28090 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot

Name of the Procedure:

Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); foot Common Names: Foot lesion removal, Ganglion cyst excision, Synovectomy of the foot

Summary

This procedure involves the surgical removal of abnormal growths or lesions on the tendon, tendon sheath, or capsule in the foot. These may include cysts or ganglions. The goal is to alleviate symptoms and restore normal foot function.

Purpose

The procedure addresses painful or debilitating conditions caused by lesions, ganglions, or cysts in the foot. It aims to relieve pain, reduce inflammation, restore mobility, or prevent further damage to the foot.

Indications

• Persistent pain in the foot
• Swelling or palpable lumps on the foot tendons or capsule
• Restricted foot movement
• Conservative treatments (e.g., medications, physical therapy) have failed
• Suspected benign or malignant lesions

Preparation

• Follow fasting instructions if general anesthesia will be used.
• Inform the doctor of any medications, allergies, or past medical history.
• Stop taking certain medications like blood thinners, as advised.
• Pre-procedure imaging tests, such as MRI or ultrasound, to locate and assess the lesion.

Procedure Description

1. The patient is prepared, and the foot is sterilized.
2. Anesthesia (local or general) is administered.
3. The surgeon makes an incision over the lesion.
4. The lesion, cyst, or ganglion is carefully excised from the surrounding tissue.
5. Any needed synovectomy (removal of inflamed synovium) is performed.
6. The incision is closed with sutures, and a dressing is applied.
7. Postoperative care instructions are given to the patient.

Duration

Typically, the procedure takes 30 minutes to 1 hour, depending on the lesion's size and complexity.

Setting

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

Personnel

• Orthopedic Surgeon or Podiatrist
• Surgical Nurse
• Anesthesiologist or Nurse Anesthetist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Recurrence of the lesion
• Scarring
• Temporary or permanent foot weakness or stiffness

Benefits

• Relief of pain and discomfort
• Improved foot function and mobility
• Removal of potentially harmful growths or lesions

Recovery

• Initial recovery typically involves keeping the foot elevated and avoiding weight-bearing activities.
• Pain management with prescribed medications.
• Follow-up appointments for suture removal and progress assessment.
• Full recovery may take several weeks, with gradual return to normal activities based on the surgeon’s advice.

Alternatives

• Observation and watchful waiting for asymptomatic or small lesions.
• Aspiration of cysts using a needle.
• Physical therapy and supportive measures.
• Medications to manage pain and inflammation.
• The pros of the described procedure include a higher chance of permanent resolution, while alternatives may not completely eliminate the problem.

Patient Experience

Patients may experience discomfort during the procedure if local anesthesia is used, but most will feel minimal pain. Postoperatively, there may be swelling, bruising, and tenderness at the incision site. Pain can be managed with medication, and most patients can return to regular activities gradually over a few weeks.