Lymphedema Surgery

Innovative Lymphedema Treatments to Reduce Swelling & Alleviate Discomfort

The University of Chicago Medicine is one of just a few centers in the country offering lymphovenous bypass and lymph node transfer, innovative surgical techniques designed to reduce swelling and alleviate discomfort for patients with lymphedema.

Lymphedema is a disorder in which lymph fluid accumulates, leading to chronic swelling. It is a common complication following lymph node removal or radiation therapy as part of cancer treatment. The condition can develop from a few days to a few years after treatment and usually affects the arms or legs.

While there is no cure, standard care for lymphedema includes physical therapy to decrease pain and improve mobility as well as the use of compression garments to keep lymph fluid moving.

Common contributors to lymphedema include:

Surgery: Removal of, or injury to, lymph nodes and lymph vessels can result in lymphedema.
Radiation: Radiation therapy treatment can cause scarring and inflammation of lymph nodes or lymph vessels.
Cancer: If cancer cells block lymphatic vessels, lymphedema may result.
Obesity: Being overweight contributes to the development of lymphedema.
Parasites: Filiriasis is a tropical disease caused by round worms that can damage lymphatic system.
Other: A patient may be born with a developmental abnormality to the lymphatic system. Problems can manifest at birth, during youth or as an adult.

If the condition worsens and becomes difficult to manage, lymphovenous bypass or vascularized lymph node transfer surgery may help relieve the problem:

Lymphovenous bypass: Under a microscope, surgeons use small instruments to connect blocked lymphatic vessels (as small as 0.3 mm in diameter) to a nearby vein. The bypass allows excess lymph fluid to flow more freely.
Lymph node transfer: Healthy vascularized lymph nodes (lymph nodes that have a rich blood supply) are microsurgically transplanted to an area of lymphatic injury to reestablish lymphatic connections.

These surgical procedures are usually more effective for swelling in the arms than in the legs and outcomes are better in the early stages of lymphedema. While it is not a cure and results vary, many patients report that their arm or leg feels lighter and more comfortable after undergoing the treatment. Read more about surgical management of lymphedema.

Comprehensive Center of Excellence

We're proud to be designated a Comprehensive Center of Excellence by the Lymphatic Education & Research Network — one of a select few centers in the United States to achieve this honor. This important distinction signifies that UChicago Medicine sets the standard for best practice multidisciplinary care in the treatment of lymphatic diseases such as lymphedema, lipedema and lymphatic malformation. Institutions designated as a Center of Excellence have been evaluated by international leaders in an extensive review process.

Lymphedema Surgery After Breast Cancer

UChicago Medicine surgeon David Chang, MD, and breast cancer survivor Jacquetta Christodolos talk about how lymph node transfer can keep the painful swelling of lymphedema at bay.

Video Transcript

[MUSIC PLAYING] Jacquetta Christodolos loves to be outside and working on her 10 and 1/2 acres. It's a big part of her life and something she wasn't willing to give up, even after being diagnosed with breast cancer and lymphedema.

We've always had a garden, so we were always outside. So this is what I enjoy doing. I couldn't let lymphedema stop me from doing all this. And I said, uh-huh. I said, this is not going to get me.

After having a mastectomy due to her cancer, she developed lymphedema, a painful and debilitating swelling of her arm and hand.

Of course, when it gets severe, it becomes disfiguring, because it's so noticeable. And they cannot fit into normal clothes. They cannot function normally in a lot of activities, whether it's social activities or physical activities.

Lymphedema happens when the lymph fluids cannot drain. It's a common condition that happens after lymph node surgery. UChicago Medicine is a leader in lymphatic surgery worldwide. We're one of the few centers offering microscopic surgeries called lymphovenous bypass and lymph node transfer.

It gives another pathway for lymphatic fluid to escape out of the damaged system. You can kind of think of it like as in a highway. When there is a major traffic jam, you can create a little feeder road. And the cars can get out and get away from the traffic into open road.

Jacquetta says her oncologist recommended she see Dr. Chang. After a couple of months, she decided she would do it and is now happy she made the appointment.

Ever since I had the lymphedema surgery, now I can do just about everything. I can do everything now, because it's not going to hold me back. I can do my gardening. I can do my planting. I can do my chickens. And that's what's important.

She had lymph nodes moved to the area impacted by her breast-cancer treatment.

If we can bring healthy lymph nodes from elsewhere in the body that are not damaged into the site where the lymph nodes have been damaged, over time, they can re-establish connection with the open lymphatic vessels to re-establish function.

Even though Jacquetta was hesitant at first, Dr. Chang made the reluctance quickly go away.

And I always say, if you ever have something like what I've had done, or if you have any trouble with lymphedema — the breast cancer, or anything like that — you have to, have to see Dr. Chang, because to me, he was the greatest.

UChicago Medicine is one of the few places these procedures for lymphedema are offered. And Jacquetta is happy she was directed here.

The care is super, super excellent. Doctors all came in very, very nice. Everybody was just so wonderful. And I will recommend it to everyone to go there at the University of Chicago.

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