Lymphedema Surgery
Dr. Granzow is a Board Certified Plastic Surgeon who performs advanced lymphedema surgery including microsurgical lymph node transfer, lymphaticovenous anastomosis, and other surgical techniques for the treatment of lymphedema.
This website is dedicated to providing surgical options as a long term solution for patients with lymphedema. Dr. Granzow performs these surgeries in California in the Los Angeles area in private hospitals.
Lymphedema Surgical Treatment Options
Several effective surgical treatments now exist for lymphedema. Some procedures, like vascularized lymph node transfers, are relatively new. Other procedures, such as lymphaticovenous anastomoses, have been described previously and have been more recently modified and improved with better results.
These techniques are performed only by a small handful of highly specialized microsurgeons worldwide. Dr. Granzow is a pioneer in this area and works with colleagues from around the world continually to further refine these procedures.
|
Tel: (310) 882-6261
|
Vascularized Lymph Node Transfer
Vascularized lymph node transfers have been shown to be an effective method for the treatment of lymphedema of the arm. Lymph nodes are taken from the groin area with their supporting blood vessels and moved to a new location in the axilla (armpit). Dr. Granzow then uses specialized microsurgical techniques to reconnect the blood vessels to new vessels in the armpit to provide vital support to the transferred lymph nodes while they heal in the new area. .
The transferred lymph nodes then serve as a filter or conduit to remove the excess lymphatic fluid from the arm and return it to the body's natural circulation.
This method of lymph node transfer often is performed together with a DIEP flap breast reconstruction. The combined procedure allows for both the simultaneous treatment of the arm lymphedema and the creation of a breast in one surgery. The DIEP flap reconstruction provides the opportunity for a beautiful and natural appearing reconstructed breast combined with contouring of the abdomen which is very similar to a tummy tuck. The lymph node transfer portion of the surgery removes the excess lymphatic fluid to return form, softness, and function to the arm.
In some cases, the groin lymph nodes may be transferred as a group with their supporting artery and vein but without the additional tissue from the abdomen for breast reconstruction.
Lymphaticovenous Anastomosis
Lymphaticovenous anastomosis involves the use of supermicrosurgery to join lymphatic channels in the affected area directly to nearby veins. The lymphatics are quite small, typically approximately 0.1 mm to 0.3 mm in diameter. The procedure employs specialized techniques and superfine surgical suture sewn with the aid of an adapted high power microscope.
The procedure can be an effective and long-term solution for extremity lymphedema. After the procedure, most patients no longer require the use of their compression garments. In our experience patients have results which range from a moderate improvement in extremity circumference to an almost complete resolution of the problem.
|
