Surgery for lymphoedema
Developments in plastic and reconstructive surgery have led to 3 different surgical techniques that all have an important role in lymphoedema. These are lymphovenous anastomosis (LVA), vascularized lymphnode transfer (VLNT) and liposuction for lymphoedema (SAPL). Each operation has a role in the different stages of lymphoedema.
Surgical treatment of lymphoedema
Lymphovenous anastomosis (LVA)
This microsurgical bypass operation connects lymphatics to small veins in the skin allowing excess fluid to drain from the affected area. Whilst it is a very technical procedure it can restore the function of the lymphatic system and remove excess fluid from the limb. We have pioneered this operation under local anasthetic as a day case. It is suitable for patients with early disease.
Liposuction for lymphoedema (SAPL)
This surgery can produce a massive and permanent volume reduction in an arm or leg affected by lymphoedema. It is particulary successful in advanced longstanding disease where most of the swelling has turned to fat and protein. It is carried out with specialist training for assessment, surgical techniques and rehabilitation following surgery. It must be emphasised that this is very different from standard cosmetic liposuction. It can produce a long term and predictable volume reduction that is maintained by a special compression garment use.
Vascularized lymphnode transfer (VLNT)
We can transfer spare lymphatics from a healthy area of your body to the arm or leg with lymphoedema. We also join the healthy lymphatics to nearby blood vessels so the tissue remains healthy and can begin to regenerate lymphatics. The transferred lymphatic tissue can then restore the conduit and filter for lymph fluid. This operation may take some time to become fully effective as the new lymphatic system grows but is suitable for a range of stages of the disease.
It would be impossible for me to fully explain the difference that the improvement in my Lymphedema has made to my quality of life so far - Thank you!
Please thank Mr Gore who saw me for his very helpful letter, it is good to know that there is somewhere to turn to for clarity on lymphoedema
Without your surgery on my arm I don’t think I could of done this , I climbed Kilimanjaro on New Year’s Day
I think the service you have given me has been the best medical experience I have ever had, the team is very professional but with a really great empathy for the patient which makes one feel very comfortable and cared for.
My left leg is still staying soft and maintaining a good shape. I have noticed a reduction in my thigh area recently just by looking!
The surgery has made a big difference to my mobility, which has enabled me to do things that I want to do. The pain has lessened, which has improved my quality of life. Everyone in the practice I've had contact with has been kind and understanding. They've worked hard to make things better for me.
Many thanks for your wonderful service. You've changed my life by correcting my painful lymphoedema. Coming to see you was the best thing. All my thanks for making such a difference to my and our lives.
Nuffield Health, The Manor Hospital, Beech Road, Oxford, OX3 7RP
Oxford Lymphoedema Practice, PO Box 1138, Oxford, OX1 9UN
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