MICROSURGICAL TECHNIQUES
MICROSURGICAL TECHNIQUES
Free vascularised lymph node transfer (fVLNT) is a complex microsurgical procedure involving the transplant of a small group of lymph nodes from one regional drainage basin to the limb affected with lymphoedema.
In patients with stage 1 and 2 lymphoedema, 98% have a positive response to this procedure with about 50% having a significantly good outcom
Description
Free vascularised lymph node transfer (fVLNT) is a complex microsurgical procedure involving the transplant of a small group of lymph nodes from one regional drainage basin to the limb affected with lymphoedema.<span style=”font-weight: 400;”>In patients with stage 1 and 2 lymphoedema, 98% have a positive response to this procedure with about 50% having a significantly good outcome</span>In patients with stage 1 and 2 lymphoedema, 98% have a positive response to this procedure with about 50% having a significantly good outcome.
The mainstay of lymphedema treatment remains conservative physical therapy.However, when this fails then a surgical technique is indicated.
Patients with clinically pitting lymphoedema would be suitable for this procedure.The presence of mostly lymphatic fluid and the predominant absence of fatty deposition can be confirmed by a Magnetic Resonance Scan (MRI).
A lymphoscintigraphy is also a useful technique to map the lymphatic drainage of the limb and also useful in the reverse mapping of the lymph nodes to be harvested from the donor site.
The procedure is performed under general anaesthesia and lasts for 4-6 hours.The inpatient stay in hospital is 4-5 days.
The site where the lymph nodes are to be placed is carefully prepared by meticulous dissection and removal of the scar tissue. Tiny recipient blood vessels are identified and meticulously dissected using microsurgical techniques. The small group of lymph nodes to be harvested is carefully mapped and harvested with tiny blood vessels (artery and vein). These are then, micro surgically transplanted to the recipient site by anastomosing the tiny blood vessels.
Post-operatively, the patient is managed in a warm environment. After a week or so, the patient is fitted with a compression garment. Measurements are carefully done in a standardised manner and recorded for audit purposes at every visit post-operatively.
Anna Lucci
Dr Oudit is absolutely GREAT! I had two procedures with him and the results are amazing! He is a fantastic doctor, very professional, very honest and moreover a very good person! He made me feel very comfortable since the first day I met him, I had the impression I was talking to a friend! If you need cosmetic surgery, do not look any further, he is the best! Thank you so much Dr Oudit and see you soon!
Cathie Riddell
I made a decision to have my left ear pinned back because it was very prominent. I made an approach to the local BMI hospital and was given an appointment to consult with Mr Deemish. He explained the procedure to me and I left the consultation happy and confident that he would do a great job. Two weeks after the consultation I had the opertation. The operation was performed under a local anaesthetic, I did not feel anything apart from the injection. My ear was dressed and my head wrapped in a bandage, I had to keep this one for one week. I had mild pain and discomfort but was able to control that with paracetamol. When the nurse removed the bandage and dressing to reveal the result I was amazed and delighted with the result. It is now three weeks since the operation and I have no pain or discomfort. My ear looks “normal” and I am really pleased. Thank you Mr Oudit.
Claudia Skillen
Absolutely amazing, I showed Dr. Oudit what I was looking to achieve in my body and he gave me better! Honestly couldn’t recommend more, thank you for everything! 🙂