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Step-by-step instruction: Suction-assisted protein lipectomy procedure combined with vascularized lymph node transfer and/or lymphaticovenous anastomosis surgery as part of an integrated lymphedema treatment system

Multimodal Management of Upper and Lower Extremity Lymphedema, Page: 151-155
2022
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Book Chapter Description

Surgery to treat lymphedema has been shown to be effective in multiple studies, is not experimental, and has long been held as the standard of care for patients with lymphedema. When integrated into a comprehensive lymphedema treatment program for patients, surgery can provide effective and long-term improvements that nonsurgical management alone cannot achieve. Such a lymphedema treatment program can provide tremendous improvements for many problems including recurring cellulitis infections, inability to wear appropriate clothing, loss of arm or leg function, and reductions in the amount of lymphedema therapy and compression garment use needed. This chapter reports the use of a two-phase approach to treat patients with chronic, solid-predominant lymphedema who have maximized the use of conservative lymphedema therapies. Suction-assisted protein lipectomy (SAPL) is used to address the excess lymphedema solids first. After patient healing is complete, vascularized lymph node transfer (VLNT) and/or lymphaticovenous anastomosis (LVA) surgery can be used to further reduce dependence on conservative treatment methods.

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