Lymphedema & Lymphatic Surgery in Mumbai, India
Overview
Lymphedema is a chronic condition caused by a build-up of lymphatic fluid in the body's tissues, leading to swelling, most commonly in the arms or legs. It develops when the lymphatic system (which is a system of channels all over our body to drain fluid, including tissue waste, proteins, immune cells, etc.) is unable to drain fluid effectively. While lymphedema cannot always be cured, appropriate treatment can help control symptoms, reduce swelling, improve comfort, and prevent complications. In Early Lymphedema, even a cure is possible. Modern treatment options range from conservative therapies to advanced lymphatic surgery.
What is Lymphedema?
The lymphatic system is a vital part of the immune and circulatory systems. It helps remove excess fluid, waste products, and toxins from tissues while supporting the body's defence against infection.
Lymphedema occurs when lymphatic vessels or lymph nodes are damaged, blocked, or do not develop properly. As lymph fluid accumulates, swelling develops and may gradually worsen over time. The condition can affect one or both limbs and, in some cases, other parts of the body.
Types and Causes of Lymphedema
Primary Lymphedema
Primary lymphedema results from abnormalities in the development of the lymphatic system. It may be present at birth or develop later in childhood or adulthood without an obvious external cause. Typically, this leads to inefficient transport of the fluid, leading to accumulation
Secondary Lymphedema
Secondary lymphedema occurs when the lymphatic system is damaged after birth. Common causes include surgery, radiation therapy, trauma, infection, or cancer affecting lymph nodes and lymphatic vessels.
Breast Cancer-Related Lymphedema
This is one of the most common forms of secondary lymphedema. It may develop after breast cancer surgery or radiation therapy involving lymph nodes in the underarm region, leading to swelling in the arm, breast, chest wall, or shoulder area. This is because the lymph nodes ( glands) in the armpit are removed during the cancer surgery/ radiation induced damage. These glands also drain the fluid of the upper limb. This leads to fluid accumulation in the arm
Post Abdominal, Genital or Gynecological Surgery Lymphedema
Similarly, Lymphedema can occur after surgical procedures that involve lymph node removal or disruption of lymphatic drainage pathways, such as after Cancer of the ovary, Uterus, Penis cancer, prostate cancer surgery, or any surgery that removes the lymph node in the abdomen or in the groin region. The risk varies depending on the type and extent of surgery performed.
Signs and Symptoms of Lymphedema: When to See a Specialist
Lymphedema often develops gradually and may initially be mistaken for temporary swelling. If diagnosed early, it can be curable. Hence the importance of observing the limb properly.
Common signs and symptoms include:
- Persistent swelling in an arm, leg, hand, or foot
- A feeling of heaviness or tightness in the affected limb
- Reduced flexibility or range of motion
- Discomfort, aching, or fullness in the affected area
- Tight-fitting clothing, jewellery, or shoes
- Skin thickening or hardening over time
- Recurrent skin infections
You should consult a specialist if swelling persists, worsens, or develops following cancer treatment, surgery, or radiation therapy.
How Lymphedema is Diagnosed
Diagnosis usually begins with a detailed medical history and physical examination.
Additional investigations may include:
- Limb measurements to assess swelling
- Ultrasound to rule out other causes of swelling
- Lymphoscintigraphy to evaluate lymphatic drainage
- Indocyanine green (ICG) lymphography
- MRI or CT imaging in selected cases
Accurate diagnosis helps determine the severity of the condition and guides treatment planning.
Lymphedema Treatment Options
Treatment aims to reduce swelling, improve function, prevent complications, and enhance quality of life.
Non-Surgical Lymphedema Management
Many patients benefit from conservative treatment, especially during the early stages of the condition.
Treatment may include:
- Compression garments and bandaging
- Manual lymphatic drainage therapy
- Exercise and movement programmes
- Skin care and infection prevention
- Weight management and lifestyle modifications
- Complete decongestive therapy (CDT)
Surgical Lymphedema Treatment
Surgical treatment is now considered the first option in our centre, given the good benefit it has provided over the last many years. Lympho-venous bypass or lymphovenous anastomosis in particular is one surgery which has shown tremendous potential to improve lymphedema. In cases where the drainage of fluid is very poor, surgery is advocated early to prevent more structural damage. This shift in treatment offering (early surgery) has happened over the last few years. It is not prudent to wait till the swelling becomes more severe and becomes hard and persistent.
Advanced Lymphatic Surgery
Advances in microsurgery have expanded treatment options for patients with lymphedema.
Lymphovenous Bypass and Lymphovenous Anastomosis
These minimally invasive microsurgical procedures connect functioning lymphatic vessels to nearby veins. This allows lymphatic fluid to bypass blocked channels and drain more effectively. It is like creating a bypass diversion channel for an obstructed highway.
