Orthopaedic Surgery - Ganglion Excision

Procedure

A Ganglion is a small sac of fluid, which is usually found stuck to a joint or tendon. A ganglion is benign (that means not cancerous). However, they may be removed if they cause pain or rarely if they are unsightly.

The area of skin around the ganglion will be cleaned by antiseptic solution and clean surgical towels (drapes) will then be placed around the ganglion. A tight inflatable band (tourniquet) may be placed around the arm (this is to limit bleeding and is necessary).

Your anaesthetist will discuss the type of anaesthesia with you before the operation. This may be a general anaesthetic (where you are asleep) or a regional anaesthetic when just a small area is numbed (but you are awake). This may sting.

A cut is made over the ganglion and then it is removed. This may be difficult because of the attachment of the ganglion to the joint or tendon.

The skin will then be closed with stitches under the skin (dissolvable) or above the skin (non-dissolvable). The non dissolvable stitches will have to be removed in ten to fourteen days. Your nurse practitioner at your GP practice will be able to do this.

Please be aware that a surgeon other than the consultant, but with adequate training or supervision may perform the operation.

Alternative procedure

The ganglion can be left alone without removal. This is unlikely to cause any further problem other than continued pain and swelling.

Risks

As with all procedures this carries some risks and complications.

Common

Re-growth of ganglion: May occur spontaneously. This may require repeat surgery. Recurrence rates can be as high as 10-20%.

Rare (<1%)

Numbness

This may be around the wound site, causing numbness of the hand or fingers.

Damage to the vessels

This very rarely occurs. This may require further surgery or amputation.

Damage to the ligaments/tendons

This may lead to instability or decreased movement in the hand or fingers.

Infection

The wound site may become red, swollen, hot or painful and have a discharge. Infection may spread to other areas including blood (sepsis). This may require antibiotic treatment.