Wrist arthroscopy DWG stalk identification success rate 9-100%* Additional intraarticular pathology may be found up to 75% of patients *Ahsan, Z.S. and J. Yao, Arthroscopic dorsal wrist ganglion excision with color-aided visualization of the stalk: minimum 1-year follow-up. Hand (N Y), 2014. 9(2): p. 205-8
Wrist arthroscopy Regional anesthesia Distraction system Tourniquet 2,7mm scope Full radius 2,5-3,5mm shaver No radiofrequency
Wrist arthroscopy Start with 6R Diagnostic arthroscopy Identify stalk / sinovitis zone at 3-4portal site 3-4portal introduced Resect ganglion site / stalk, make DW capsule defect Stop when ECRB is clearly visible
Questionnaire Patient outcomes following wrist ganglion excision surgery, J. D. Craik and S. P. Walsh, J Hand Surg Eur Vol 2012 37: 673 originally published online 5 January 2012
Results What others say: The reason for consultation: unsightly appearance - 55.2%, the presence of pain 28.9%, both – 15,8%.* Pain (79%) and cosmesis (71%) were the primary pre-operative symptoms. Other symptoms such as paraesthesia, numbness, weakness, and stiffness were experienced by 27–44% of patients.** *Gallego, S. and C. Mathoulin, Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy, 2010. 26(12): p. 1675-82. ** Craik, J.D. and S.P. Walsh, Patient outcomes following wrist ganglion excision surgery. J Hand Surg Eur Vol, 2012. 37(7): p. 673-7.
Results The ganglion recurred in 3 patients (12%).
In conclusion… Etiology and pathogenesis of ganglion is not completely clear Conservative treatment often fails Incision scar may be avoided using arthroscopic technique Arthroscopic technique has definite role in management of DWG with very promising future Our results are similar to other published data