Ganglion Removal

What is Ganglion Removal?

Ganglion removal, known medically as ganglionectomy, refers to the surgical process aimed at eliminating ganglion cysts. These cysts are benign lumps, most commonly found on the wrists, hands, or feet, and are characterised by their fluid-filled nature. Despite their benign nature, ganglion cysts can cause a range of uncomfortable symptoms, including pain, swelling, and an impeded range of motion, which can affect your ability to carry out everyday tasks and engage in physical activities.

The presence of a ganglion cyst is typically noticeable due to a visible lump, which may fluctuate in size over time. Some individuals experience a sensation of pressure or discomfort, particularly when using the joint near where the cyst has formed. In certain cases, the cyst can press against a nerve, leading to more pronounced pain or tingling sensations, further motivating the consideration for surgical removal.

The primary aim of ganglion removal surgery is not just to remove the visible lump but also to alleviate any associated symptoms that might be impacting your quality of life. The procedure is relatively straightforward and is often performed on an outpatient basis, meaning you won’t need to stay in the hospital overnight. It involves making an incision over the site of the cyst, through which Anca can access and remove the cyst, along with a portion of the joint capsule or tendon sheath, to discourage its recurrence.

Who Needs Ganglion Removal?

Ganglion removal surgery becomes a consideration for individuals whose daily lives are impacted by the symptoms associated with ganglion cysts. Although these cysts are non-cancerous and, in some cases, can disappear on their own, the decision to proceed with surgery usually comes down to a few critical factors:

• Persistent Pain and Discomfort: If the ganglion cyst causes continuous pain or discomfort that interferes with daily activities or sleep, surgical removal may be advised. The level of pain is not necessarily related to the size of the cyst; even smaller cysts can press on nerves, causing significant discomfort.
• Impaired Functionality: Those who experience a reduction in joint mobility or difficulty in performing tasks that require fine motor skills might be ideal candidates. This impairment often motivates the need for surgical intervention to restore full functionality.
• Ineffectiveness of Non-Surgical Treatments: Candidates often include individuals for whom conservative treatments, such as aspiration or the use of splints and anti-inflammatory medications, have not provided relief. In such cases, surgery may be the next step to consider.
• Aesthetic Concerns: In some instances, individuals may opt for removal due to the cyst’s appearance, especially if it is in a visible location and causes feelings of self-consciousness.
• Recurrent Cysts: Those who have experienced recurrent ganglion cysts, despite previous attempts at non-surgical management, may also be candidates for surgical removal to potentially reduce the likelihood of future recurrence.

Benefits of the Ganglion Removal Procedure

Choosing to have the ganglion removal procedure is a decision influenced by the desire to alleviate the discomfort and limitations caused by ganglion cysts. The surgery offers several potential benefits, impacting both physical capabilities and overall satisfaction with one’s quality of life.

Alleviation of Pain and Discomfort

The most immediate benefit you notice following ganglion removal is the relief from pain and discomfort. Ganglion cysts, particularly those that press against nerves or are located in areas of frequent movement, can cause significant discomfort. Surgical removal of the cyst addresses this pain at its source, offering a direct solution to this issue.

Restoration of Function and Mobility

Ganglion cysts can impede the normal range of motion of the affected joint, making everyday tasks challenging and limiting physical activity. Following successful surgery and recovery, you can expect a restoration of function and mobility, allowing for a return to daily activities, hobbies, and sports that were previously hindered by the presence of the cyst.

Decrease in Recurrence Rates

While non-surgical treatments like aspiration may offer temporary relief, they often carry a higher risk of the cyst returning. Surgical removal, especially when it includes the excision of the cyst’s root or the involved joint capsule, tends to result in lower recurrence rates, offering a more permanent solution for those affected by recurrent cysts.

Improvement in Aesthetic Appearance

For some, the presence of a ganglion cyst can be a cosmetic concern, especially if it’s located in a highly visible area. The removal of the cyst can thus provide psychological and aesthetic benefits, enhancing one’s comfort and confidence in their appearance.

How is the Ganglion Removal Performed

Ganglion removal surgery, whether through open or arthroscopic methods, is designed with the primary aim of eliminating the cyst and alleviating any associated symptoms. The choice of procedure depends on various factors, including the cyst’s location, size, and your specific circumstances. Here’s a closer look at what the process entails for both surgical options:

Open Surgery Process

• Preparation: Initially, you’ll be prepared for surgery, which may involve administering a local, regional, or general anaesthetic, depending on the complexity of the surgery and your comfort.
• Incision: Anca makes an incision over the cyst, which is carefully planned to allow for the best access while minimising visible scarring.
• Removal: With direct access to the cyst, Anca delicately separates the cyst from the surrounding tissues. She may also remove a portion of the joint capsule or tendon sheath to reduce the risk of recurrence.
• Closure: Once the cyst is completely removed, the incision is closed with sutures. In some cases, a drain may be placed to prevent fluid accumulation.
• Recovery: A bandage or splint is applied to protect the area, and instructions are given for post-operative care, including pain management and when to resume activities.

