Lymphedema is a disorder that is common after lymph node removal or radiation therapy which creates a block in the lymphatic system and causes lymph fluid to accumulate. The fluid builds up leading to swelling in areas like the arms and legs. Lymphedema is often seen in breast cancer patients after the breast is removed, as well as after prostate cancer, uterine cancer, melanoma, and several other cancers. While the damage done to the lymphatic system cannot be reversed, the symptoms created, including swelling, can be treated with microsurgery that restores the flow of the lymph system. PeaceHealth Medical Group specializes in several microsurgical lymphedema surgeries at their practice in the Portland/Southwest Washington area.
"After meeting 3 other surgeons, I began to get "cold feet" on having my breast defect addressed at all. Discovering Dr. Gabriel was my saving grace. He doesn't have the typical attitude of other surgeons & is very warm hearted, compassionate, & will help you understand the procedure & what is expected post-surgery. He's respectful & has an amazing spirit. He's also curated a staff that supports his standard of care. He actually made me laugh - huge given how nervous I was about surgery. :)"- E.J. / Healthgrades / Feb 28, 2018
"Dr. Gabriel and staff is the best around. From the moment you walk in you really feel well taken care of. I have always been extremely self conscious of my eyebrow because it makes me look like a grouch. I explained to Dr. Gabriel the problem area and I walked away feeling so much more confident. I also received fillers in my cheeks that really added to the dimension of my face. Dr. Gabriel is so good I travel from out of town to see him!"- K. / Healthgrades / Feb 20, 2018
"Five Stars - Dr. G is the best! So attentive and strives to make all treatments look natural and enhancing."- Anonymous / Vitals / Feb 19, 2018
"It has been several years since my surgeries by Dr. Gabriel, He and his staff are welcoming, warm and friendly. He had wonderful bedside manner throughout the whole process, with his staff calling regularly to check up on me. If you are looking for a doctor that treats you with dignity, respect with a side of humor, then look no further! Dr. Gabriel is it."- L. / Healthgrades / Feb 12, 2018
"Did an amazing job with my surgery. Highly recommend him."- Anonymous / RateMDs / Feb 12, 2018
Since the lymphatic vessels and lymph nodes are invisible to the naked eye, lymphedema surgery involves advanced microscopic surgery. New techniques include lymphosuction and excision of the lymphedema tissue, while more traditional techniques include lymph node transfer and lymphatic bypass.
Lymphosuction involves liposuction of the lymphedema limbs to treat lymphedema. Lymphosuction uses smaller incisions than some of the other techniques and has a shorter recovery period. Patients will need to wear compressions garments after the surgery to maintain their results.
Vascularized lymph node transfer (VLNT) treatment transfers healthy lymph nodes to the part of the body with non-functioning lymph nodes. This technique is best at treating swelling and reducing the amount of infections caused by lymphedema.
Lymphaticovenous anastomosis bypass surgically re-routes the lymphatic channels to a nearby vein, which allows the excess lymph fluid to drain and establish a normal flow. The bypass involves the surgeon using advance microsurgical techniques to work on lymphatic vessels as small as 0.3 mm.
Another option is surgical excision of the affected skin and tissue. Several techniques may be used depending on the location and severity of the lymphedema, but the blocked tissue will be removed and the skin may be reconstructed, if needed.
Lymphedema surgery usually takes 3 – 6 hours, depending on the technique that is being used, in an accredited surgical facility. Most patients will need to spend 1 – 3 nights in the hospital after their procedure for care and monitoring. Once the patient is able to leave and recover at home, it generally takes 2 – 3 weeks before full recovery. The surgeon will speak to the patient about post-operative care including home treatments that will encourage blood and fluid circulation for more efficient healing.
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Lymphedema Surgery FAQs
The Lymphatic System?
The lymphatic system consists of all the tissues and organs that fight infections and diseases by creating, storing, and transporting white blood cells. The lymphatic system includes the lymph nodes, lymphatic vessels, the spleen, bone marrow, and more.
What Are Lymph Nodes?
Lymph nodes are the small structures within the lymphatic system that filters lymph fluid and stores white blood cells. The stored white blood cells can be used to fight future infections.
Causes of Lymphedema?
Primary lymphedema: occurs on its own, usually from an inherited condition like Miroy’s disease, Meige’s disease, or late-onset lymphedema
Secondary Lymphedema: occurs as the results of another disease, such as surgery, radiation treatment, cancer, or infections
There are several home treatments that can help a patient relieve their lymphedema symptoms or speed their healing after lymphedema surgery. Certain pressure garments and exercises can promote fluid movement. Other treatment options include weight loss, laser therapy, massage, prescription medications and more. The surgeon will discuss all possible treatment options during the patient’s initial consultation.