Lymphedema surgery Munich

At our specialized clinic in munich, we offer cutting-edge solutions for lymphedema surgery. Whether caused by hereditary factors or secondary issues like tumor surgery, our innovative techniques aim to alleviate swelling, reduce discomfort, and improve your quality of life. Explore our advanced surgical options today.

Info table on Lymphedema surgery:

Intubation anaesthesia

60 – 150 min

3-4 Days

Immediately after OP

What is lymphedema and how does it develop?

Lymphedema is a condition characterized by painful swelling in the arms and/or legs. It occurs when the normal drainage of lymphatic fluid through the lymph vessels or lymph nodes in a specific area of the body is disrupted. There are two types of lymphedema:

  • Primary lymphedema, which is congenital.
  • Secondary lymphedema, caused by damage to the lymphatic system (e.g., due to surgeries or radiation therapy for cancer, infections, or trauma).

This disruption leads to an influx of fluid into the tissues, resulting in swelling. This not only causes feelings of tension and pain but also increases the affected area’s circumference. All of these factors significantly impact the daily lives of those affected.

Chronic lymphedema, whether primary (hereditary) or secondary (e.g., post-tumor surgery), significantly impacts patients’ lives. Symptoms include swelling, recurring infections, and cosmetic concerns, often leading patients to seek effective solutions. At our munich clinic, we specialize in advanced lymphedema surgery techniques to alleviate these challenges and improve daily life.

Recognizing Lymphedema: Symptoms

Lymphedema can present with the following symptoms, which typically worsen over time:

  • Swelling of the extremities caused by lymphatic fluid
  • Excess fat in the extremities
  • Pain in the extremities
  • Changes in skin quality (e.g., skin fibrosis)
  • Temporary redness

How does lymphedema surgery help manage symptoms?

Even the most modern methods of microsurgery are not evaluated uniformly by all sides. Statements ranging from “it can be used to heal patients” to “this should definitely not be done” can be found online. So, what is it all about – what can patients expect and how can you recognize a good facility for such interventions?

When is lymphedema surgery the right choice?

Modern microsurgical techniques, including lymphovenous anastomoses (LVA) and free vascularized lymph node transfers (VLNT), offer effective solutions for lymphedema treatment in munich. These procedures are especially beneficial in early stages, targeting the excess fluid in affected areas. However, in advanced cases with hardened tissues, alternative approaches may be necessary.

Conservative therapy vs. surgery: Which option is right for lymphedema?

Warnings are often given in forums that one should never have an operation in the early stages, and only conservative therapy should be carried out here. However, keeping the progressive damage of the lymphatic system and the increasing hardening of the tissue in mind, it should correctly be said: If conservative treatment have not led to a significant improvement in the findings/resolution of the symptoms after a sufficiently long period of time (6-12 months), an operative microsurgical treatment should be considered.

The longer the patient waits, the less favorable the conditions for surgical therapy with reconstructive procedures. However, this must also be seen individually in individual cases: in some patients, the lymphedema and the damage to the tissue progresses very quickly, in other patients microsurgical therapy can still be successful many years after the onset of the disease.

Contact

When is the treatment of lymphedema successful?

Now what does successful mean? In very few cases can patients be “cured”, but in the majority of cases a significant improvement can be brought about and at least the course of the disease can be stopped and the intensity of conservative measures reduced. In individual cases, patients can even end this.

Many patients are afraid that this form of therapy is even harmful in many cases. Of course, this depends not least on the planned procedures, but many innovations have been introduced in the operations in recent years. In the case of lympho-venous anastomoses, the trend is clearly moving weg from multiple anastomoses to nur noch 1-2 anastomoses per extremity. These can be performed by the surgeon with much more concentration in a significantly shorter operation time, the flow on these few anastomoses is higher and thus also reduces the anastomosis closure rate. However, these few anastomoses are usually sufficient for an improvement.

If an occlusion occurs, the patient still has other lymphatic vessels, so that the risk of a worsening of the findings is minimized. In the area of free lymph node transfer, techniques are used today in which with a high degree of certainty only those lymph nodes that are dispensable are removed, whereas the “important” lymph nodes are marked and spared (reverse lymphatic mapping ) can.

When can good results be achieved?

Overall, it must be stated that really good results can almost always only be achieved if the entire interaction between surgical and conservative therapy is perfectly coordinated. In the course of this, the intensity of the conservative therapy can then be reduced if necessary and, in exceptional cases, it can be dispensed with entirely.

If there are no longer sufficient lymph channels and the hardening of the tissue due to protein and fat deposits predominates, liposuction can be the procedure of choice in selected cases and if the technique is used correctly. Here, too, it must be clearly communicated that the conservative therapeutic measures must be continued even after the procedure has been completed.

How to choose the best center for lymphedema surgery

Choosing the right center for lymphedema surgery in Munich is crucial. Look for:

  • Look for testimonials from other patients
  • Ask how many patients the center treats surgically on average.
  • What technical equipment is provided?
  • Is a fluorescence imaging camera used for preoperative diagnostics and OP planning, does the center have a fluorescence unit integrated in the OP microscope?
  • Is there a differentiated post-treatment scheme?
  • Does the surgeon work with conservative lymphatic clinics?
  • Do the patients receive follow-up care from the treating surgeon for years after the operation?

At the end of the day, it should be clear to you as a patient that a special team within the center is looking after you with a high degree of motivation, a clear plan and the appropriate expertise. If in doubt, a second opinion should always be obtained. It is not uncommon for colleagues from conservative lymphatic clinics to be able to give you good advice, because here the colleagues can assess the operative results of the centers and their patient management.

Lymphedema surgery options at our munich clinic

Using state-of-the-art fluorescence imaging, our specialists in munich identify lymphatic channels and connect them to veins under a surgical microscope. This minimally invasive procedure improves lymphatic drainage and reduces swelling effectively.

In this advanced procedure, dispensable lymph nodes are harvested and transplanted to the affected area. Reverse lymphatic mapping ensures only non-critical lymph nodes are used, minimizing risks while optimizing results.

If hardened tissue predominates in the late stages of lymphedema, the excess hardened tissue can be removed with the help of liposuction.

If, for example, lymph fluid collects or leaks after an operation, microsurgical techniques with the help of fluorescence imaging can help .

© 2024 Widenmayer16