A ganglion cyst is a common mass you can find on the hand or wrist. The cyst is made of gelatin and can come out of a tendon sheath or joint. Ganglion cysts can be extremely small but often grow so they are visible gradually. They are completely benign and can be single or multi-lobular. Some cysts can be mistaken for bones because they are so hard. Medications can be used to treat these cysts; however, if this doesn't work or if the cyst bothers you, then a ganglion cyst surgery is recommended.

Ganglion Cyst Surgery Overview

The doctor may decide to do a surgery for ganglion cyst if your symptoms cannot be relieved using medications or if it comes back after the doctor tries to aspirate it. The surgery is also known as cyst excision.

1.   Before the Surgery

Before having the surgery, the doctor will help you understand the other possible options. The surgery is often seen as a last resort after other methods of treatment have been tried. The doctor may aspirate the cyst to draw out the fluid or provide you with a brace for your wrist so it doesn't move as much. If the doctor recommends ganglion cyst surgery, you should follow the doctor's advice in preparing for the procedure.

2.   During the Surgery

The surgery can be done in two ways. The most commonly used methods are:

• Open Surgery. The surgeon makes a cut about 2 inches long directly over the ganglion cyst and removes the cyst by scraping it off the tendon or joint.
• Arthroscopic surgery. This is a surgery in which tiny incisions are made near the cyst and a camera is introduced via an arthroscope. The arthroscope provides a guide for various tools to be used to remove the ganglion cyst.

Either technique can be used under general anesthesia (where you are asleep) or local anesthetic (when you are awake during the surgery). The choice as to which type of anesthesia to use depends on the location of the ganglion cyst and on your preference. Both techniques are good types of ganglion cyst surgery but the second one is less painful than the first surgery, even though the waiting time is longer.

You can watch the video below to see a live surgery for ganglion cyst.

3.   After the Surgery

The surgeon often uses stitches to close the wound and will provide you with a bandage of gauze and tape that will keep the area from becoming infected after the surgery. The bandage will also help prevent bumping into the surgical site. You will get some type of painkiller for surgical discomfort following the procedure.

You might need to have a sling on your arm for the first several days if the cyst was removed from the hand or wrist. This helps protect the surgical area and will lessen the degree of pain and swelling you might experience. You need to regularly wiggle your fingers so they stay flexible. There will be a scar after ganglion cyst surgery and there may be numbness in the area of the scar that lasts for a long period of time.

Bruising is also possible after surgery, but it shouldn't last long. You can also have swelling, stiffness, or pain of the joints of the hand and wrist. It can be secondary to an infection, which can be treated by antibiotics. Physiotherapy can be performed if your pain and stiffness is persistent.

You may need to take a leave of absence from your job, depending on the location of the cyst and the type of job you do. If you do a job that involves heavy lifting or other manual labor, time off is usually necessary. You should be able to drive once the sling comes off and the wrist feels better.

Are There Any Risks of Ganglion Cyst Surgery?

The surgery tends to be a minor surgery, so there are very few and not very dangerous complications. Some people who have had it will have some pain in the area of the surgery that can be relieved by taking prescription painkillers, over the counter pain pills, or medications that numb the area.

Swelling at the site of the surgery is another complication. You can apply ice to the affected area to reduce the swelling and you can expect the swelling to reduce over time. There can also be stiffness of the joint, which gets better if you do the exercises recommended for after the procedure.

Infectious complications are rare but can occur after ganglion cyst surgery. The doctor will recommend that you keep the wound properly dressed and always clean. Antibiotics may be prescribed for you in order to clear up the infection. This can lessen the scarring after the procedure.

If you decide to have the procedure under general anesthesia, there are anesthesia risks you need to consider, such as lung or heart complications. The anesthesiologist will assess you before surgery to see if you are a good candidate for general anesthesia.