Name of the Procedure:

Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection

Summary

This surgical procedure involves the removal of a cystic hygroma, a fluid-filled sac that typically occurs in the neck or armpit area. The operation requires careful dissection around deep nerves and blood vessels.

Purpose

Cystic hygromas can cause discomfort, infection, or interfere with normal function. The primary goal of this procedure is to remove the cystic hygroma to alleviate symptoms and prevent complications.

Indications

• Presence of a noticeable, often painless lump in the neck or armpit.
• Difficulty swallowing or breathing due to the cyst's location.
• Recurrent infections or discomfort caused by the cyst.
• Rapid growth of the cyst causing functional impairment.

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Blood tests and imaging studies such as ultrasound or MRI may be performed to assess the extent of the cyst.
• Adjustments to current medications, especially blood thinners, may be necessary.

Procedure Description

1. The patient is placed under general anesthesia to ensure they remain unconscious and pain-free.
2. An incision is made over the site of the cystic hygroma.
3. Surgeons carefully dissect around surrounding nerves and blood vessels to remove the cyst without causing damage.
4. The cyst is excised completely.
5. The incision is closed with sutures, and a drain may be placed to prevent fluid accumulation.

Duration

The procedure typically takes 2 to 4 hours, depending on the size and complexity of the cyst.

Setting

This procedure is usually performed in a hospital operating room under sterile conditions.

Personnel

• Surgeon, usually specialized in pediatric surgery or ENT (ear, nose, throat).
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Infection at the site of surgery
• Bleeding or hematoma formation
• Injury to surrounding nerves or blood vessels
• Recurrence of the cyst
• General anesthesia risks such as allergic reactions.

Benefits

Removal of the cyst should alleviate symptoms, reduce the risk of infections, and improve the patient's quality of life. Benefits might be noticeable immediately post-surgery but will continue to improve as healing occurs.

Recovery

• Patients can expect to stay in the hospital for 1-2 days for monitoring.
• Pain management will be provided through medications.
• Avoid strenuous activities for several weeks.
• Follow-up visits will be scheduled to monitor healing and detect any potential complications.

Alternatives

• Observation: Small, asymptomatic cysts may be monitored without immediate intervention.
• Sclerotherapy: Injection of a solution to shrink the cyst.
• Pros and cons: Surgery is more definitive but involves more risks and recovery time compared to less invasive options like sclerotherapy.

Patient Experience

• Patients will feel the effects of anesthesia during the operation and will not feel pain.
• Post-operative discomfort will be managed with pain relief medications.
• There may be mild to moderate pain, swelling, and bruising around the incision.
• Follow post-operative care instructions to ensure smooth recovery and minimal complications.