A 32-year-old female from Penn has been suffering from swelling of the left lower limb since 3 years. The swelling initially involved the foot and gradually increased up to the knee. She has been seeking treatment for this over the last three years at multiple hospitals.
However, she was advised, only conservative management including limb elevation and pressure garments. This has resulted in significant modification of lifestyle with no definite cure of the swelling. To have this disease at such a young age was Frustrating and disappointing.
She has been suffering from a disease called filariasis which is rampant in India. Filariasis is due to a parasite called Wuchereria Bancrofti and is transmitted by mosquitoes. The parasite blocks the passage of lymph in the body, subsequently leading to gradually increasing swelling which is called lymphedema.
Treatment of filariasis has over the years been medical management to eliminate the parasite only. However, the lymphedema element of filariasis has never been dealt with. Patients deal with this issue for years and require major lifestyle modifications which are not feasible many times
However, with greater research and development of microsurgical techniques, there has been a new hope towards dealing with such pathologies. More and more data has come up in favour of newer surgical management in lymphedema cases.
With recent training in Taiwan, Dr Bharat Saxena and his team of Plastic Surgeons have been able to perform such surgery in a Government Hospital at Gokuldas Tejpal Hospital, Mumbai for the first time.
The procedure involves microsurgical management to transfer vascularised lymph node from the neck to her ankle to initiate a new pathway for drainage of lymph stagnated in the leg.
This initiative by the Department of Plastic Surgery at Gokuldas Tejpal Hospital, under the guidance of Dr Nitin Mokal, has been a great step forward in this direction.
Early research claims the development of newer drainage tracks and can reduce oedema significantly without the need of pressure garments on a regular basis in future. Results are significantly better in the early stages of the disease.
Although the science is new currently there is a hope for patients who have been suffering from this disease for years.
India is the world capital of lymphedema with maximum cases due to filariasis. Another major cause of lymphedema is after breast or uterine cancer and radiotherapy. The patient gradually develops swellings after surgical removal of the lymph nodes as a part of oncological treatment. This lymphedema persists with a patient with no definite care available.