Lymphatic surgery is at the cutting edge of reconstructive microsurgery, a specialty within body plastic surgery. Using highly specialized and state-of-the-art techniques, we can surgically treat lymphedema. These operations are most beneficial in patients with earlier-stage disease, where the swelling of the extremity is still largely due to fluid rather than fat deposition.
Lymphatic Surgery Procedures
Lymphovenous Bypass (LVB)
The small lymphatic channels that run under the skin are identified and connected to a nearby superficial vein through multiple small and superficial incisions in the affected arm or leg. The entire surgery is performed under a specialized microscope with “supermicrosurgery” techniques that allow us to sew vessels and lymphatics smaller than 0.8 mm in diameter. This procedure reroutes the flow of lymph fluid into the venous system in the forearm or lower leg to “bypass” the area of lymphatic damage, which is often in the armpit or groin. The flow of lymph fluid out of the extremity is then re-established. As a result, patients see significant improvement in the risk of infection, decreased need for compression garments, and reduction in the limb circumference and weight.
Vascularized Lymph Node Transfer (VLNT)
Lymph nodes are harvested from another area of the body — often the abdomen, groin, neck, or armpit — and are transferred to the extremity with lymphedema as a free flap. The lymph nodes are taken with an artery and a vein to keep them alive. Those blood vessels are then reconnected to vessels where the nodes are placed. In the short term, the transferred lymph nodes act like a sump pump to absorb excess fluid in the nearby soft tissues. Over time, they stimulate new lymphatic channels to grow. As with lymphovenous bypass, patients see significant improvement in the risk of infection, decreased need for compression garments, and reduction in the limb circumference and weight. View our full page on the procedure.