Ganglion Cyst Removal

A ganglion is a type of cyst that can occur alongside any joint but is most common in the hand or wrist.

HCA UK's specialist hand and wrist orthopaedic consultants will assess your cyst and deliver expert treatment.

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Ganglion cystectomy available at private hospitals across London and Cheshire
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What is a ganglion cyst?

Ganglion cysts are fluid-filled sacs next to a joint or tendon. This fluid forms a lump under the skin typically found on the wrist, hand or fingers. The cyst is attached to the joint like a balloon on a string. The 'string' here is referred to as the 'root' or 'stalk' of the cyst.

The cyst is filled with colourless, jelly-like fluid. It’s not fully clear how they form. One theory is the normal fluid inside the wrist or finger joints can push out of the lining of the joint and form a swelling. This swelling is the ganglion cyst.

It’s not fully clear why they form either. Common theories suggest that ganglions might form after a joint injury or repetitive stress of the wrist joint. This may explain why it's common for sportspeople who repeatedly apply stress to the wrist, such as gymnasts, to experience these cysts. In some cases, these cysts might form because of arthritis. There might be one large ganglion or several smaller cysts. They typically measure a few millimetres to a few centimetres across and feel firm to the touch.

When would I need treatment for a ganglion cyst in my hand or wrist?

As they're benign lumps and aren’t cancerous, ganglions can be left alone and may disappear without any treatment. However, they can be painful if the cyst grows in size and increasingly puts pressure on the surrounding structures. Those experiencing pain from a wrist ganglion often report feeling symptoms when the wrist is in the press-up or plank position.

In such instances, your orthopaedic consultant will discuss potential treatment approaches with you and recommend what they think will be most effective.

GANGLION REMOVAL SURGERY

In some cases, such as if a previously drained ganglion cyst has returned to your hand or wrist, your consultant may recommend surgery to remove it. This is sometimes referred to as a ganglion cystectomy or ganglion cyst excision. There are two ways in which surgery can be used to remove a ganglion cyst and the root:

Open surgery: This could be recommended by your consultant if they think it is a suitable method for ganglion cyst extraction. The procedure usually takes 15 to 30 minutes. A cut of 2-3cm is made over the site and the cyst is separated from surrounding blood vessels, nerves and tendons. It is then removed in its entirety at the root using surgical tools. Once the cyst is removed, the opening is stitched up.

Arthroscopy: An arthroscopic procedure, also known as keyhole surgery, uses a small camera called an arthroscope to examine the cyst. The camera is inserted through a small incision and relays video footage to your surgeon via a monitor. Any surgical instruments to remove the ganglion will be passed through a separate incision. Arthroscopy is less commonly used as a technique for wrist ganglion excision.

Surgery is normally carried out under general anaesthetic or sometimes local anaesthetic. Your consultant and anaesthetist will let you know which will be used for the removal of the ganglion cyst on your wrist, hand or finger.

WHAT TREATMENT OPTIONS ARE AVAILABLE FOR A GANGLION CYST?

There are two main options to treat a ganglion cyst on your hand, wrist or finger.

Click the arrows below to learn what they are.

ASPIRATION

This is a quick and straightforward procedure with little or no pain. During this process, the fluid-filled cyst is drained with a needle.

An ultrasound scanner is usually used. It helps with guiding the needle to the cyst so that it can be lined up to withdraw the fluid. Ultrasound-guided aspiration also helps to make sure the sac is fully clear of fluid as images of the affected area will be displayed on a monitor.

A steroid injection is sometimes used at the same time as the aspiration to reduce the chance of the cyst returning (recurrence). However, it’s estimated that there is around a 40-50% chance that the ganglion will return after aspiration. This is because the procedure drains the cyst but doesn't remove it at the root.

GANGLION REMOVAL SURGERY

ASPIRATION

This is a quick and straightforward procedure with little or no pain. During this process, the fluid-filled cyst is drained with a needle.

GANGLION REMOVAL SURGERY

Experts in hand and wrist ganglion cystectomies

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Ganglion cystectomy FAQs

Who is most likely to develop a ganglion cyst on their hand or wrist?

