Lymphedema surgery is a group of delicate operations that treat swelling of an arm or leg caused by faulty drainage of lymph fluid, often after lymph node removal or radiotherapy for cancer. The two main options are lymphovenous anastomosis and lymph node transfer, and they aim to reduce swelling and improve lymph drainage.
In lymphovenous anastomosis, the surgeon uses a surgical microscope to join tiny lymph vessels to small veins through short incisions, giving the fluid a new route; this may be done under local or general anaesthesia. In lymph node transfer, healthy lymph nodes with their blood vessels are moved from another part of the body to the affected limb, usually under general anaesthesia. The treating team decides which suits each case.
The operation takes from two hours to several hours, with a short hospital stay in some cases. Compression bandaging and physiotherapy are often continued afterwards as the team directs. Swelling improves gradually, and the benefit may take several months to become apparent and varies between patients.
The final cost is set after a medical consultant reviews your case and photos.
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It may reduce swelling and heaviness and lower the number of infection episodes, and some patients may need less compression. It is not a guaranteed cure, and the benefit differs from person to person.
People with persistent lymphedema despite conservative care such as compression and physiotherapy, who are at a stage that can still improve and are fit for surgery. The team assesses with lymphatic imaging, and advanced cases usually respond less.
Tests, lymphatic imaging and limb measurements are done, and avoiding smoking is advised. Never stop a prescribed medicine on your own; your treating doctor decides.
In anastomosis, tiny lymph vessels are joined to small veins under a microscope. In node transfer, lymph nodes with their blood vessels are taken from a donor area, placed in the affected limb and connected to its blood supply.
Swelling and pain usually ease over a few days, and rest, elevation and limited activity are advised for weeks. Compression and physiotherapy usually continue as the team directs.
Swelling improves gradually over months, and the improvement may continue or level off. Duration varies between patients, symptoms can partly return, and it is not a guaranteed cure.
They include infection, bleeding, lymph fluid collections, poor wound healing and no improvement in swelling. In node transfer the moved nodes may fail, or swelling may develop at the donor site; this is uncommon but can be lasting, and careful planning reduces the chance.
Short scars remain after anastomosis, and a larger scar at the donor and recipient sites in node transfer. They fade with time but are permanent.
Waiting some weeks may be needed depending on the procedure, compression is often advised during flights, and your treating doctor confirms the timing after examining you.
Doctors usually advise continuing them afterwards, and the team may reduce them gradually if you improve. Do not stop them on your own.