This surgery is very safe and hardly has any side effects. The process of surgery is also not painful, and no bed rest is generally needed. In early stages, it can be done as day care surgery.
Lymphatic Microscopic fibrolysis or lymphatic release
This involves highly specialised techniques performed using advanced microscopes and delicate instruments to restore or improve lymphatic flow. Usually, it is undertaken in moderate to severe lymphedema where hardness of the limb is present.
Vascularised Lymph Node Transfer
This procedure involves transferring healthy lymph nodes along with their blood supply from one part of the body to another. The transferred lymph nodes may help improve lymphatic drainage and reduce swelling.
Lymphedema Liposuction
In long-standing lymphedema, excess fat tissue gets accumulated within the affected limb. This is because more stagnant lymph induces the growth of fat cells. Increased fat cells, in turn, produce more lymph. Liposuction thus interrupts the vicious cycle and can help reduce limb volume.
Limb Reduction Surgery
For advanced cases with significant enlargement and tissue changes, limb reduction surgery may help decrease limb size, improve mobility, and enhance quality of life.
Condition-Specific Lymphedema Management
Breast Cancer-Related Lymphedema Management
Management focuses on early detection, compression therapy, physiotherapy, exercise programmes, and surgical options when appropriate. Close follow-up helps prevent progression and improve function.
Post-Surgical Lymphedema Management
Treatment depends on the extent of lymphatic disruption and may involve rehabilitation, compression therapy, manual lymphatic drainage, and advanced lymphatic surgery.
Primary and Secondary Lymphedema Management
A personalised treatment plan is developed based on the cause, severity, symptoms, and impact on daily activities. Early surgery is advocated. Long-term monitoring is often necessary to maintain.
Why Choose Nanavati Max Super Speciality Hospital for Lymphedema Treatment?
Nanavati Max Superspecialty Hospital is one of the few centres in the country offering specialized lymphedema clinics. All the patients are carefully examined and investigated, and if Lymphedema is diagnosed, proper counselling is provided.
Managing lymphedema often requires a combination of specialised diagnostics, rehabilitation, and advanced surgical expertise. At Nanavati Max Super Speciality Hospital, patients benefit from comprehensive care tailored to their individual condition and treatment goals.
Key advantages include:
- Expertise in lymphatic disorders and Super microsurgery, which is done routinely.
- Advanced diagnostic imaging for lymphatic assessment
- Comprehensive non-surgical lymphedema management
- Access to advanced lymphatic surgical procedures
- Multidisciplinary rehabilitation support
- Personalised treatment plans focused on long-term outcomes
- Patient-centred care in a modern healthcare environment
Frequently Asked Questions
1. What is the best treatment for lymphedema?
The best lymphedema treatment depends on the cause, stage, and severity of swelling. Compulsory treatment includes compression, specialized massage, physiotherapy, skin care and lifestyle measures. Early surgical intervention is advised if the lymphatic obstruction is complete, to prevent more structural damage.
2. What is lymphovenous bypass?
Lymphovenous bypass is a microsurgical procedure that connects lymphatic vessels to small veins to help lymph fluid drain better. It is synonymous with Lympho venus anastomosis.
3. What is lymphovenous anastomosis?
Lymphovenous anastomosis is a type of lymphatic microsurgery where tiny lymphatic channels are connected to nearby veins to improve lymphatic drainage. It is synonymous with lymphovenous bypass
4. Who may need lymphatic microsurgery?
If there is a complete blockage of lymphatic fluid flow, surgery is the best option. If the obstruction is not complete on investigation, conservative treatment is generally preferred.
5. What is vascularised lymph node transfer?
Vascularised lymph node transfer is a surgical procedure in which healthy lymph nodes are transferred with their blood supply to improve lymphatic drainage in selected patients.
6. Can breast cancer-related lymphedema be treated?
Yes. Breast cancer-related lymphedema can be managed with early diagnosis, compression therapy, physiotherapy, rehabilitation and lymphatic surgery.
7. When is lymphedema liposuction recommended?
Lymphedema liposuction may be considered in long-standing lymphedema where excess fat deposition causes persistent limb enlargement.
8. What is limb reduction surgery for lymphedema?
Limb reduction surgery is a specialised option for advanced lymphedema with significant limb enlargement, heaviness, or functional difficulty.
Book an Appointment for Lymphedema Treatment and Lymphatic Surgery Evaluation
If you are experiencing persistent swelling, heaviness, discomfort, or have developed lymphedema following cancer treatment or surgery, early specialist evaluation can help improve outcomes and prevent progression.
- Consult Lymphedema Doctors
- Book an Appointment
- Request a Call Back
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