A ganglion cyst is harmless swelling that consists of a jelly-filled bag that balloons out from a joint or tendon. Swelling can enlarge with activity and reduce with rest.

What is excision of a ganglion cyst?

This is an operation to ‘excise’ or surgically remove the ganglion cyst from near a joint or tendon. The entire ganglion is removed and traced back to the area of origin to try to reduce the chance of recurrence. Once it has been removed, the skin is sutured (stitched) and a bulky dressing is applied.

Why would it be performed?

Surgical removal is only advised if the ganglion is causing pain or weakness. Ganglion cysts in older patients are often related to arthritis in the joint and therefore removal of the swelling does not resolve the pain due to the underlying arthritis. Sometimes ganglion cysts can disappear without treatment.

How long would I be in hospital?

This operation is done as a day case procedure with no overnight stay needed.

Will I have to go to sleep? (general anaesthesia)?

The operation will likely be done under local anaesthesia (while you are awake) and the foot is numbed but a general anaesthetic (you are asleep) can be used in some cases.

What will happen afterwards?

Your foot will feel numb for a few hours after the operation. There will be some swelling and you will need to rest as much as possible with your foot raised to help the swelling go down. You may need to wear a boot or a plaster cast following surgery and you will be advised whether you can put your full weight through your foot. Approximately 10-14 days after the operation you will be seen back in a nurse led clinic to have your foot checked. The stitches will be removed (and plaster cast if you have one) and you will have a smaller dressing applied. If a further check-up is required, this will be arranged for you.

When can I...

Go back to work

If you work in a clean environment and are in a desk-based job you will be able to return to work within a week or so. If you work in a manual job with a lot of dirt or dust around and there is a lot of pressure on your foot, you will require longer.

Drive

Once you have had your wound check 10-14 days after the operation, you should be able to drive short distances. It is advisable to try the pedals while stationary and to drive short distances before longer ones. If you cannot safely make an emergency stop your insurance company will not cover you in the event of an accident.

Play sport

When your dressing has been removed you can start taking increasing exercise, starting gently and building up gradually as comfort allows.

What are the risks?

In the short term you will need to manage the swelling. There is a small chance of wound infection which normally settles after a short course of antibiotics.

Sometimes cuts can be slow to heal. It’s important to protect the wound with appropriate dressings and keep a watchful eye to make sure it doesn’t become infected.

No operation caries a guarantee of cure and if the operation is successful, research shows there is a 20% chance of recurrence of the ganglion cyst.

General risks

There are general risks with any operation including:

• Blood clots
• Anaesthetic complications
• Tourniquet complications
• Generalised pain
• swelling and stiffness can occur
• Chronic regional pain syndrome-CRPS).

What can I do to reduce my risks?

Most patients find that simple measures can make a big difference to the outcome of foot surgery. The evidence from studies and our own experience supports this:

• Take simple Vitamin C and D tablets needed for healing.
• Stop smoking as smoking slows down the healing and is linked to increased complications.
• Keep fit and maintain a healthy weight as many foot problems are improved by losing weight.