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Surgery for Ganglion Cyst Removal

A wrist ganglion cyst is a swelling or an abnormal enlargement that usually occurs over the back of the hand or wrist. There are several methods of treatment for ganglion cyst and one of them is surgery. This article provides some information on the same.
Kanika Khara
Last Updated: Feb 8, 2018
Ganglion cyst is non-cancerous in nature and does not spread to the other parts of the body, but may grow gradually. It looks like a sac of liquid that arises from the fluid-filled areas like small joints of the wrist or fluid within the sheath that surrounds the wrist tendons (tissue that connects muscles to the bone). Inside the cyst, there is a thick, sticky, clear, colorless jelly-like fluid also known as synovial fluid that leaks out from the spaces and becomes a cystic structure.
Depending on the size, the cyst may feel firm or spongy. It occurs mainly on the back of the hand, wrist joint, or on the palm side of the wrist. Rarely, it grows on the base of the fingers on the palm, fingertips, on the knee and ankle, or on the foot. Also known as the Bible cyst, it is more commonly seen to occur in women, especially between the ages of 20-40.
The cause of ganglion cysts is not still known, but according to some theories, trauma causes the tissues of the joint to break down, forming small cysts, which later join together to form a larger and more obvious mass. The cyst is usually soft and looks like a bump or mass, about 1-3 cm in diameter. It may cause some degree of pain that is continuous and becomes worse during any joint movement.
Treatment
There are different methods of treatment for this condition. Aspiration is a non-surgical method in which the doctor inserts a needle into the ganglion cyst and removes the fluid slowly by suction. Another alternative method is to smash the cyst with a hard object like a book. This pops the cyst and tears the lining of the cyst. One of the best treatments to remove it is surgery.
In the surgery, the cyst is shelled out, i.e. both the fluid and the sac is removed. Along with this, the connection to the joint or tension sheath is also blocked. The arm is draped and a pneumatic tourniquet on the upper arm is inflated to stop the flow of blood and avoid injury to the delicate tissues in the region. The surgery includes the dissection of the wall of the ganglion and removal of the cyst and stalk from its origin on the ligament or joint capsule.
During the procedure, the cyst is kept intact, as its decompression will make it difficult to identify the limits of the cyst and the ligamentous and capsular attachments. The next step after the excision of the wrist ganglion cyst is the placement of a protective dressing that lasts for 2-3 days. A bulky dressing or a volar splint is applied to minimize the pain, bleeding, and swelling. The affected person can resume his/her routine life after few weeks. Moreover, some motion exercises are encouraged to restore wrist and finger mobility.
The non-surgical treatment leaves behind the cyst lining and there are 50% chances of the cyst being formed again. The surgical treatment for its removal is believed to be highly effective, however, there is also a risk of ganglion recurrence. Some surgical complications like infection, bleeding, tendon injury, scarring, and vascular injury are also possible.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.