State-of-the-art surgery for Lymphedema


State-of-the-art surgery for lymphedema offers a promising treatment for patients who are frustrated by their condition.  Plastic surgeons use specialised microsurgery to transplant healthy lymph nodes to the affected area to help drain the excess lymph fluid and reduce swelling in the affected limb.


Lymphedema is an uncomfortable and painful swelling that can occur in a person’s arms or legs and occasionally in other areas, after treatment for certain cancers, such as biopsy or removal of lymph nodes or radiation treatment.

Lymphedema can also be caused by a hereditary condition that may occur at birth, or develop in adolescence or later, in adulthood. It occurs when the lymphatic system develops abnormally, preventing the proper flow of the lymphatic fluid, and leads to fibrosis, thickening and swelling of the skin.


Conventional treatment for lymphedema is through manual lymphatic drainage (a type of skin massage by specially trained lymphedema therapists), compression bandaging and garments, exercise and sometime antibiotics.


Surgery for lymphedema can be divided into two approaches – physiological and ablative. Physiological treatment is aimed at correcting the impaired lymphatic drainage system, through transplantation of new lymph nodes or through lymphatico-vascular bypass procedures. Ablative surgery for lymphedema, removes via direct excision or liposuction, the excessive swelling in the limb. 


The vascularised groin lymph node transfer surgery was pioneered in Taiwan. It is done through an incision in the groin and with the aid of loupe magnification. Using careful dissection the targeted healthy lymph nodes are identified, along with the veins and the artery and surrounding tissue. The lymph nodes are transferred to the the affected limb, where the blood vessels are reconnected under microscopic magnification using specialised micro-instruments and tiny sutures. 

Once the transplanted lymph nodes are reestablished, they act as a physiologic “sponge” to drain the excessive lymphedema fluid and divert it to the venous system to be drained away, explains plastic surgeon Dr Conrad Pienaar, a super-specialist in microsurgery.

Lymphedema is often underestimated, and under-recognised, and it can have a significantly negative impact on a persons quality of life. So this state-of-the-art surgery offers a very promising treatment for patients who are frustrated by their condition.

A patient that had the novel vascularised groin lymph node transfer surgery in Cape Town earlier this year described the whole procedure as painless and he says that his arm is already improving and feeling softer. He added “I am very glad that there are doctors that can treat this condition which is very difficult to treat”.