Lymphoedema is characterised by swelling in the extremities, which is often painful, and has multiple surgical treatment options available.
Early lymphoedema is usually treated medically without any surgical procedures. Medical treatment options include elevation, compression, prevention and treatment of infection. Specialised lymphoedema therapists assist with physical therapy, compression bandaging and massage to reduce pain and swelling. This is known as complete decongestive therapy (CDT) and is the primary initial treatment of lymphoedema.
If the lymphoedema progresses despite the above medical treatments surgery may be an option.
WHAT ARE THE SURGICAL OPTIONS?
After a careful surgical consultation, Dr Sofianos will recommend the treatment suited to your condition and stage of lymphoedema. It is important to realise that there is no absolute cure for lymphoedema, and treatment is directed toward alleviating symptoms.
- Excision and skin grafting (Charles procedure)
- Lymphaticovenous anastomosis (LVA)
- Vascularised lymph node transfer
LIPOSUCTION AND CHARLES PROCEDURE
These procedures are used to remove excess volume and tissue.
With excess lymphatic fluid in the tissues, inflammation results leading to growth of fat cells. Liposuction is performed to remove this extra fat. It is a day procedure with relatively rapid recovery.
The Charles procedure involves removal of the excess tissue by cutting it out. The skin from this excess tissue is then applied as a skin graft to cover the raw areas. Recovery from this procedure is usually prolonged and can take a few weeks for the skin grafts to heal, and even longer if infection occurs.
LYMPHATICOVENOUS ANASTOMOSIS AND VASCULARISED LYMPH NODE TRANSFER
These procedures aim to restore function to a non-functioning lymphatic system. Dr Sofianos uses specialised microvascular techniques to achieve this.
With lymphaticovenous anastomosis the damaged lymphatic tissue is bypassed by connecting lymphatic channels directly to nearby veins to allow for drainage of lymphatic fluid. This is a day procedure with rapid recovery and return to normal function within a few days.
Vascularised lymph node transfer involved transplanting a group of lymph nodes from a healthy part of your body, either the groin or the neck, to the affected area, in attempt to restore function. This is an inpatient procedure with a longer recovery that lymphaticovenous bypass.