Lymph node transfer is a relatively new procedure, which is proving to be very successful in the management of lymphoedema as a result of surgical removal of lymph nodes during breast cancer treatment. It was originally described by French plastic surgeon, Corinne Becker, and has shown to be of great benefit to patients plagued by lymphoedema. I am one of a few surgeons in Europe offering this technique and so far have had very promising results to date with several years follow up.
The procedure involves harvesting several superficial lymph nodes from the groin area attached to the DIEP flap. The superficial lymph nodes are not responsible for draining the leg and therefore it is unlikely that you would develop lymphoedema of your leg. However, to reduce the risk of donor site lymphoedema even further, we use a video fluoroscopy camera to identify which lymph nodes are important for draining the leg. These important lymph nodes are then avoided to reduce the risk of developing leg lymphoedema.
The lymphoedema begins to improve rapidly and many patients will notice a reduction in the size of their affected limb before discharge from the hospital. However the limb will continue to soften and reduce over the following 18 months. The lymph nodes have been shown to release cytokines (cell signaling chemicals) that encourage old lymphatic pathways to open up and new networks to develop. Most patients will notice reduced discomfort and heaviness in their affected limb. Those suffering from recurrent cellulitis should also notice a reduction in the number of episodes. Depending on the severity and length of time you have had lymphoedema, you may need subsequent procedures such as liposuction or lymphatic venous anastomosis. It is essential to continue to wear your lymphoedema garments and be managed by a lymphoedema nurse as you recover. We have our own lymphoedema nurse who will look after you throughout your time with us. She will liaise with your local team following your discharge.