Ganglionectomy for palmar wrist ganglion

Anatomy Perioperative management Technique Complications Evidence Total Video

Planning/Incision
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Anatomical orientation by palpation and marking of anatomical landmarks:
- Radial artery
- Ganglion
- Retinaculum
Longitudinal skin incision from the retinaculum over the ganglion proximally along the course of the radial artery. Sharp transection of the subcutis with bipolar coagulation of individual veins.
Exposure of the radial artery
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Free dissection of the radial artery from proximal to distal The ganglion is also exposed and successively dissected free.
Caution
- Cutaneous branches of the lateral antebrachial cutaneous nerve or superficial branch of the radial nerve
Isolation of the Ganglion Stalk

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The stalk is exposed up to its entry into the palmar joint capsule between the ligaments and is severed here.
Irrigation and Skin Suture

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Careful irrigation of the surgical site with e.g. normal saline solution with final inspection. If necessary, insertion of a mini- or an 8-French Redon drain. Everting skin suture (interrupted/continuous/subcuticular, if necessary Omni- or Steri-Strips). Sterile elastic compressive dressing If necessary, application of a radiopalmar wrist splint.

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Ganglionectomy for palmar wrist ganglion

Planning/Incision

Exposure of the radial artery

Isolation of the Ganglion Stalk

Irrigation and Skin Suture