Surgical Information – Procedures

Ganglion Cyst Excision

What is a ganglion cyst excision?

Ganglion cysts are noncancerous lumps that develop along the tendons or joints in the hand. These fluid-filled cysts can occur in various locations, but most frequently occur on the back of the wrist. They often change shape and may disappear on their own. If they persist, cause pain or limit function, an excision may be necessary.

The vast majority of excisions are performed arthroscopically. In this minimally invasive approach, the surgeon makes several small incisions around the cyst and inserts a narrow fiber optic scope (called an arthroscope) to examine the inside of the joint. Tiny instruments are used to remove the cyst and the stalk that attaches it to the joint or tendon. The procedure is performed on an outpatient basis and patients return home the same day.

Anatomy

A ganglion cyst grows out of the tissues surrounding a joint, such as ligaments, tendon sheaths and joint linings. The swelling looks like a smooth, soft lump under the skin and can range from pea-sized to as big as a golf ball. Ganglion cysts contain a jelly-like substance called synovial fluid. In addition to the back of the wrist, the most common locations are the palm side of the wrist, the base of the finger on the palm side and the top of the end joint of the finger.

When is surgery recommended?

Many ganglion cysts do not require treatment and may disappear spontaneously. However, if the cyst is bothersome, non-surgical treatments may provide relief. They include:

  • Immobilization with a brace or splint, followed by exercises to strengthen the wrist
  • Fine needle aspiration to drain fluid from the cyst

If these non-operative remedies don't work or the cyst recurs, a surgical excision may be a good option.

What is the recovery time?

Recovery time varies by patient and method of treatment. Following an excision, there may be some tenderness, discomfort and swelling. Most patients wear a splint for about a week, followed by physical therapy to rebuild strength and range of motion in the hand.

Patients can usually return to work and activities within a few days. For those whose jobs involve heavy manual labor or repetitive work, the time off may be longer.