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Excision of Ganglion

A ganglion cyst is a fluid-filled swelling that usually develops near a joint or tendon. The cyst can range from the size of a pea to the size of a golf ball.

Ganglion cysts look and feel like a smooth lump under the skin.

They’re made up of a thick, jelly-like fluid called synovial fluid, which surrounds joints and tendons to lubricate and cushion them during movement.

Ganglions can occur alongside any joint in the body, but are most common on the wrists (particularly the back of the wrist), hands and fingers.

Ganglions are harmless, but can sometimes be painful. If they do not cause any pain or discomfort, they can be left alone and may disappear without treatment, although this can take a number of years.

It’s not clear why ganglions form. They seem to happen when the synovial fluid that surrounds a joint or tendon leaks out and collects in a sac.

How to treat a Ganglion

Treatment is usually only recommended if the cyst causes pain or affects the range of movement in a joint.

The 2 main treatment options for a ganglion cyst are:

  • draining fluid out of the cyst with a needle and syringe (aspiration)
  • cutting the cyst out using surgery

Surgery

There are 2 ways surgery can be used to remove a ganglion cyst:

  • open surgery – where the surgeon makes a medium-sized cut, usually about 5cm (2in) long, over the site of the affected joint or tendon
  • arthroscopic surgery – a type of keyhole surgery where smaller cuts are made and a tiny camera called an arthroscope is used by the surgeon to look inside the joint; using the arthroscope as a guide, they then pass instruments through the cut to remove the cyst

Both techniques can be performed under either local anaesthetic, where you’re awake but will not feel any pain, or general anaesthetic, where you’re asleep during the operation.

The choice depends on where the ganglion is, which anaesthetic you’d prefer and what your surgeon thinks is best.

Open or keyhole surgery?

Both techniques are equally effective at removing the cyst and reducing the risk of it returning.

Keyhole surgery tends to cause less pain after the operation, but waiting times are often longer.

What complications could occur with surgery?

Having a ganglion cyst removed is a minor procedure, so complications are rare and seldom serious.

But a small number of people experience permanent stiffness and pain after surgery.

If you have the operation under general anaesthetic, there’s also a very small risk of complications to your heart and lungs. 

Pre-assessment tests before surgery should make sure your risks are as low as possible.

There’s always a chance a ganglion cyst will come back after treatment. This is more likely if the ganglion is on certain areas of the wrist.