Vascularized lymph node transfer surgery in lymphoedema in Bergman Clinic im Park for Innovational Phlebology Hilden

About the department

The Department of Phlebology at the Bergman Clinic im Park for Innovational Phlebology Hilden provides the full range of medical services in the field of its competence. The department's team of doctors provides highly accurate diagnosis and effective treatment of venous diseases, with a special focus on helping patients with varicose veins, lymphedema, lipedema, and trophic ulcers of the lower extremities (ulcus cruris). The department's specialists have all the necessary technical resources to examine the venous system and detect the slightest pathological changes. The treatment involves the use of the very latest laser procedures and minimally invasive surgical interventions. When the department's doctors detect venous pathology in its early stages, they often use only conservative therapy. The department admits more than 20,000 patients with clinical cases of varying severity annually and sees an increasing number of patients each year. The medical facility is certified as the Competence Center for Venous Diseases, which provides each patient with high-quality treatment of the European standard. The department is headed by Dr. med. Elisabeth Langer.

The most common disease in the department's clinical practice is varicose veins. The condition causes the pathologic enlargement of superficial veins in the lower extremities. Many people mistakenly believe that varicose veins are only an aesthetic problem. However, without treatment, the disease may lead to the development of severe complications such as deep vein thrombosis, pulmonary embolism, eczema, or trophic ulcers on the legs. The primary diagnostic method for confirming the diagnosis is ultrasound scanning. Taking into account the stage of the pathology, the department's doctors elaborate an individual treatment regimen for each patient.

The department uses both conservative and surgical treatment methods for varicose veins. Conservative therapy includes wearing compression stockings, physiotherapeutic procedures, lymphatic drainage, and naturopathy. If the attending physician finds the advanced stage of varicose veins, minimally invasive surgical intervention is mostly required. Varicose vein surgery is performed under local anesthesia and on an outpatient basis whenever possible. The specialists of the medical facility have at their command all the advanced surgical techniques for removing varicose veins: stripping, crossectomy, extraluminal valvuloplasty, ligation, and phlebectomy. The department's doctors also brilliantly perform radiofrequency ablation for varicose veins and endovenous laser coagulation.

The department's range of services includes the innovative CHIVA procedure. The method involves modeling venous blood flow instead of removing the affected vein. The CHIVA procedure is highly effective and allows for the avoidance of trauma to the adjacent lymphatic vessels, nerve endings, and subcutaneous tissue. The therapeutic manipulation is performed under local anesthesia on an outpatient basis. Clinical trials confirm that the risk of disease recurrence after the CHIVA procedure is negligible.

The department's doctors also specialize in the treatment of lymphedema. Patients with this disease have a gradual increase in limb volume due to impaired lymphatic outflow and its accumulation in the intercellular space. A clinical examination is usually sufficient for diagnosis, although imaging tests (ultrasound, CT, or MRI) may also sometimes be required. The best results in the treatment of lymphedema can be achieved by a combination of physiotherapy, lymphatic drainage, and compression therapy.

The medical facility admits many patients with lymphedema. The disease occurs only in women and is characterized by the abnormal distribution of adipose tissue in the thighs and buttocks. Palpation of adipose tissue deposits causes severe pain in women. During the diagnosis, the attending physician carries out a thorough examination, often additionally performing an ultrasound scan of adipose tissue deposits on the lower extremities. The most effective methods in the fight against lipedema include manual lymphatic drainage and compression therapy. If conservative treatment fails, the specialists resort to liposuction, a surgical procedure for removing adipose tissue deposits.

The department's diagnostic options include the following:

• Light reflection rheography (LRR)
• Venous occlusion plethysmography (VOP)
• Vascular deformation mapping (VDM)
• Color-coded duplex sonography
• Doppler ultrasound scanning
• Other diagnostic procedures

The department's therapeutic options include the following:

• Treatment of varicose veins, starburst varices, and spider veins
  • Conservative treatment methods
    • Compression therapy
    • Manual lymphatic drainage
    • Physiotherapeutic procedures
    • Classical sclerotherapy and ultrasound-guided foam sclerotherapy
    • Laser removal of spider veins with a diode laser
  • Surgical treatment methods
    • Stripping
    • Crossectomy
    • Extraluminal valvuloplasty
    • Ligation
    • Phlebectomy
    • CHIVA procedure (innovative treatment method)
    • Endoluminal laser therapy
    • Radio frequency therapy
• Treatment of lymphedema
  • Physiotherapy
  • Lymphatic drainage
  • Compression therapy
• Treatment of lipedema
  • Manual lymphatic drainage
  • Compression therapy
• Treatment of venous ulcers
  • Conservative treatment methods
    • Compression therapy
    • Physiotherapy
  • Surgical treatment methods
    • Split-skin grafting (autodermoplasty)
• Treatment of other venous diseases

Photo of the doctor: (c) Bergman Clinics Klinik im Park