Removing the Hygroma

Currently, only the removal of the hygroma is the most effective method of treatment, giving a minimum of relapses.

Benign type, like a cyst, a rounded tumor is a hygromous (ganglion). The size of a sedentary formation varies from a small pea to a ball, with a diameter of more than 10 cm. A favorite place of localization of the neoplasm is the back of the hand, but it is found on the palm and fingers. Hygromes are also diagnosed on the foot, wrist and wrist, in the neck area.

With small hygromes, people live their entire lives, because, in addition to aesthetic dissatisfaction, neoplasms do not cause any discomfort. Tumor growth entails a number of problems - compression of the neuromuscular bundles and tendons, disruption of the normal functioning of the joint, severe pain syndrome. The presence of unpleasant symptoms makes the question of methods of treatment open. Conservative therapy, even in combination with alternative medicine, unfortunately, does not lead to the expected result, especially in neglected cases. 

Carrying out a puncture (a small puncture, which makes it possible to withdraw the contents of the tumor outwards) helps only for a while, until the released capsule is filled again. Previously, the method of crushing the hygroma, which spreads the tumor fluid through the tissues, was practiced. Such manipulation as a minimum led to the resumption of one or several gigromas, and as a maximum - it threatened an inflammatory process.

Most doctors agree that the removal of the ganglion is the only radical way to get rid of the neoplasm. Indication for surgical treatment will be rapid tumor growth, pain syndrome, joint stiffness, loss of sensitivity.

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The operation to remove the hygroma

To establish an accurate diagnosis or detailed study of the tumor, an additional examination is prescribed. The patient gives a number of tests, often from the tumor take a puncture to examine the liquid contents. Puncturing is a method of differentiating the hygroma from other tumoral formations - lipomas (abnormality of adipose tissue) and atheroma (a benign gland tumor of the benign type).

When suspected of a hygromous joint, it is recommended to undergo roentgenography in order to exclude osteoarticular pathology. Ultrasound can perform a structural assessment of the ganglion, reveal in the capsular wall of blood vessels. MRI gives a conclusion about the presence of nodal structures, the structure of the walls of the capsule and the nature of the liquid contents. Each of the described methods helps the specialist to appoint the right conservative treatment or to send the patient to the surgery.

Currently, the operation to remove the hygroma is carried out in three ways: 

• excision - the doctor cuts out the ganglion completely with the capsule; 
• heating by laser beam - continues until the destruction of the hygroma without affecting the healthy cells; 
• endoscopically - through a small incision with the help of special equipment.

The surgical intervention should be followed by mandatory immobilization of the joint with a hard bandage to avoid relapses, and drug therapy is recommended. In a number of cases, a gypsum longus is shown up to 3-5 weeks, preventing the movement of the joint.

The operation to remove the hygroma lasts up to half an hour. After excision of the capsule, the cavity is washed with aseptic solution and sutured, if necessary, drainage is placed in the wound for up to 2 days.

Laser removal of the hygroma

Modern medicine offers tumor removal through laser therapy and endoscopy. These techniques are virtually bloodless, are characterized by the speed of manipulation, a neat post-operative suture and a minimal period of rehabilitation.

Removal of the hygroma by the laser is essentially the same operation with the incision and exposure of the tumor. The result of treatment, as in the case of surgical intervention, will depend on the experience and qualification of the operating doctor.

Before the start of laser treatment, you should undergo additional diagnosis - radiography or magnetic resonance imaging. These methods of research will help the surgeon to establish the feasibility of using a laser, as well as the effectiveness of the effect.

In most cases, a carbon dioxide laser device with coagulating and disinfecting properties is used. The temperature of the high-energy ray is 800 degrees. The operation is performed under local anesthesia. After dissecting the skin over the tumor, the surgeon acts on the capsule with heat, which ensures removal of the hygroma. The procedure is completed by treating the cavity by stitching from the inside and outside, using an immobilizing gypsum or a brace dressing.

The removal of laser formation in addition to obvious advantages - the duration of burning out no more than 15 minutes, the possibility of operating children, over seven years old - also has its drawbacks. The main disadvantage of modern technology is a high probability of relapse, which is explained by the fact that the mouth of the capsule is not filed, as in the usual excision with a scalpel.

Technique for removing hygromes

A painful operation to excise the ganglion requires the surgeon to be highly skilled and skillful. This is due in part to the location of the tumor, in which one wrong move provokes an irreparable complication. The location of the hygroma in the forearm area, namely: the palm surface of the projection of the wrist joint, is considered to be the most traumatic due to proximity to the radial artery. Insufficient accuracy of the doctor can damage the artery. On the other hand, if the surgeon leaves at least a small part of the tumor capsule, the hygroma integrity is restored with time and the formation is refilled with fluid.

