Arthroscopic Technique for Volar and Dorsal Ganglion Excision

Description

This video presentation features Eric Wagner, a specialist from Emory University, discussing the technique of arthroscopic ganglion excision for both volar and dorsal ganglions. The presentation begins with an overview of the procedure, emphasizing the benefits of the arthroscopic approach, including reduced postoperative pain compared to traditional open surgery. Wagner notes that while literature suggests minimal difference in outcomes between the open and arthroscopic techniques, the arthroscopic method is considered safer due to the lower risk of complications like radial artery injury.



Wagner meticulously explains the dorsal approach, utilizing standard portals (3-4 and 6-R) to visualize and excise the ganglion. He details the anatomy involved, including the ligaments and the necessity to carefully expose the ganglion while avoiding damage to surrounding structures. He elaborates on how to identify the appropriate anatomical landmarks and emphasizes the importance of monitoring for fluid extravasation.



The presentation transitions into the volar technique, similarly highlighting portal selection (3-4 or 4-5) and the critical landmarks to avoid complications. Throughout the presentation, Wagner offers practical advice on visualization techniques and cautions against overzealous resection, emphasizing the significance of anatomical safety markers such as the flexor pollicis longus (FPL) tendon.



In summary, Eric Wagner presents arthroscopic ganglionectomy as an effective procedure with reasonable recurrence rates. He provides detailed technical guidance for each technique, referencing specific anatomical structures while ensuring patient safety and efficacy of the procedure. The video concludes with mention of references for further reading, underscoring the academic nature of the presentation.

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