What is Ganglion Removal?

A ganglion or synovial cyst is a soft tissue lump that can occur around the joints and tendons of the hand, wrist and feet. This is thought to be caused by a distention of a weakened portion of a joint capsule or tendon sheath. These ganglia can persist, or spontaneously resolve. Ganglion removal aims to remove the ganglion from the location either through surgical and non-surgical options, depending on the location and severity.

Who does this procedure suit?

Those who have diagnosed ganglia on their hands, wrists or feet that haven’t had success with other treatments and would like them removed for functional and/or aesthetic reasons.

What results will I expect?

Ganglion surgery is usually a successful procedure which dramatically improves the quality of the wrist and hand function for patients. It is important to remain realistic in your outcome as ganglia have the potential to reoccur in some patients.

What’s the first step to take?

During your initial consultation your surgeon will determine the site of the ganglion, discuss associated symptoms, severity, any expectations you have, questions about the procedure, medical history and current medication. We will provide as much information as possible so that you feel comfortable and informed.

How do I prepare for surgery?

Please ensure you have arranged someone to drive you home after your surgery and to help you out at home for a few days. To reduce risk of bleeding and bruising please make sure to:

• Avoid pain relievers and Vitamin E two weeks before surgery. Panadol, and vitamins B and C are safe to use.
• Inform your surgeon if you take any herbal medicines that may affect clotting and the anesthetic.
• Avoid smoking before and after surgery so as not to restrict circulation to the area and delay healing. Giving up is best.
• Inform us immediately if you’ve had any infection (cold or flu) the week before your surgery.

What happens on the day of my surgery?

We will guide you to prepare for surgery so that your procedure and recovery go smoothly.

• If your procedure is in the morning – do not eat or drink anything after midnight the night before.
• If your procedure is in the afternoon – do not eat or drink anything after 8.00am.

What should I expect during surgery?

Ganglion removal is performed under general anesthetic or an arm block where only your arm is anesthetized. Finger ganglia can be removed under local anesthetic. Whichever is used, you will be very comfortable and experience no pain during the surgery.

During the procedure, excision of the ganglion cyst is made, tracing it down to the origin which is often the joint. The area of joint weakness can be reinforced with sutures. It is common for finger ganglia to occur when there is arthritis and if a bone spur or osteophyte is located, this will be removed also. The incision is sutured and dressings applied. Simple procedures take approximately 30 minutes or up to an hour for a more complex operation, and you will likely be able to go home that day.

What should I expect after surgery?

• Your hand will be in a bulky bandage or plaster with a sling to wear at home. You may notice some bruising which will fade in 4-5 days.
• Local anesthetic is used at the end of the procedure so that you have pain relief for the following 6-8 hours.
• Some discomfort is normal for the first few days which is easily relieved with oral analgesics. Keeping the hand elevated in a sling for 2 days will also help settle the pain.
• A follow up appointment will be made 1 week after surgery to assess that the wound has healed well and to remove any sutures. If necessary, we will refer you a see our hand therapist who will make a splint for you and guide you for the best recovery.
• After 2-4 weeks your hand can be used for light duties and return to heavier activities such as sports after 8 weeks. Your surgeon or hand therapist will guide you.

What are the risks and complications with this procedure?

As with any surgery there are some risks involved such as:

• Infection, excessive bleeding or bruising
• Joint stiffness – occurs initially but normally resolves over time and hand therapy
• Joint pain
• Ganglia recurrence

Please call our office if you experience any of the following: excessive pain or bleeding, abnormal swelling or fever during the first 24 hours.