Surgical Treatments for Lymphedema
Lympho venous bypass shunt for Lymphedema
It is one of the most effective microsurgery in which the lymph channels before the obstruction are joined to nearby veins, thus bypassing the obstruction.
An operation involving microsurgical lymphovenous shunts is designed for decompressing the lymphedematous limb of the accumulated lymph and directing its flow to the venous system distally.
Because of the removal of lymph nodes the lymphatics are unable to drain and flow further. This gets accumulated and forms lymphedema. To cure the lymphedema the dilated lymphatic ducts joined to the vein so that they drain into the vein and through this bypass surgery the obstruction is thus relieved and the swelling decreases.
Preventive Lympho venous shunt during cancer surgery -
"A Revolutionary Concept"
Introducing a novel way to prevent lymphedema… In a preventive form after any cancer surgery after the lymph glands are removed, the cut ends of the lymphatics can be immediately joined to the veins so that there is no accumulation of lymph as they will be drained through the lymphatics into the vein and thereby prevent lymphedema, thereby giving it a preventive value as well.
Lympho Nodo Venous Shunt
Once lymphatic fluid spills in the surrounding tissues, it can cause inflammation and stimulate fat cells to grow. This excess fat caused by lymphedema can be removed by liposuction and hence effective in decreasing the swelling for a long duration.
Fat in itself is known to stimulate further formation of lymph thereby causing a vicious cycle. This fat if removed can interrupt that vicious cycle as well as cause volume reduction. Thus, lymphedema can be removed by liposuction and hence effective in decreasing the swelling for a long duration.
Excisional & Reconstructive Procedures
Excisional techniques remove the affected tissues and excess skin, thus reducing the lymphedema load.
Many a times reconstructive procedures also need to be done to address the ulcers which form because of lymphedema and skin grafting or other reconstructive procedures are added on as a procedure to rehabilitate the patient.
Vascularised lymph node transfer
Lymph nodes from other parts of the body are taken and transplanted in the affected area. It has been found to stimulate the regeneration of the lymphatics.
Studies are still on long term efficacy of this procedure but it looks to be promising.
Lympho–Nodo Venous Shunt
These are effective in Filarial cases, where the lymph node is not obstructed. These are also effective in Filarial cases and in pelvic lymph node dissection where the inguinal lymph nodes are present and patent (not abstructed).