Treatment of Lymphedema in Israel

The conditions of stay at Ihilov are designed with attention to detail, creating an atmosphere of comfort and safety. Foreign patients can take advantage of personal accompaniment services, which removes language and organizational barriers at all stages of treatment. The combination of advanced techniques with a personalized approach provides not just temporary relief but long-term remission.

About the Disease

Lymphedema is a chronic disorder of lymphatic drainage, where tissues swell and harden; primary lymphedema occurs due to congenital vascular anomalies, while secondary lymphedema develops after injuries, surgeries, infections, or tumours.

Causes

• Hereditary defects of lymphatic vessels
• Surgical interventions and lymph node removal
• Radiation therapy
• Soft tissue injuries
• Infectious lesions of the lymphatic system

Symptoms

• Persistent swelling of the limb
• Feeling of heaviness and tension in the skin
• Thickening and roughening of tissues
• Reduced joint mobility
• Frequent skin inflammations

Treatment Methods for Lymphedema

The choice of treatment methods for lymphedema at Ihilov is based on comprehensive diagnostics, including the stage of the disease, the degree of tissue damage, and the individual characteristics of the patient's body.

Comprehensive Physical Therapy

This method becomes the first line of assistance in the early stages of lymphedema, when swelling is still reversible and tissues retain elasticity. Specially trained therapists perform manual lymphatic drainage massage, stimulating the movement of stagnant lymph through healthy vessels bypassing the affected areas. The procedure is complemented by the application of multilayer compression bandages, creating a pressure gradient from the periphery to the center of the limb. Patients are provided with an individual therapeutic exercise program that activates muscle pumps and improves venous outflow. The final stage involves the constant wearing of medical-grade compression garments, made considering anatomical features.

Pneumatic Compression Therapy

When conservative methods require enhancement, hardware technologies of intermittent pneumatic compression come to the rescue. Modern multi-chamber devices used at Ihilov create wave-like pressure that mimics the natural movement of lymph through vessels. Each chamber of the cuff is sequentially filled with air, creating a mechanical massage from the distal parts of the limb to the proximal. Computer control allows adjusting pressure parameters, cycle duration, and the sequence of chamber operation for the specific patient. Procedures are conducted in courses, with their frequency and duration determined by the dynamics of the condition. This method is particularly effective in secondary lymphedema after oncological surgeries, where gentle yet active influence on the lymphatic system is required.

Hydrotherapy and Balneological Procedures

Therapeutic baths and underwater massage are used as auxiliary methods that improve the overall condition of the lymphatic system. The hydrostatic pressure of water naturally compresses superficial tissues, facilitating the movement of stagnant fluid from the interstitial space into the vessels. Contrast temperature effects tone the vascular wall and activate microcirculation. Adding mineral salts, herbal extracts, or essential oils enhances the therapeutic effect of the procedures. Underwater massage combines the beneficial effects of water with mechanical stimulation of tissues, providing a deep lymphatic drainage effect without discomfort.

Kinesiotaping

Special elastic tapes, applied according to specific patterns on the affected limb, create additional opportunities for lymphatic drainage. The tapes lift the skin, increasing the space between the skin and underlying tissues, which facilitates the movement of lymph through superficial vessels. The elasticity of the material provides a constant gentle massage effect with every movement, stimulating the work of lymphatic capillaries. Ihilov specialists use various taping techniques depending on the localization of swelling and the direction of disrupted lymph flow. The method is completely safe, does not restrict movement, and can be used for an extended period, complementing the main therapy.

Laser Therapy

Low-intensity laser radiation of specific wavelengths has a stimulating effect on the lymphatic system at the cellular level. Photons penetrate tissues to a depth of several centimeters, activating metabolic processes in lymphatic vessels and surrounding tissues. Under the influence of laser radiation, the contractile ability of lymphangions improves, and the formation of collateral lymphatic drainage pathways is enhanced. Anti-inflammatory and anti-edema effects complement the primary action of the method. Procedures are conducted in courses, with their parameters selected based on the stage of the disease and the localization of the lesion. Laser therapy combines well with other methods of conservative treatment, enhancing their effectiveness and accelerating the achievement of positive results.

Extracorporeal Shock Wave Therapy

High-energy acoustic waves generated by a special device directly affect fibrotic areas in the affected tissues. Shock waves destroy pathological collagen structures, soften hardened tissues, and stimulate neoangiogenesis. The method is particularly effective in moderately expressed fibrosis, when tissues have not yet reached a critical degree of hardening. Procedures are conducted on an outpatient basis, do not require anesthesia, and are well tolerated by patients. Improved blood supply and lymphatic drainage in the area of impact create conditions for the regeneration of healthy tissues. The treatment course consists of several sessions with intervals allowing the tissues to adapt to changes. The combination of shock wave therapy with manual lymphatic drainage provides a pronounced synergistic effect.

