How is surgery performed for removal of lymphedema?

Updated: Mar 24, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Answer

Surgery for removal of lymphedematous tissue includes the following steps:

  • After the establishment of appropriate anesthesia, the operative field is sterilized and draped according to surgeon preference

  • A pneumatic tourniquet is placed at the root of the extremity and insufflated after the extremity has been exsanguinated

  • A longitudinal incision is made along the entire extremity, and skin flaps, 1.0-1.5 cm thick, are elevated

  • Subcutaneous tissue is then excised, with care taken not to injure peripheral sensory nerves

  • Some authors also excise a strip of deep fascia; however, this should not be performed around joints, because it may cause instability

  • Once the subcutaneous excision is complete, redundant skin is resected; often, a strip that is 5-10 cm wide may be removed

  • The wound is closed over suction drains


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