or hand surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve damage causing numbness or weakness
• Recurrence of the lesion
• Scarring

Benefits

• Pain relief
• Restoration of normal hand or finger function
• Improved cosmetic appearance
• Rapid return to daily activities

Recovery

• Keep the hand elevated and apply ice packs to reduce swelling.
• Follow a specific regimen for wound care and changing dressings.
• Avoid strenuous activities for a few weeks.
• Attend follow-up appointments for suture removal and assessment.
• Physical therapy might be recommended to enhance recovery.

Alternatives

• Aspiration (draining the cyst with a needle)
• Corticosteroid injections
• Observation and monitoring if the lesion is not causing significant symptoms

Pros of alternatives:

• Less invasive
• Shorter recovery time

Cons of alternatives:

• Higher chance of recurrence
• May not fully resolve symptoms

Patient Experience

During the procedure, the patient will be awake but should not feel pain due to anesthesia. Afterward, there may be some discomfort, manageable with prescribed pain relievers. Most patients can resume light activities within a few days and return to normal activities within a few weeks, depending on healing progress.