Lymphatic surgery, microsurgery and super-microsurgery are used when a patient has certain pathologic requirements not satisfied by the rehabilitative therapy.
Lymphatic surgery and microsurgery are an option to be chosen to avoid the progression of the illness from 1st to 3rd stage, and the consequent anatomic-histophatologic, morphologic, functional and clinical alterations, which gradually become more irreversible and disabling.
Lymphatic surgery, microsurgery and super-microsurgery currently are the best possible therapeutic option, with the exception of other kinds of microsurgery, identified on a case by case basis.
In cases of advanced stages of the disease, interventions of exeteric-reductive kind can also be considered, especially concerning the adipose tissues, by means of liposuction.
The autologous lymph-nodes transplantation (ALNT), also calledmicrosurgical vascularized lymph nodes transfer (VLNT) is a procedure where healthy lymph nodes with a vein and artery from a donor site are transferred to the lymphedema affected area. Artery and vein are anastomosed with the previously prepared vessels, using microsurgical techniques.
The Lympholymphatic graft is a procedure that connects a blocked lymphatic vessel to an unobstructed one by using a vein or lymphatic vessel as graft.
The lymphatic venous anastomosis (LVA) connects a lymphatic vessel to a vein. It drains the lymphatic fluid into the circulatory system and seems to be an effective procedure in the early stage of lymphedema. Usually more than one is done at the same time and they require the use of the operating microscope (superficial and deep lymphatic venous anastomosis).
The surgical therapy must be done in facilities of renowned and proved expertise, equipped with the right technologies and with trained personnel.