Lymphedema Surgical Treatment – Current And Future

VASCULARIZED LYMPH NODE TRANSFER (VLNT)

Vascularized Lymph Node Transfer (VLNT) surgery is effective for the treatment of the arm or leg lymphedema.  Dr. Granzow uses excess lymph nodes from a healthy area with their supporting blood vessels and moves them to the affected area to replace the lymph nodes previously lost.  He then uses specialized microsurgical techniques to reconnect the blood vessels to new vessels, providing 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 or leg and return it to the body’s natural circulation.

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Click here to see published studies about VLNT surgery by Dr. Granzow

LYMPHATICOVENOUS ANASTOMOSIS (LVA)

Lymphaticovenous anastomosis (LVA) surgery involves the use of superfine microsurgery, or “supermicrosurgery” to join lymphatic channels in the affected area directly to nearby veins. This creates additional outflow pathways to drain the excess lymph fluid.  The lymphatics are quite small, typically approximately 0.1 mm to 0.3 mm in diameter. The procedure employs specialized techniques and superfine surgical sutures sewn with the aid of an adapted high power microscope.

LVA surgery can be an effective and long-term solution for arms or legs. Patients must have swelling that is mostly excess fluid to be good candidates for this procedure.  Published studies by Dr. Granzow and others have shown that LVA surgery has significantly decreased or eliminated the use of their compression garments.

LVA surgery is the least invasive when compared to other lymphedema surgeries with the fastest recovery process.

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SUCTION-ASSISTED PROTEIN LIPECTOMY (SAPL)

SAPL surgery can produce massive, permanent reductions in arms or legs of patients with even longstanding, chronic, solid-predominant lymphedema. It must be emphasized that the surgical technique used in SAPL surgery is NOT the standard cosmetic liposuction technique. The surgery must be performed using parameters, methods, and protocols before, during and after surgery.  Specific training in this method is required.  Patients are good candidates if the swelling in the limb is due to deposition of fat, protein, and fibrotic tissue with non-pitting edema.

SAPL surgery also reduces the risk of dangerous infections, such as cellulitis, by over 80%. Dr. Granzow’s published studies and other studies throughout the medical literature have repeatedly confirmed the long-term and reproducible reduction in the size and also infections of the affected arm or leg.

This procedure does not damage lymphatics.  In fact, it is Dr. Granzow’s experience lymphatic drainage appears to improve following the procedure and care of the affected arm or leg becomes easier.  Published studies in the medical literature have specifically looked at the lymphatic system before and after SAPL, and no decrease in function has been found.

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