Introduction
The aim of surgery is to cut out the ganglion in entirety and the root from which fluid enters the ganglion.
Indications
When symptoms are not improved with non-surgical measures, surgery is recommended. Very large ganglions which cause pain or cosmetic concern can be removed earlier.
Procedure
Surgery may be Open or Arthroscopic. Both types are effective and long-term outcomes are similar.
Dr Baba performs Arthroscopic (keyhole) excision of ganglion in majority of patients. This involves a smaller incision and potentially less post-operative pain and a quicker return to activities including work.
In addition, arthroscopy allows inspection of the joint for injury to the ligaments and tendons and treat them if needed.
Arthroscopic ganglion excision
This is keyhole surgery which involves two tiny incisions. Through one incision, a 1.9mm camera is inserted, inspection of the joint and tendons / ligaments carried out. A second instrument (shaver) is introduced through the second incision to cut out the ganglion and its root.
Any damage to ligaments and joint can also be potentially treated with this procedure.
Dressings are placed over the wound and the wrist and hand can be moved and used straight away.
Recovery
- Day surgery procedure.
- Drive within 2-3 days.
- Return to office work within 2-3 days.
- Return to Manual work within 2-4 weeks.
Results
Satisfaction rates with surgery are over 95%
Risks and Complications
These include:
- Stiffness – Most patients will have some wrist stiffness after surgery and may require hand therapy.
- Recurrence of ganglion (Approximately 10%).
- Nerve injury.
- Blood vessel injury.
- Infection.