Microsurgery
Super microsurgery skills bring hope for lymphoedema
A UK medical first is set to reduce breast cancer related lymphoedema by 4% to 8% worldwide with preventative treatment.
Lymphoedema is a chronic condition where patients experience potentially lifelong swelling of arms or legs. In the UK, most patients develop it after lymph node removal for cancer surgery, such as in breast cancer, although other patients can be born with it However, two new UK studies recently
presented to the British Association of Plastic, Reconstructive and Aesthetic Surgeons’ (BAPRAS –
www.bapras.org.uk) Scientific Meeting are set to relieve the pain and misery for many of the estimated 450,000 people living with lymphoedema in the UK today,1
with an
estimated 250 million sufferers worldwide.2 Lymphoedema is a chronic condition where patients experience potentially lifelong swelling of arms or legs. It can affect patients of any age and is incredibly common, more than the combined number of people with Multiple Sclerosis, Motor Neurone Disease, HIV and Parkinson’s Disease.3 Of the many causes of secondary lymphoedema (that develops as an adult), the most common cause in the UK is after any surgery or treatment (such as radiotherapy) that removes a large number of lymph nodes to treat cancer. This may include cancers of the breast, pelvis, skin cancers, head, and neck cancers to name just a few. One in five women treated for breast cancer are affected by lymphoedema.4
This usually occurs because cancer cells have travelled from One in five women treated for breast cancer are affected by lymphoedema.
the breast to lymph nodes in the armpit and need to be removed. Because the same lymph nodes drain the arm, around 20-30% of these patients may develop lymphoedema after because fluid cannot drain from the arm. Treatment for established lymphoedema may involve a combination of physio, surgery (with mixed results) and garment use which can be lifelong. Two new studies address the importance of
prevention of lymphoedema where possible, to reduce the number of patients going on to develop this debilitating condition. So-called immediate lymphatic reconstruction uses a super-microsurgery technique to join arm lymphatics (which are often less than 0.5 mm)
Two new UK studies recently presented to the BAPRAS’ Scientific Meeting are set to relieve the pain and misery for many of the estimated 450,000 people living with lymphoedema in the UK today.
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www.clinicalservicesjournal.com I July 2026
to veins (lymphovenous anastomosis or LVA) straight after lymph node removal, using very fine instruments and a microscope. The first new study, ‘Immediate Lymphatic
Reconstruction (ILR) after Axillary Lymph Node Dissection with no additional donor site morbidity in patients undergoing immediate breast reconstruction with DIEP flap’ was carried out in St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, Essex. Patients undergoing mastectomy and lymph node removal from the armpit, were offered simultaneous breast reconstruction and immediate lymphatic reconstruction. To bridge the gap between these cut arm lymphatics, a vein graft was used from the abdomen (which was also being used for the breast reconstruction) to join the very small lymphatics in the arm back to veins in the body. Mr Kavan Johal, Consultant Plastic surgeon, runs the lymphoedema service at St Andrew’s with his Consultant colleague Mr Mat Griffiths. For this new study, Mr Johal said: “This work is preventative and is key to stop lymphoedema
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