Removal of hygroma is not always justified under local anesthesia, as deeper tissues retain sensitivity. Adequately excise ganglion is possible only under general anesthesia or regional anesthesia, when the solution is delivered directly to the neural bundles, turning off the pain sensations of the entire limb / zone.

The sequence and technique of removing the hygroma: 

• a minimal incision is made above the tumor, the size of which depends on the size of the formation itself; 
• the internal fluid is evacuated (sometimes the tumor is excised along with the contents); 
• surrounding ganglion tissues, neatly separated, and excision of the tumor is performed. Particular attention is paid to the foundation of the hygroma, so as not to leave pathological cells provoking a repeated growth of education; 
• processing and filing of the cavity; 
• suturing and fixation with orthosis.

In the postoperative period, bandages are performed with wound treatment. Sutures are removed after 7-14 days. Some cases require a complete immobility of the foot or hand for a week, in order to rule out the possibility of relapse.

Removing the hygroma of the brush

Tumor formation on the hand is one of professional diseases associated with frequent repetitive movements of hands by athletes, musicians, programmers, secretaries, etc.

The brush hygroma is localized in the region of the metacarpophalangeal or radiocarpal joint, in the zone of flexor muscles on the fingers. If the neoplasm, in addition to external hostility, causes pain syndrome and disturbs limb mobility, then it is necessary to resort to surgical intervention. The moving subcutaneous ball is treated by complete excision, laser beam or endoscopy.

Surgical removal of the hand hygroma is the most common procedure, which allows to cut out the entire pathological focus as much as possible and to prevent the neoplasm re-growth. There is also a conservative treatment of hygroma, in which a tumor capsule is opened, the synovial fluid is evacuated, and the space that has been freed up is filled with medicinal preparations.

Removing the hygroma of the hand through the laser and endoscopic equipment is less traumatic techniques that guarantee a quick recovery period.

After performing the operation by any of the methods, a fixing bandage (orthosis) is imposed on the wrist for a period of 7-14 days.

Removal of hygroma of wrist joint

The synovial tumor of the wrist under the palm often exists for several years, without disturbing its carrier. Increased neoplasm, pain, numbness of fingers on the hand with marked tingling indicate the need for surgical intervention.

The hygroma of the wrist joint often coincides with the radial artery, which requires the surgeon to have special accuracy in her excision, otherwise the blood circulation can be disrupted.

The removal of the hygroma of the wrist joint is performed under local or general anesthesia. Some doctors recommend general anesthesia, because during the operation deep tissue is scratched to completely excise the capsule parts. Before surgery, you should undergo additional diagnosis (ultrasound, MRI), as well as pass a series of tests (often a puncture from the hygroma itself).

Removal of the hygroma has several important stages: 

• separation of the tumor from healthy tissues; 
• excision of the ganglion; 
• accurate hemming of the cavity in order to prevent leakage of fluid from the joint; 
• suturing the wound from the outside; 
• fixation of the limb with a special orthosis or a pressure bandage.

Removal of the wrist hygroma

The hygroma of the wrist is formed on the outer surface of the hand joint. The growth of the neoplasm leads to unpleasant consequences in the form of: aching pain, restriction of the motor activity of the brush, impossibility of lifting the weight, rapid muscle fatigue,

The listed symptomatology is the reason for the examination, which includes visual examination from palpation, radiography and histological examination. X-ray allows you to differentiate the hygroma from the lipoma and other tumor formations. These diagnostic methods are very important before the final direction to remove the wrist hygroma, as they form a complete picture of the disease and give an idea of the peculiarities of the internal structure of the hygroma.

On the wrist removal is carried out by excision or burning with a laser beam. In both methods, it is of great importance to remove all parts of the capsule so that the cavity is not re-filled with the synovial fluid. Much depends on the skills of the operating doctor who must sew the outlet hole. The patient is required to maintain a sparing regimen, and in some cases to ensure complete immobility of the brush.

Removal of the hygroma on the leg

On the feet of favorite places of localization gigrom is a stop (including fingers), an area of the knee or hip. Moreover, the location of the tumor is possible both near the joint and the tendon. The maximum discomfort is caused by growing popliteal ganglia, preventing free movement. Constant friction of the tumor causes pain. You can try to get rid of the hygroma with various ointments, lotions or injections, but the real result is obtained only by surgical intervention.

Removal of the hygroma on the leg, formed on the tendon, is also the most effective method. The tendon ganglion of small size does not present any danger and has no symptoms. The increase in the tumor neoplasm causes pressure on the tendon, as a result of which the patient's gait becomes clumsy, causing considerable suffering. The launched process of growth of a tendon hygroma besides strong pains threatens with impossibility of movement.

A reliable method of treating hygroma on the leg is surgery or laser burning. The procedures give a minimal amount of relapses by completely destroying the capsule with liquid contents.

