Lymphedema: Controlling It with Bypass Surgery


COLUMBUS, Ohio (Ivanhoe Newswire) – Lymphedema is a condition where fluid gets trapped in an arm or leg and causes swelling – most often after cancer surgery to remove lymph nodes. Until recently, patients were told there was nothing they could do, except wear a compression sleeve to control the swelling. Now, surgeons have better options for some patients.

Pandora Porcase has been a musician for 60 years.

“I can make a pipe organ sound awesome,” she boasts.

But 35 years ago, Porcase was diagnosed with cancer in her left breast, and it had spread.

She recalls, “I had 33 nodes that were positive.”

Doctors treated the cancer and removed the cancerous nodes. Months later, Porcase’s arm started to swell – a condition called lymphedema.

“I saw the growth in my hand, my wrist, in my forearm,” she demonstrates.

Porcase still wears a glove and compression sleeve to control the swelling. But in 2014, doctors diagnosed her with cancer in her right breast. This time, when swelling started again, her plastic surgeon had a plan.

“We actually transplanted lymph nodes from one part of her body into two different areas of her upper extremity,” explains OSU Wexner Medical Center reconstructive plastic surgeon, Dr. Roman Skoracki, MD.

(Read Full Interview)

Dr. Skoracki also performed a lymphovenous bypass. Using microsurgery, he bypassed damaged nodes and connected to veins so the fluids could drain. The doctor also used liposuction to clear the arm of deposits.

Porcase’s arm isn’t perfect, but she’s got good control over her hands and fingers.

“It’s wonderful to see her be able to do the things that she loves to do,” Dr. Skoracki expresses.

“I just love it. I love the sound of it. It’s the king of all instruments,” Porcase says about the pipe organ.

Dr. Skoracki says the lymphovenous bypass surgery has improved in the eight years since Pandora Porchase’s second case of cancer. Surgeons now can perform the bypass at the same time the nodes are removed, which minimizes the risk of the patient developing lymphedema.

Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #5143

BACKGROUND: Half of cancer patients that have lymph nodes removed suffer from lymphedema. It is a condition that can cause debilitating swelling. This is caused by fluid getting stuck in the arms and legs. It is most caused after cancer surgeries that remove lymph nodes. Enlarged white blood cells from leukemia or infection also maximize lymph flow and cause lymphedema. The most common cancers that lymphedema follow are breast cancer, prostate cancer, lymphoma, melanoma, pelvic cancers, and head and neck cancers. However, it can arise after any radiation treatment or surgery.


DIAGNOSING: Lymphedema is most commonly diagnosed after a recent cancer surgery that included lymph nodes. Many doctors diagnose lymphedema based upon symptoms and signs. If the presence is not as obvious, doctors often arrange imaging tests to look at the lymph system. These tests can include MRI scans, CT scans, ultrasounds, and lymphoscintigraphy. While there is no existing cure for lymphedema, there are treatments that focus on lowering swelling and blocking complications. Lymphedema also holds great risk of skin infections. Doctors will often prescribe antibiotics for infections as a precaution.


NEW TECHNOLOGY: New surgical treatment options are surfacing every year in treatment of lymphedema. Vascularized Lymph Node Transfer surgery, Laparoscopic Omental Lymph Node Transfer, and Lymphaticovenous Anastomosis are all surgical procedures designed to remove lymph nodes and reduce swelling in the patient. The surgeries are only minimally invasive and do not require a long recovery period. Lymphaticovenous anastomosis is even an outpatient performed procedure, requiring small incisions and a low blood loss. These surgical procedures help greatly in preventing and controlling lymphedema and help the patient’s standard of life as well.



Amanda Harper

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

Doctor Q and A

Read the entire Doctor Q&A for Roman Skoracki, MD, a plastic surgeon and medical director

Read the entire Q&A