Comprehensive Lymphedema Care at Tampa General Hospital

At Tampa General Hospital, our Lymphedema Center offers world-class, comprehensive, and multidisciplinary care focused exclusively on patients with lymphedema, particularly those experiencing cancer-related lymphedema. Our dedicated multidisciplinary clinic combines state-of-the-art treatments, innovative research, and compassionate care to enhance the quality of life for our patients.

Led by our esteemed plastic surgery team, our clinic brings together specialists with expertise in both surgical and non-surgical lymphedema management, ensuring personalized and effective treatment tailored to each patient's unique needs.

Multidisciplinary Care Team

Our specialized care team comprises experts from diverse fields, providing a holistic approach to lymphedema management:

• Plastic Surgery
• Surgical Oncology
• Medical Oncology
• Physical Therapists (Certified in lymphedema management)
• Registered Dietitians
• Radiation Oncology
• Nuclear Medicine

Causes of Lymphedema

Lymphedema is a chronic condition characterized by the accumulation of lymphatic fluid, leading to swelling, discomfort, and functional impairment in affected areas, most commonly in the arms or legs. It occurs when the lymphatic system is unable to properly drain fluid, resulting in persistent swelling that can impact a patient’s quality of life. Individuals with lymphedema may experience pain, restricted mobility, increased risk of infection, and significant emotional distress.

The condition can be classified into primary lymphedema, which is a rare genetic disorder, and secondary lymphedema, which occurs due to external factors that damage the lymphatic system. The most common cause of secondary lymphedema is cancer and its treatments, including surgery, radiation therapy, and chemotherapy. Cancer-related lymphedema often arises following the removal of lymph nodes or radiation therapy, both of which can disrupt normal lymphatic drainage and lead to fluid accumulation.

Cancer-Related Lymphedema

One of the most common causes of secondary lymphedema is cancer and its treatments. Cancer-related lymphedema can develop due to:

• Lymph Node Removal: Surgical removal of lymph nodes, often performed in breast cancer, melanoma, gynecologic, and head and neck cancers, can disrupt lymphatic flow and lead to fluid accumulation.
• Radiation Therapy: Radiation treatment can cause fibrosis and scarring of the lymphatic vessels, further impairing fluid drainage.
• Tumor Growth: In some cases, tumors themselves can block lymphatic pathways, leading to lymphedema.
• Chemotherapy: Some chemotherapy drugs may contribute to lymphatic dysfunction and increased risk of lymphedema development.

Patients with cancer-related lymphedema often experience progressive swelling, discomfort, and an increased risk of infection. Early detection and intervention are crucial in managing symptoms and preventing further complications.

Among cancer types, breast cancer-related lymphedema is one of the most prevalent forms. Patients who undergo mastectomy or lumpectomy with axillary lymph node dissection, as well as those receiving radiation therapy to the underarm area, are at higher risk of developing lymphedema in the arm, chest, or breast. The condition can manifest months or even years after treatment, and early detection is critical in managing symptoms effectively. Preventative surgical interventions, physical therapy, and advanced medical treatments are key to improving patient outcomes and maintaining quality of life.

Symptoms of Cancer-Related Lymphedema 

Cancer-related lymphedema can present with a range of symptoms that vary in severity. Recognizing these early signs is crucial for timely intervention and management. Common symptoms include:

• Swelling: Gradual or sudden swelling in the affected limb or area, often worsening over time.
• Tightness or Heaviness: A sensation of tightness, heaviness, or fullness in the affected area.
• Restricted Range of Motion: Difficulty moving the affected limb due to increased swelling or discomfort.
• Skin Changes: Thickening, hardening, or redness of the skin, sometimes accompanied by a feeling of warmth.
• Discomfort or Pain: Aching, tingling, or burning sensations in the affected area.
• Increased Risk of Infections: Recurring infections such as cellulitis due to impaired lymphatic drainage.

Diagnosing Lymphedema 

Accurate diagnosis is essential for effective treatment planning. Our center employs advanced diagnostic methods, including:

• Comprehensive clinical evaluation
• Bioimpedance spectroscopy
• Lymphoscintigraphy (Nuclear medicine imaging)
• High-resolution ultrasound
• Magnetic Resonance Imaging (MRI)
• Indocyanine Green (ICG) Near-Infrared Fluorescence Imaging

Innovative Clinical Research

Our commitment to advancing lymphedema care includes pioneering clinical research aimed at improving diagnostic accuracy, exploring novel treatments, and enhancing patient outcomes. Patients at our center benefit from access to cutting-edge clinical trials and research protocols, positioning Tampa General Hospital at the forefront of lymphedema care innovation.

Advanced Robotic Lymphatic Microsurgery

Our center proudly offers robotic lymphatic microsurgery using the advanced Symani microsurgical robot. Tampa General Hospital is the first center in the Southeast United States and one of the few in the country equipped with this groundbreaking technology. Robotic microsurgery offers significant advantages, including:

• Enhanced surgical precision for optimal patient outcomes
• Improved visualization and magnification of microscopic structures
• Expanded patient treatment options
• Minimized surgical trauma
• Improved overall quality of life

Comprehensive Lymphedema Treatment Options

Non-Surgical Care

• Complex Decongestive Therapy (CDT)
• Manual lymphatic drainage
• Compression garments and bandaging
• Exercise therapy specifically tailored to lymphedema
• Nutrition and dietary support
• Skin care education

Surgical Care

Surgical treatment for lymphedema is divided into two primary categories: Physiologic Procedures and Ablative Procedures.

• Physiologic Procedures: These aim to restore or improve lymphatic drainage by reconnecting or transferring lymphatic pathways, helping to reduce fluid buildup and prevent disease progression.
  • Liposuction for advanced lymphedema: Removes excess fat and fluid accumulation in affected areas.
  • Excisional procedures: Surgical removal of excess skin and tissue in severe cases to alleviate symptoms.

• Ablative Procedures: These focus on reducing the volume of fluid and fibrotic tissue that accumulates due to long-standing lymphedema when physiologic treatments are not effective alone.
  
  • Liposuction for advanced lymphedema: Removes excess fat and fluid accumulation in affected areas.
  • Excisional procedures: Surgical removal of excess skin and tissue in severe cases to alleviate symptoms.

At Tampa General Hospital, our goal is to deliver exceptional, personalized care to each patient, improving outcomes and restoring quality of life.