Removal of foot hygroma

Impressive dimensions of the hygroma on the foot prevent to live a full life, bringing aesthetic dissatisfaction and severe pain. Patients with foot tumors sometimes can not wear shoes because of discomfort and possible injury to the neoplasm. Involuntary opening of the capsule of the ganglion is fraught with inflammation and subsequent suppuration, which complicates the therapy many times. For this reason, it is necessary to remove the hygroma of the foot in a timely manner by surgical means, using laser treatment or endoscopic equipment.

Therapeutic tactics are chosen by the doctor based on the symptoms, the size of the neoplasm, the additional examination (ultrasound, x-ray, MRI), histological examination data. Removing the hygroma of the foot is a delicate, laborious work that can be done by an experienced surgeon. Do not settle for surgery without passing X-rays and taking the tests. Minimal collection of information on the internal structure of the tumor (the presence of blood vessels, nodular forms, etc.) will allow the doctor to act as accurately and confidently as possible.

Removal of hygroma in the child

Fortunately, hygromes rarely appear in childhood. The tumor is more often formed during the intrauterine development with excessive fetal activity or vice versa. Provocative tumor tumors near the ankle often become the load or injury obtained in sports sections and dance studios.

The beginning of any treatment begins with an examination of the orthopedic surgeon, the delivery of tests and the necessary examinations (X-ray, ultrasound). The doctor chooses the optimal solution to the problem conservatively or surgically.

The direction to remove the hygroma in the child is given in the following cases: 

• rapid growth of the neoplasm; 
• painful syndrome of aching, permanent character, not only when moving, but also at rest; 
• limitation of mobility, tingling sensation, numbness of the limb; 
• impossibility to lead a habitual way of life (the child does not want to wear shoes, etc.); 
• absence of positive result from conservative therapy.

Babies under 10 years old under general anesthesia, older than 10 years - under individual indications under local or general anesthesia. The operation is the same as in adults. After the end of the procedure, a tight bandage is applied, an orthosis, an elastic longe for limiting limb mobility for up to 14 days.

Removal of the hygroma in the child through the endoscope and the laser are considered more gentle methods. The advantages of treatment are minimal injuries (surrounding tissues are not damaged), a small incision and a short recovery period.

Complications after removal of the hygroma

Postoperative problems are swelling, suppuration, discharge of fluid from the healing wound. All this testifies to poor-quality treatment of the cavity after excision of the hygroma capsule, non-compliance with the dressing regimen and recommendations of the doctor to ensure limb rest for the indicated period.

The most frequent complications after removal of the hygroma are restoration of the integrity of the ganglion cavity and its re-filling with the synovial fluid. Relapse is possible in the following cases: 

• incomplete isolation of the capsular sac (after the operation there remains a small fragment or cell); 
• not carrying the hemming of the cavity from the inside; 
• absence of fixative bandage (gypsum longi, orthesis, etc.).

Removal of a benign tumor by an unqualified, inexperienced surgeon can result in damage to the neuromuscular bundles, loss of sensitivity and even limb mobility. Therefore, it is important to undergo an X-ray examination and ultrasound examination before the beginning of an operation.

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Rehabilitation after removal of the hygroma

After surgical treatment, which takes approximately half an hour, the patient leaves the medical facility on the same day. Burning the hygroma laser lasts up to 20 minutes. Next days the patient comes to the dressing and wound treatment daily. Sutures are removed (if they are not bioresorbable) after 7-14 days, depending on the particular course of the healing process.

Rehabilitation after removal of the hygroma includes: wearing an immobilizing gypsum tire, an orthosis or a popular brace dressing, the purpose of which is fixation of the limb for early scarring and minimization of cases of repeated hygroma formation.

The term of the patient's return to the habitual way of life is individual in each specific case and depends on the complexity of the operation, the localization of the tumor, and the observance of all the recommendations of the attending physician.

Removal price of hygroma

The price list for medical services in Kiev varies according to the institution's ownership of the public or private structure. Why do most patients, despite the overpriced pricing policy, choose private clinics? The answer lies in the lack of queues and greater responsiveness of medical personnel.

The price of removing the hygroma consists of the amount: 

• primary consultation of the surgeon. Approximately - this is 150-600 UAH. The run-up of the price depends not only on the status of the institution, but also on whoever you want to undergo the examination - from an ordinary surgeon or professor; 
• pictures of the tumor (X-ray, ultrasound, MRI) for the intended use - from 200 UAH per site. The cost of a tomogram can reach 800 UAH; 
• necessary tests (blood, histology of ganglion contents, etc.) - approximately 1000-1500 UAH; 
• excision of the hygroma itself - in the area of 2500 UAH; 
• anesthesia, installation of droppers, injections, seam materials, preparations, etc. - about 3000 UAH; 
• postoperative manipulation (dressing, wound treatment) - from 100 UAH.

In total, the amount needed to remove the hygroma, can reach 7000 UAH. Although everything depends on the clinic, the method of excision and the complexity of the case itself.