Excision of dorsal wrist ganglia under local anesthesia with adrenaline without tourniquet,and with evacuation of the cyst during dissection for the ease and completeness of the excision

Aim: to introduce and evaluate an easy and safe operative procedure with comparable good results under local anesthesia in the surgery of wrist ganglia as compared to the common treatments like aspiration,arthroscopic resection and open excision under general anesthesia and tourniquet. there is a wide variation in the results reported by different treatments options and the general anesthesia and tourniquet is also prone to a lot of complications. the purpose was to avoid these complications and do the surgical procedure under local anesthesia and as a day case procedure. methods: we excised dorsal wrist ganglia under xylocaine with adrenaline and without the use of tourniquet. for the ease of dissection the cyst was punctured and drained during the dissection. the results of the surgery at avicenna medical college and at laser looks jail road lahore were recorded between january 2013 and march 2015. results: the 50 patients included in this study were followed after surgery on an average for 6 months. the recurrence rate after surgery in this series was 2%,tender scar was 8% and unsatisfaction with the scar was 10%. this study showed that the surgical excision of wrist ganglia when performed under local anesthesia with this new technique is very effective. conclusion: we propose that for symptomatic ganglia the surgeons with sufficient experience in performing local anesthesia procedures should use this technique as it reduces the anesthesia related complications,shortens the hospital stay and is more cost effective. and because unsatisfaction with the scar is a major complication so surgeons who also give cosmetically good scar should perform it.