Anyone can be affected by ganglions. However, they are more common in women aged between 20 and 50. Women are three times more likely than men to experience this type of cyst, although the reasons why they affect women more are unknown.

People are also more susceptible if they have osteoarthritis or their joints have experienced significant wear and tear. Ganglion cysts can also occur at the site of tendon or joint injuries as the impact of trauma to the area can cause synovial fluid to leak and form a cyst.

They are frequently found in people who do sports or other activities that require them to put pressure on their joints.

Are there alternative ways to treat a ganglion cyst on the wrist or hand?

Aspiration or ganglion cystectomy aren't always necessary. Your doctor might recommend monitoring the ganglion and it could be that it doesn't require any treatment. If a cyst is causing discomfort, you may be given anti-inflammatory pain medications. In some cases, wearing a splint could help to immobilise the joint and relieve pain.

These initial steps may be sufficient to alleviate your symptoms and potentially reduce the size of the cyst. However, your consultant will assess the ganglion and recommend the best course of treatment for you.

What are the risks of treatment for a ganglion cyst?

As it is less invasive than surgery, aspiration is the primary type of treatment for ganglion removal, whether it's in the hand, wrist, finger or elsewhere. However, around half of ganglion cysts that are drained will come back.

It's less likely that a ganglion will return after surgery. However, as with any type of surgery, there are some risks to be aware of. These include:

Scarring
Significant swelling
A new ganglion forming – this is called recurrence. It sometimes happens, even if the operation is performed well and the cyst is removed at the root.
Pain during a healing process that can last for up to six months

How do I prepare for a ganglion removal?

Your consultant will talk you through which type of treatment they recommend for you and answer any questions you may have.

If you're having an aspiration to treat the cyst, your consultant will explain the procedure, which involves puncturing the cyst with a needle and removing the fluid.

If you're having ganglion removal surgery on your wrist, hand or any other part of the body, it may be recommended that you have this done under general anaesthetic. In this case, you'll be told about the potential risks and side effects involved with any surgical procedure, including bleeding and infection.

Before this type of surgery, you'll also be assessed to check your suitability for anaesthetic and given information about the recovery process and include details on:

How long you should avoid eating and drinking beforehand
Arranging travel to and from your surgery
Preparing your home so that you are comfortable during your recovery
Arranging for help afterwards with everyday tasks

What happens after ganglion removal?

You should be able to go home immediately after an aspiration. You'll have a plaster over the area where the needle was inserted, which you should keep on for a few hours. You may need to rest your hand and wrist for a day or so afterwards. But the recovery is fast.

If you're having surgery, you should be able to return home on the same day as your procedure. Your consultant will explain how to care for the area until it's fully healed. They may even recommend hand therapy to help with your recovery.

What is the typical recovery time after a ganglion cyst removal?

After ganglion cyst removal surgery, the recovery period can typically be anything from two to six weeks, but this can depend on the person. Your consultant will let you know when you can get back to your usual routine.

When you return to work will depend on the job you do and the location of the ganglion. For instance, if you had treatment for a ganglion cyst on your hand, you may need two weeks before you can use a keyboard again. The consultant will also advise you about when you can drive or exercise, although you can usually return to driving when you feel ready to do so.

What does a ganglion cyst removal cost?

Prices vary, subject to the specifics of your treatment as recommended by your consultant. The procedure is described as a day case, where an overnight stay is not required. Payment can be arranged via your medical insurance provider or made directly by yourself using self-pay.

Find out more about how to pay for your treatment

Why choose HCA UK?

Fast access to specialist care: You'll have an appointment with one of our hand and wrist specialists confirmed within 24 hours.

Effective treatment: You can rest assured you'll receive exceptional care from leading experts in world-class private facilities.

Number One: We're ranked number one for private orthopaedics as we treat the most cases in London, as reported by Private Healthcare Information Network (PHIN).

Trusted by patients: 97% of orthopaedic patients rated us as very good or excellent in our 2022 patient satisfaction survey, and 96% would recommend us to their loved ones.

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