PATIENT'S ASSESSMENT
During the first consultation, we take a detailed medical history to evaluate the patient and find the cause of lymphedema.
We also note if there are any complications arising due to Lymphedema, such as skin infection leading to cellulitis, skin hardening, skin ulcers and so on.
The next step involves certain investigations if required, to understand the depth of the problem and sometimes to establish a diagnosis of lymphedema. Depending on the staging of the disease, the treatment is started with medical options – medicines (if required) and non- Surgical or conservative home management treatments specific to lymphedema like manual lymphatic drainage, lymphatic pumps and special bandaging of the lymphedema limb.
Options of surgery are also discussed in cases where lymphedema can be helped by surgery and make a huge difference to the quality of the patient’s life.
Clinical examination is a must and can diagnose Lymphedema to a fair bit of accuracy. It also helps the clinician to know if there are any infection or any complication.
lymphoscintigraphy is the gold standard to diagnose Lymphedema and to understand the level of obstruction. This is an OPD procedure were a very very small amount of radio tagged sulphur is injected in the affected limb and images are taken to identify the obstruction. The medicine only travels by the lymphatics, Hence a diagnosis can be make.
MRI with contrast, specific for lymphatic system can delineate the lymphatic structure to a very high degree of accuracy, this new procedure helps in diagnosing and planning the surgery. A very useful tool indeed, for lymphatic surgeons
ICG fluroscence lymphography is a OPD procedure in which the ICG- dye is injected in the skin. ICG is only taken up by the Lymphatics and by using special instruments florescent image of the lymphatics can be seen. This is a very useful tool for Lymphatic mapping and it also picks up very early lymphedema through its specific patterns. This Investigation has the capacity to revolutionize and simplify the treatment of Lymphedema.
ICG fluroscence lymphography for lymphatic mapping
We are using all of these investigations including ICG fluorescence lymphography to provide the best treatment matching international standards.
Lymph vessels transport lymphatic fluid from the limbs throughthe lymph nodes to larger lymphatic vessels which in turn join to large veins
at the bottom of the neck.
When the lymphatic system is not working properly, the lymph fluidbuilds up and causes swelling, leading to the condition known as lymphedema.
LVA gives the best results in patients with:
- Early-stage lymphoedema with some functioning lymphatic channels
- Minimal skin and tissue changes (such as thickening or hardness), before irreversible damage
- Evidence of some movement of lymph fluid.