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What is
Ganglionectomy?
A ganglionectomy, also called a gangliectomy,
is the
surgical removal of a ganglion.
The removal of a ganglion
cyst usually requires a
ganglionectomy, and this procedure is
frequently confused with a ganglionectomy.
Such cysts usually form on the hand, foot or
wrist and may cause
pain or impair body function.
Aspiration of the cyst and
steroid injections are typically
performed first. If they fail, the cyst is
excised under local, regional or even
general
anesthetic.
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Effects
of Ganglionectomy
This procedure will result in the removal of
ganglion cysts. Ganglionectomies are also
performed for other reasons, such as the
treatment of
chronic pain.
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Candidates
for Ganglionectomy
The best candidates for this procedure are
those who have been diagnosed with ganglion
cysts.
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Your
Consultation
Plan for your care and recovery after the
operation, especially if you are to have
general anesthesia. Allow for time to rest
and try to find other people to help you
with your day-to-day duties.
Follow the instructions your health care
provider gives you. Do not eat or drink
anything after midnight or the morning
before the procedure. Do not even drink
coffee, tea, or water after midnight.
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The Ganglionectomy
Procedure
You will be given a general, regional, or
local anesthetic. Local and regional
anesthetics numb part of the body while you
remain awake. A general anesthetic relaxes
your muscles and puts you to sleep. All
three types of anesthesia should keep you
from feeling pain during the operation.
Your doctor will cut around the cyst and
remove it. Your doctor will then close the
cut with stitches or special surgical
strips.
Most physicians use the more conservative
procedure, which is known as aspiration.
Aspiration
-
An 18- or 22-gauge needle attached to a
20–30-mL syringe is inserted into the
cyst. The doctor removes the fluid
slowly by suction.
-
The doctor may inject a corticosteroid
medication into the joint after the
fluid has been withdrawn.
-
A compression dressing is applied to the
site.
-
The patient remains in the office for
about 30 minutes.
Excision
Some ganglion cysts are so large that the
doctor recommends excision. This procedure
also takes place in the physician's office
with local or regional anesthetic.
Excision of a ganglion cyst is performed as
follows:
-
The physician palpates, or feels, the
borders of the sac with the fingers and
marks the sac and its periphery.
-
The sac is cut away with a scalpel.
-
The doctor closes the incision with
sutures and applies a bandage.
-
The patient is asked to remain in the
office for at least 30 minutes.
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Recovery
Patients should avoid strenuous physical
activity for at least 48 hours after surgery
and report any signs of infection or
inflammation to their physician. A follow-up
appointment should be scheduled within three
weeks of aspiration or excision. Excision
may result in some stiffness after the
surgery and some difficulties in flexing the
hand because of scar tissue formation.
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Risks
-
There are some risks when you have
general anesthesia. Discuss these risks
with your health care provider.
-
A local or regional anesthetic may not
numb the area quite enough and you may
feel some minor discomfort. Also, in
rare cases, you may have an allergic
reaction to the drug used in this type
of anesthesia. Local or regional
anesthesia is considered safer than
general anesthesia.
-
The cyst may come back.
-
There is a small risk of infection and
bleeding. However, the cut usually heals
quickly without any problems.
-
In rare cases, nerves or blood vessels
in the area may be damaged.
-
The healing
cut could form an unsightly scar.
usually the scar is not noticeable in
the long run.
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Frequently Asked
Questions
Q: What is a ganglion cyst?
A:
A ganglion cyst is a bump or mass that forms
under the skin. Most commonly, ganglions are
seen on the wrist (usually the back side)
and fingers, but they can also develop
around joints on the shoulder, elbow, knee,
hip, ankle and foot. Ganglion cysts form
when tissues surrounding certain joints
become inflamed and swell up with
lubricating fluid. They can increase in size
when the tissue is irritated and often can
"disappear" spontaneously. These masses or
cysts appear to grow sometimes but they are
not tumors or cancerous.
Q: What are the symptoms?
A:
Ganglions can be painless; however, they
often are associated with tenderness and
pain which may restrict the range of
movements.
Q: How is a ganglion cyst diagnosed?
A:
Ganglion cysts are fairly easy to diagnose
because they are usually visible and pliable
to the touch. They are distinguished from
other growths by their location near tendons
or joints and by their fluid consistency.
Ganglion cysts are sometimes confused with a
carpal boss (a bony, non-mobile spur on the
top of the wrist), but can usually be
distinguished by the fact that they can be
moved and are usually less painful for the
patient.
Q: What are the causes of ganglion cysts?
A:
The cause of ganglions is not always clear.
Non-occupational factors or conditions such
as rheumatoid arthritis have been associated
with ganglion cysts. Occupational factors
play also an important role in the
development of ganglions. Those occupations
that require workers to excessively overuse
certain joints such as the wrist and fingers
pose the risk for ganglion cysts.
Q: What is a Ganglionectomy?
A:
Ganglionectomy is a procedure in which the
doctor removes a cyst from your hand, wrist,
foot, or other part of your body. A ganglion
cyst is a swollen, closed sac under the
skin. The sac is attached to the sheath of a
tendon or may be attached to a joint. The
cyst contains fluid similar to joint fluid.
Q: What are the alternatives to this
procedure?
A:
Alternatives to this procedure include:
Taking out the fluid with a needle or a
syringe, with or without a cortisone
injection, and choosing not to have
treatment, recognizing the risks of your
condition.
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