Arthroscopic Surgery Process

• Preparation: Similar to open surgery, the preparation involves administering an appropriate anaesthetic to ensure comfort throughout the procedure.
• Incision and Insertion: Anca makes one or more small incisions near the cyst. Through these incisions, a tiny camera (arthroscope) and specialised surgical instruments are inserted.
• Cyst Removal: The camera provides a clear view of the inside of the joint and the cyst. Using the images transmitted to a monitor, Anca uses special tools to carefully remove the cyst and, if necessary, a portion of the surrounding structures.
• Closure and Recovery: The small incisions are closed with sutures or adhesive strips, and a bandage is applied. Recovery instructions, including care for the incision site and managing discomfort, are provided.

When it comes to addressing ganglion cysts through surgical intervention, there are primarily two types of procedures that Anca may recommend, based on the cyst’s location, size, and your overall health and specific needs. Understanding the distinctions between these methods is important for making an informed decision about which option might be best suited to your situation. The two type are Open Surgery Process and Arthroscopic Surgery Process.

Recovery after Ganglion Removal Procedure

The recovery period following a ganglion removal procedure varies from person to person, influenced by factors such as the type of surgery performed, your overall health and your adherence to post-operative care instructions. Here’s an outline of what you can generally expect during the recovery process, along with tips for ensuring a smooth and effective healing period:

Immediate Post-Operative Period

In the first few days after surgery, managing pain and preventing infection are the primary concerns. You may be prescribed pain relief medications and given specific instructions on how to care for the surgical site. It’s important to keep the area clean and dry, and you might need to return to the hospital or clinic to have stitches removed or to assess the healing progress.

Use of Bandages or Splints

A bandage or splint is typically applied immediately after the surgery to protect the area and support healing. Depending on the location of the cyst and the type of surgery, you may be advised to wear this protective covering for 1 to 2 weeks. It’s important to follow Anca’s advice on how long to keep the area immobilised to ensure optimal healing.

Activity and Exercise

You’ll likely be encouraged to start gentle activities a few days after the surgery to promote circulation and prevent stiffness. However, it’s important to avoid strenuous activities or putting pressure on the affected area until Anca advises that it’s safe to do so. A physical therapist may provide you with specific exercises to gradually restore strength and flexibility without risking injury to the healing tissues.

Monitoring for Complications

Throughout the recovery process, it’s vital to be vigilant for signs of complications, such as increased pain, redness, swelling, or discharge from the incision site, which could indicate infection. Additionally, any numbness or tingling sensations should be reported to Anca as these could be signs of nerve involvement.

Long-Term Care

Complete recovery and the full return of function can take several weeks to months. During this time, adhering to your Anca’s advice and attending follow-up appointments are essential to monitor your progress and address any concerns. It’s also an opportunity to discuss the potential for cyst recurrence and strategies for minimising this risk.

Tips for a Successful Recovery

• Follow Post-Operative Instructions: Adhere strictly to the guidelines provided by your healthcare team, including wound care, medication usage, and when to resume activities.
• Rest and Elevate: Give your body the time it needs to heal by resting and, when advised, elevating the affected limb to reduce swelling.
• Stay Active Within Limits: Engage in approved activities and exercises to maintain mobility and strength, but avoid overexertion.
• Nutrition and Hydration: Support your body’s healing process with a balanced diet rich in vitamins and minerals, and stay well-hydrated.
• Communicate with Your Healthcare Provider: Report any unusual symptoms or concerns during your recovery, and keep all scheduled follow-up appointments.

How Much Is Ganglion Removal in the UK

The cost of ganglion removal in the UK can vary based on factors such as the location of the clinic, the complexity of the procedure, and whether it is performed under local or general anaesthesia. Typically, the price for this surgical procedure in a private healthcare setting ranges from £1,200 to £2,500. This fee usually covers the surgical removal of the ganglion cyst, the use of the clinic’s facilities, and the surgeon’s fee. In some cases, the price might also include any necessary follow-up appointments. It’s important for patients to check if additional costs might apply for diagnostic tests or post-operative care.

Further Reading

• Read Anca’s Blog on Treatment Options for Lipoma and Other Swellings
• Read Anca’s Blog on How to Get Rid of Moles