Lymphsystem

Lymphology

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Your private specialist practice for lymphology

Diseases of the lymphatic vessels and subcutaneous fatty tissue, such as lymphoedema or lipoedema, can significantly impair quality of life. Early diagnosis and correct treatment are therefore particularly important for affected patients. In your Zentrum / Innere Medizin / Fünf Höfe is available to you in the person of Dr. med. Gerson Strubel, lymphology BVL/DGL™, therefore not only has particularly proven medical expertise at its disposal. As part of a lymphological network, we also maintain trusting contacts with the disciplines of radiology, nuclear medicine, dermatology and plastic surgery.

We work with specialised lymph therapists and medical supply shops to develop a therapy and treatment concept tailored to your individual needs as a patient. The specially trained and experienced nutritional advice at the Zentrum / Innere Medizin / Fünf Höfe rounds off our comprehensive range of lymphological therapies.

Background
Lymphoedema
Lipoedema

Lymphoedema: what is it?

Lymphoedema occurs as a result of an accumulation of protein-rich lymph fluid in the interstitial space. This accumulation of fluid is caused by damage to the lymph channels, as a result of which the lymphatic drainage is no longer sufficiently ensured. Such problems with the lymphatic system occur particularly frequently after surgery and/or radiotherapy for malignant tumours.

In addition to the limbs, the genitals, trunk, abdominal wall, face and neck can also be affected. If left untreated, the protein-rich oedema fluid leads to chronic inflammatory reactions with increased connective tissue formation (fibrosis) in the subcutaneous tissue, which can result in impaired mobility. With the help of basic lymphological diagnostics, the diagnosis can usually be made correctly if the examiner is sufficiently experienced. This is completed by volume measurement (perometry), photo documentation and ultrasound examination of the soft tissue.

Treatment options for lymphoedema:

Treatment is carried out in most cases conservatively, using manual lymphatic drainage and compression therapy. These are complemented by therapeutic exercise, skin care, and patient education, forming the foundation of what is known as Complex Decongestive Physiotherapy (CDP). Surgical procedures (e.g. lymph node transplantation or the creation of bypass connections between lymphatic vessels and veins) complete the range of treatment options.

Lipoedema: What Is It?

Lipoedema is defined as a disproportionate, always painful increase of subcutaneous fat tissue on the legs and, in some cases, also the arms. If there are no symptoms, it is referred to as “lipohypertrophy.” Other symptoms of lipoedema include a feeling of heaviness and tension, swelling, and a tendency to bruise easily after minor injuries. Unfortunately, it is not always easy to distinguish it from obesity caused by poor diet and lack of exercise— a fact that often leads to an unnecessarily long period of suffering for many patients until the actual cause of the fat distribution disorder is identified.

Even in the case of lipoedema, a basic lymphological diagnosis is of crucial importance. In particular, assessing early stages requires many years of lymphological expertise. At your Zentrum/ Innere Medizin / Fünf Höfe, we also use a special method for the ultrasound examination of soft tissue (high-frequency soft tissue sonography) as well as for volume measurement (perometry) of arm and leg volumes. A comprehensive photographic documentation completes the diagnostic procedures.

Lipoedema Treatment Measures:

Conservative lipoedema therapy includes, in addition to consistent compression therapy, manual lymphatic drainage, physical activity (preferably water sports), and comprehensive nutritional counselling. Achieving a normal weight is also a goal for this condition. Surgically, liposuction in tumescent local anaesthesia has become established and is used when conservative treatment is insufficient.