Lymphedema is a chronic condition marked by swelling due to lymphatic fluid accumulation, often in the limbs. Surgical interventions are increasingly effective, especially when conservative treatments like compression therapy and manual lymphatic drainage are insufficient. Advanced microsurgical techniques are providing significant relief globally, with specialized centers like Elrevo Clinic in India leading in adopting these innovations.

Surgical treatment is indicated for patients with moderate to severe lymphedema who do not respond adequately to non-surgical methods. Other indications include recurrent infections (cellulitis), significant limb dysfunction affecting daily activities, fibrosis, and substantial limb enlargement with skin changes. Approximately 10–20% of lymphedema patients may require surgical intervention based on severity and response to initial treatments.

• Microsurgery Procedures: Lymphaticovenular Anastomosis (LVA), Vascularized Lymph Node Transfer (VLNT), and lymphatic vessel grafting aim to restore lymphatic flow by creating new pathways or transferring healthy lymph nodes.
• Supermicrosurgery Procedures: Supermicrosurgical LVA and Nodo-Venous Shunt involve connecting tiny lymphatic vessels to venules or veins to improve drainage.
• Other Surgical Procedures: Partial excision (debulking), Modified Charles Procedure (circumferential debulking), and liposuction focus on removing excess tissue and reducing limb volume.

• Partial Excision: Involves preoperative planning, anesthesia, incision, removal of affected tissue, and wound closure.
• Modified Charles Procedure: Includes removing diseased skin and subcutaneous tissue, followed by skin grafting to cover the area.
• Lymphaticovenular Anastomosis (LVA): Entails identifying lymphatic vessels and venules, then microsurgically connecting them to bypass blockages.
• Vascularized Lymph Node Transfer (VLNT): Harvests healthy lymph nodes from a donor site and transfers them to the affected area with microsurgical connections.
• Nodo-Venous Shunt: Creates a connection between lymph nodes and venous structures to facilitate lymph drainage.
• Liposuction: Removes excess fatty and lymphatic tissue using specialized cannulas after tumescent solution infiltration.

Post-surgical management is crucial for maintaining results:

• Compression Therapy: Essential to reduce swelling and prevent fluid reaccumulation.
• Physiotherapy and Manual Lymphatic Drainage: Enhance lymphatic function and mobility.
• Skin Care: Maintaining hygiene to prevent infections.
• Regular Follow-Ups: Monitoring progress and early detection of complications.
• Patient Education: Encouraging adherence to lifestyle modifications and self-care routines.

Elrevo Clinic, led by Dr. Ram M. Chilgar, offers comprehensive care combining surgical expertise with advanced postoperative management. With innovative techniques and a patient-centric approach, the clinic ensures optimal outcomes for lymphedema patients.