• Having met with a road accident 10 years ago, the patient developed Elephantiasis (Lymphederma)
• Super-microsurgery has helped cure the disorder, legs size has reduced to half

Forty- year old Amit Kumar, had lost all hope of ever getting back a normal life after he developed Elephantiasis in the left leg post trauma a decade ago. He had visited multiple hospitals across Delhi-NCR and was repeatedly told that there was nothing that could be done to cure his debilitating condition.

He underwent a procedure that involved microsurgical technique at Max Super Speciality Hospital, Patparganj as his last and only hope to cure his ever deteriorating condition. After the microsurgery, followed by multiple reduction surgeries and non-surgical means to reduce the swelling his left leg which earlier weighed 45 kgs has come down to 25 kgs. The leg had swollen to 120 cms in width when Amit first came to the hospital. This has reduced to 65 cms now. The normal leg circumference of an adult male ranges from 35 to 40 cms.

According to the team of doctors led by Dr Manoj Johar, Senior Director & his associate Principal Consultant, Dr. Pradeep K Singh, Dept of Aesthetic, Reconstructive and Plastic Surgery, Max Hospital, Patparganj, highly specialised & superfine microsurgery, Lympho-venous anastomosis (LVA), is a one-of-its-kind treatment for treating Lymphedema that could be caused due to a trauma and/or common in patients of cancer surgeries or filariasis.

The doctors gave a detailed description of the treatment given to Amit Kumar, who met with a road traffic accident ten years ago. He underwent an operation on the left groin which resulted in disruption of the lymph nodes (lymphatics). Following which he started developing Lymphedema or Elephantiasis because of accumulation of excessive fluids. The patient consulted with several doctors in the following years, but his situation worsened; which compromised his walking and daily chores along with the psychological trauma. The patient received a new lease of life after he successfully underwent a highly specialised and superfine microsurgery. He can now walk freely and has resumed his daily activities while also undergoing conservative therapy for improvement/rehabilitation

Talking about the case, Dr Johar said, “Lymphedema was traditionally treated with debulking, ablative treatments in which the excess volume of fat and fluid was immediately excised or eliminated via liposuction. These methods, on the other hand, are far from physiological and are frequently disfiguring or only provide brief relief. LVA is relatively new, and is now considered one of the gold standard therapies for lymphedema.”

Dr. Johar, led the highly trained team of doctors comprising of Dr. Pradeep K Singh & Dr. Ankur Bhatia who performed the surgery.

“We adopted conservative management with manual lymphatic drainage therapy, triple bandaging, and other methods to achieve optimal status. He was taken up for multiple lympho-venous anastomoses, and his leg circumference came down from 120 cms to 112 cms, and all the compartments softened up two-month post-surgery. Then we planned reduction surgeries, and after two stages of reduction surgeries, his limb girth is now 65 cms, and weight of his leg has now reduced to 25 kgs. Using highly specialised microscopes, we were able to magnify operating area by 40 times. This was a highly challenging case,” said Dr. Johar.

Dr Kousar Ali Shah, Sr. Vice President – Operations & Head at Max Hospital-Patparganj said: “We take pride in pioneering in tertiary and quaternary care. This particular case is a testimony to how super specialised procedures could alter the life of not just the patient but his entire family. I congratulate the team of treating doctors for achieving this feat. Such procedures are bound to help many more patients who suffer from Lymphedema”.

Dr. Pradeep K Singh, Principal Consultant, Dept of Aesthetic, Reconstructive and Plastic Surgery, said, “Lympho-venous anastomosis is a specialised surgery where 0.1-0.2 mm diameter lymph vessels are (joined) anastomosed with nearby veins under a specialised microscope with special super microsurgery instruments, and we bypass the proximal blocked lymphatic pathways and lymph is directly drained into the venous system.”