What is Lymphedema Surgery?
Patients whose lymphedema does not respond to conservative measures may be candidates for surgery to reconstruct the blocked lymphatic system.
Who is a good candidate for Lymphedema surgery?
Surgery is not considered a primary treatment for lymphedema. The ideal candidates for surgical intervention are those patients who have been thoroughly evaluated and treated by a specialist in the field of Occupational Therapist Certified in Lymphedema Treatment. At the University of Michigan, plastic surgeons and occupational therapists work hand-in-hand to determine the optimal treatment regimen for patients with this illness.
How is the Procedure Performed?
Several surgical procedures are available, depending on the specific situation. Lymphaticovenous bypass (LVB) involves connecting small lymphatic channels under the skin to small veins, using a microscope and specialized techniques. This allows the lymph fluid to bypass the blockage and re-enter the blood stream. Vascularized Lymph Node Transfer (VLNTx) is a process of transplanting lymph nodes from one area of the body to another, allowing them to alleviate the blockage of lymph fluid in their new location. Additional treatments involve removal of impeding scar tissue and the introduction of new tissues to the site to prevent re-scarring.
Planning for Your Surgery
The first step is to schedule a personal consultation with a knowledgeable, experienced plastic surgeon. Communication is crucial in reaching your goals. You will have the opportunity to express your goals and the results you'd like to achieve. Together, you and your surgeon will reach an understanding about what you can expect from this procedure and the long-term benefits you will experience. Every patient is different, and your surgeon will choose the surgical technique and treatment plan that is right for you. During the initial consultation, you should expect:
- To arrange for communication between your occupational therapist and the surgeon.
- To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications or herbal supplements you are taking.
- Your surgeon to conduct a complete physical examination.
- To discuss possible risks and complications of the procedure.
Preparing for Your Surgery
You will be given a pre-operative information packet that explains everything you should do and know before your surgery date. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.
Where Your Surgery Will be Performed
Your procedure will take place at the University of Michigan Hospitals, which provide state-of-the-art surgical suites and recovery areas. The majority of these procedures are completed on an out-patient basis.
Types of Anesthesia
You'll remain comfortable throughout the entire procedure. In most cases, general anesthetic is used so that you will sleep throughout the procedure; although local anesthesia with intravenous sedation is also an option for some patients.
After Your Surgery
It is very important that you follow your surgeon's instructions in order to promote healing and progress towards your new physical appearance. Also, it is important that you attend all follow-up appointments scheduled so that your surgeon can assess your long-term results and answer any questions or concerns you may have.