Lymphedema treatment palmieri beniamino

FIBER OPTIC LASER TREATMENT OF LYMPHOEDEMA

Prof. Beniamino PalmieriDott. Gregorio Fistetto

Dott. ssa Valentina RottigniDott. Alessandro Di Cerbo

Università di Modena e Reggio Emilia Dipartimento di chirurgia generale

C.E., FEMALE, 77 YEARS OLD

- RIGHT BIQUADRANTECTOMY

- AXILLARY LYMPHADENECTOMY WITH SURGERY COMPLICATIONS (2011)

- RADIOTHERAPY CYCLE (OCTOBER 2011)

- LYMPHEDEMA OF THE RIGHT UPPER LIMB (IN NOVEMBER), EXTENDED TO THE METACARPAL AREA UNTIL THE AXILLA WITH DIFFERENT STIFFNESS LEVELS

- THE CONTROLATERAL LIMB IS UNAFFECTED

I° Treatment

Right arm (lymphoedema) pre treatment, diameter 36 cm

Left arm (control), diameter 30 cm

Lidocain injection

The fiber optic and the laser

Power: 14 W

Energy: 145 mJ

The fiber optic is inserted into the arm, which is cooled

Removal of the fiber optic

Increased arm motility soon after the treatment

Principle: 20 MHz, 3.7 mm penetration

LYMPHOEDEMA CONTROL

IN THE ARM AFFECTED BY LYMPHOEDEMA, LESS SOFT DERMAL TISSUE AND FIBROSIS

LYMPHOEDEMA CONTROL

1° Follow up

BEFORE

AFTER

Diameter – 2 cm

BEFORE AFTER

BEFORE AFTER

POST TREATMENT WE OBSERVE AN INCREASE OF THE DERMAL TISSUE IF COMPARED BEFORE THE TREATMENT

2°Treatment

BEFORE AFTER

BEFORE AFTER

Lidocain injection

Cooling arm

The fiber optic

PENETRATION POINT OF THE FIBER OPTIC

END-POINT OF THE FIBER OPTIC

Arm appearance at the end of the treatment

2° Follow up

BEFORE AFTER 2 LASER TREATMENTS

Before: 33 cm

After 2 treatments: 30 cm

RIGHT ARM

LEFT ARM RIGHT FOREARM

LEFT FOREARM RIGHT WRIST

LEFT WRIST

1° TREATMENT 36 cm 30 cm 33 cm 26 cm 22 cm 19 cm

1° FOLLOW UP 34 cm 30 cm 31 cm 26 cm 22 cm 19 cm

2° TREATMENT 34 cm 30 cm 31 cm 26 cm 20 cm 19 cm

2° FOLLOW UP 34 cm 30 cm 30 cm 26 cm 20 cm 19 cm

Arm, forearm and wrist circumference

MOVIE

Thank you!