gms | German Medical Science

Introduction: The dorsal ganglions cysts are the most common benign tumors in the wrist. The length of the surgical incision can cause inconformity for the patient, for that reason it is proposed a controlled emptying technique to achieve resection of the mass with a decrease in the size of the injury during the surgery, without modification of the risk of recurrence. We studied the demographic data and the clinical and intraoperative characteristics of these lesions in our population, and determined the recurrence rate with this technique in a population that underwent surgical resection of the ganglion during the period of January 2016 to January 2018.

Methodology: A retrospective descriptive study, case series, was performed in patients diagnosed with a dorsal ganglion cyst from 2016 to 2018, who underwent total resection with a minimally invasive technique with assisted drainage.

Surgical technique: The patient is under anesthesia, according to its location, is performed. A 0.6 - 1 cm transverse incision is made on the mass in accordance with the skin folds at that level, then it is dissected by planes. The mass is partially drained with a scalpel, by small dotted incision, maintaining minimal content to avoid losing its visualization and delimitation. The small incision is closed with a mosquito clamp leaving a fusiform sac and keeping some tension. The procedure continues by dissecting and exposing the mass and its pedicle; with the drained content it will be easier to visualize the capsule and perform the resection of the ganglion cyst, from the original pedicle.

Results: 6 patients were found to have met the inclusion criteria for management with assisted voiding technique, the average age was 43 years, the female to male ratio was 1:1, the size of the ganglions cysts was 4 - 2 cm and histological confirmation and resection of the pedicule, capsule and ganglion were performed. There were no recurrences in the patients at the 6-month follow-up. There were no complications. The patients were satisfied with the size of the surgical wound and with the result obtained.

Conclusions: The technique of controlled intraoperative emptying of the dorsal ganglion cyst by minimum incision to improve visualization and complete resection of the lesion does not show an increase in the recurrence rate and is a safe and easy technique to perform. Patients have a small aesthetic wound that meets the patient's expectations without modifying the rate of recurrence.