Surgical treatment

Surgical treatment of lymphoedema

The Surgical Assessment Clinic is an important first step in determining the presence and extent of lymphoedema, and your suitability for surgical intervention using specific criteria. We also diagnose and manage lipedema.

A medical referral is required for assessment by our multidisciplinary team.

The ALERT treatment difference

In your initial visit to the clinic you will be assessed by Dr Helen Mackie (lymphoedema medical specialist) and a lymphoedema therapist. A medical and lymphoedema history will be taken, and a complete physical, functional and psychological assessment will gauge the impact that lymphoedema has on your life. You will be encouraged to fill in some questionnaires and have measurements taken.

Physical measurements may include:

• circumferential measurements using a tape measure
• bioimpedance spectroscopy measurements to monitor the fluid
• range of movement measurements of your limb and joints
• how hard or soft the limb feels and whether the symptoms vary with time.

Functional assessment may include how the lymphoedema symptoms affect your ability to complete everyday activities such as personal care, household tasks, paid and unpaid work, sleep and leisure activities.

Research shows us that living with lymphoedema can impact your feelings and emotions. Our clinical team wants to assist in managing lymphoedema across all aspects of our patients' lives, including by providing support and strategies to help you deal with psychological symptoms.

You may also be encouraged to complete further diagnostic testing such as lymphoscintigraphy, MRI scanning, ultrasound and blood tests. The results of these tests are used to help the team understand your condition, gaining better knowledge of how lymphoedema develops and what might be the best treatment recommendation for you.

Following your initial assessment, recommendations for any further assessment and lymphoedema management will be made in consultation with yourself and the team, according to your own personal goals and needs. A follow-up appointment will be scheduled if required.

If surgical options are appropriate for you, we will give you written information and make an appointment for you to see one of the plastic surgeons on the team.

We offer three different surgical options:

• lymphovenous anastomosis (LVA) for early to moderate lymphoedema
• lymph node transfer (LNT) for early to moderate lymphoedema
• liposuction for advanced lymphoedema and lipedema.