Lymphedema surgery
Treatment of lymphedema using mini-invasive surgery in Brno
Initial consultation
Is a mutual introduction of the doctor and the patient at the outpatient clinic. The doctor will assess the patient's health, expectations, and the risks associated with the
surgery. Previous therapy, type and stage of lymphedema, previous functional examination of the lymphatic system (lymphoscintigraphy) are evaluated. If the patient is a suitable candidate for surgery, additional investigations, including ICG lymphography, are performed at the chosen appointment.
Admission to the clinic
The patient presents to the clinic with an internal pre-operative examination by a general practitioner or internal medicine physician and an anesthetic report. The admitting physician assesses the patient's condition, and if the patient does not suffer from a serious illness, the patient is admitted to the clinic.
Surgery
The operation is performed under general anesthesia. LVA is a minimally invasive procedure of short skin incisions no deeper than the thickness of the subcutaneous tissue. The length of the operation depends on the number of lymphaticovenous anastomoses performed.
Release
The patient is discharged most often on the first day after surgery. The operation is minimally invasive and therefore early discharge and subsequent rehabilitation is possible. The follow-up of the patient is done on an outpatient basis.
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I will help you with the lymphedema treatment
I will help you quickly and painlessly with the treatment of lymphedema in Brno
Very frequently asked questions
What exactly is lymphedema?
The lymphatic system is a network of tiny vessels and small, bean-shaped organs called lymph nodes that carry lymph throughout the body. Lymph is a clear, colorless fluid that contains a few blood cells. It starts in many organs and tissues. The lymphatic system is part of your immune system. It helps protect and maintain the fluid balance of your body by filtering and draining lymph and waste products away from each body region. The lymphatic system also helps the body fight infection.
What does primary and secondary lymphedema mean?
What is primary lymphedema?
Primary lymphedema comes from rare, inherited conditions that affect how your lymphatic system develops. Primary lymphedema affects about 1 in 100,000 people in the U.S. Lymphedema from these conditions can appear at these ages:
- Infancy: Infants may be born with Milroy’s disease, an inherited form of lymphedema.
- Puberty, during pregnancy or up until age 35: Meige’s disease (lymphedema praecox may affect people going through puberty or pregnancy and up until age 35.
- After age 35: A rare, late-onset lymphedema (lymphedema tarda) can cause lymphedema, with swelling limited to your legs.
What is secondary lymphedema?
Secondary lymphedema may happen if your lymphatic system is damaged from surgery, trauma, or radiation therapy.
- It is most common in people who’ve had breast cancer treatment or pelvic cancer treatment.
That said, not everyone who has breast or pelvic cancer treatment develops lymphedema.
What causes lymphedema?
Several things may cause lymphedema, including:
- Breast cancer surgery: Sometimes, breast cancer surgery includes removing lymph nodes under your arms and possibly damaging nearby lymph vessels.
- Pelvic surgery: Surgery to remove pelvic lymph nodes may cause lymphedema.
- Radiation therapy: Radiation therapy may cause scarring and damage to your lymphatic system, inflaming your skin and placing pressure on your lymphatic circulation system.
- Trauma: Your lymphatic system is a rich network of vessels that are directly under your skin, as well as deep. Sometimes, trauma to an area of your body may damage lymphatic vessels under your skin, causing lymphedema.
- Infection: An infection may increase lymphatic system damage.
Are there stages of lymphedema?
Yes, healthcare providers use the following staging system:
- Stage 0: The affected area may feel swollen, tight, and heavy but without outside signs of swelling.
- Stage I: There may be occasional swelling that goes away when you elevate the affected area.
- Stage II: The affected area is almost always swollen and your skin in the area may feel firmer than the surrounding area.
- Stage III: The affected area has significant swelling with changes in your skin such as changes in its color and texture.
Why is the treatment of lymphedema a complex process?
- Exercise. Exercise helps improve lymph drainage. Specific exercises will be advised by your doctor or physical therapist.
- Bandages. Wearing a compression sleeve or elastic bandage may help to move fluid and prevent the buildup of fluid.
- Diet and weight management. Eating a healthy diet and controlling body weight is an important part of treatment.
- Keeping the arm raised. Raising the arm above the level of the heart when possible lets gravity help drain the fluid.
- Preventing infection. It’s important to protect the skin in the affected area from drying, cracking, infection, and skin breakdown. Your healthcare provider will advise you about how to care for your skin and nails to help prevent problems.
- Massage therapy. Massage by someone trained in lymphedema treatment can help move fluid out of the swollen area.
Lymphatico-Venous Anastomosis (LVA)
Lymphatico-Venous Anastomosis (LVA) surgery directly connects the lymphatics in the arm or leg to the veins. This means that the fluid has a direct route back into the bloodstream. The same principal appears in chest, where lymph is drained the way thoracic duct into the the systemic (blood) circulation at the left venous angle. In this way, LVA imitates the physiological process of the human body. The aim of the LVA surgery is to restore the lymphatic drainage and reduce the volume of lymphoedematous limb.
LVA surgery is highly technical and needs special training. Supermicrosurgery technique is used, where stitches thinner than a human hair are used to join tiny tubes less than a 0.8 millimeter in diameter.
LVA surgery is minimally invasive procedure. We perform it under general anesthesia to prevent the patient from involuntary moves during the precise and delicate procedure. Patients are usually discharged one day after the surgery. Most patients have two weeks off work, after which the stitches are removed, and most normal daily activities can be performed.
I will help you with the lymphedema treatment
I will help you quickly and painlessly with the treatment of lymphedema in Brno