Pharmacological Support

Medication therapy complements physical treatment methods, affecting various links of the pathological process. Phlebotonics improve the tone of venous vessels and microcirculation, preventing further accumulation of fluid in tissues. Angioprotectors strengthen the vascular wall, reducing its permeability and decreasing the leakage of protein molecules into the interstitial space. In the case of inflammatory complications, anti-inflammatory agents and broad-spectrum antibiotics are prescribed. Enzyme therapy promotes the resorption of protein deposits and softening of fibrous tissues. Diuretics are used restrictively and for short courses, only in cases of pronounced swelling, as prolonged use may disrupt electrolyte balance and exacerbate lymph stasis.

Microsurgical Lymphovenous Anastomoses

In cases of disease progression and ineffectiveness of conservative treatment, Ihilov surgeons perform delicate microsurgical operations under high magnification. Using surgical microscopes and microsurgical instruments, specialists create connections between lymphatic vessels and small veins with a diameter of less than a millimeter. These anastomoses form bypass routes for lymph, allowing it to flow directly into the venous system, bypassing damaged areas of the lymphatic system. Preoperative mapping using lymphoscintigraphy and fluorescent lymphography with indocyanine green determines the optimal points for creating anastomoses. The result is a significant reduction in swelling and an improvement in the quality of life for patients with severe forms of lymphedema.

Transplantation of Lymphatic Drainage Complexes

When lymph nodes are removed during oncological surgery or are absent from birth, creating bypass routes becomes an insufficient solution to the problem. In such cases, Ihilov surgeons perform transplantation of viable lymphatic tissues from healthy areas of the patient's body. Vascularized flaps from the groin area or fragments of the greater omentum containing functioning lymph nodes and vessels are most often used. The operation requires the application of microsurgical techniques to connect the feeding arteries and draining veins of the transplant with vessels in the transplantation area. The engrafted lymphatic drainage complex begins to perform the function of the lost lymph nodes, taking on part of the load for filtering and transporting lymph.

Tunneling

This surgical method is used in massive lymphedema when the limb is significantly enlarged, and other drainage methods prove ineffective. The operation involves creating artificial channels within the affected tissues, through which stagnant lymph can move to healthy areas with a normally functioning lymphatic system. Surgeons form tunnels using special drainage tubes or threads made of biocompatible materials, which pave the way from the peripheral parts of the limb to the central areas. Through these artificial pathways, fluid is gradually evacuated, reducing the pathological volume of tissues.

Liposuction for Lymphedema

In the late stages of the disease, excess adipose tissue accumulates in the tissues, formed as a result of chronic inflammation and metabolic disturbances. Traditional methods cannot eliminate these fat deposits, so a specialized liposuction technique adapted for lymphedematous limbs is used. The procedure is performed through minimal incisions using thin cannulas that gently remove pathologically altered adipose tissue without damaging the remaining lymphatic vessels. The volume of intervention is calculated individually based on MRI and ultrasound data of the soft tissues. After the removal of the excess volume, the limb becomes significantly lighter, and its shape and functionality are restored.

Resection Operations

When the limb reaches enormous sizes due to massive fibrotic and adipose changes, radical surgical intervention becomes necessary. Charles' operation involves the complete removal of altered skin and subcutaneous tissue with subsequent transplantation of skin flaps. The more modern Homans' operation preserves the skin, removing only subcutaneous tissue and fascia in stages, which ensures a better cosmetic result. Surgeons carefully plan the volume of resection, aiming to restore the normal contours of the limb while preserving as much functional tissue as possible. The intervention is performed under general anesthesia and requires a long recovery period with active rehabilitation. Despite its traumatic nature, these operations radically change the lives of patients with advanced forms of elephantiasis, restoring their ability to self-care and mobility.

Diagnostic Methods for the Disease

Accurate diagnosis of lymphedema is crucial as it allows determining the degree of damage and selecting the optimal treatment strategy. At the Ihilov clinic, examinations are performed on high-precision equipment, all procedures are planned in advance, and conducted in the shortest possible time.

First Day

Upon arrival at the clinic, the patient undergoes a consultation with the attending physician. The specialist collects a detailed medical history, conducts a thorough examination, and prescribes a set of studies that will provide a complete understanding of the patient's condition.

Second Day

The patient undergoes the necessary diagnostic procedures, including the following methods:

• Complete blood count
• Biochemical blood analysis
• Ultrasound of soft tissues
• Doppler ultrasound of vessels
• Lymphoscintigraphy
• MRI of the affected area
• CT if necessary
• Fluorescent lymphography

Third Day

The attending physician gathers an interdisciplinary council to discuss the results and form a personalized treatment plan. This approach ensures the patient receives a more accurate diagnosis and a thoroughly considered treatment plan, allowing the problem to be viewed from different angles, taking into account all accompanying factors, and reducing the risk of errors.

How Much Does Treatment Cost in Israel

Advantages of Treatment in Israel

1. Highly qualified vascular surgeons
2. Modern diagnostic equipment
3. Individual therapy programs
4. Comfortable conditions of stay
5. Patient support at all stages of treatment

The patient can arrange an online consultation with a specialized doctor even before arriving in Israel. As a result, they will receive personal recommendations, answers to important questions, and information about available modern treatment technologies.