Lymphedema Surgery and Specialized Microsurgery
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www.LymphedemaSurgeon.com (click here for link)
Lymphedema Surgical Treatment Options
Several effective surgical treatments exist for lymphedema. Some, like vascularized lymph node transfers, are relatively new techniques. Others, such as lymphaticovenous anastomoses, have been described previously and more recently modified and improved with better results.
These specialized techniques are performed by only a small handful of highly specialized microsurgeons worldwide. Dr. Granzow is a pioneer in this area and continually works with colleagues from around the world continually to further refine these procedures.
Techniques
Vascularized Lymph Node Transfer - (click here for more information)
Lymph nodes are moved from the groin to the armpit to improve the lymphatic clearance of the affected arm.
Lymphaticovenous Anastomosis - (click here for more information)
Lymphatic channels are connected directly to the veins using supermicrosurgery.
Patient Selection
Both microvascular lymph nodes transfers and lymphaticovenous anastomoses are most effective in patients whose extremity circumference reduces significantly with compression wrapping, indicating most of the edema is fluid. Patients who do not respond to compression are less likely to fare well with lymphaticovenous anastomoses as a greater amount of their increased extremity volume consists of fibrotic tissue, protein or fat.
Prior to any lymphedema surgery, patients should have been treated by an occupational or physical therapist for initial conservative treatment of their lymphedema. The therapist preferably should have training and experience specifically with lymphedema patients. Complete decompression therapy (CDT), manual lymphatic drainage (MLD) and compression bandaging are all helpful components of conservative lymphedema treatment.
Specialized Liposuction for Advanced Lymphedema of the Extremity
Patients who have limbs which no longer adequately respond to standard lymphatic compression therapy may be candidates for liposuction specifically adapted to treat this advanced condition. This technique has been pioneered by Dr. Hakan Brorson in Malmo, Sweden.
The liposuction appears to be an effective method of reducing the size and stiffness of the affected extremity. However, a significant limitation of the technique is that currently the procedure must be followed by lifelong use of compression garments to prevent a recurrence of the lymphedema.
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