Diseases of the lymphatic vessels and subcutaneous fatty tissue, such as a lymphedema or lipedema, can significantly affect the quality of life. Their early diagnosis and correct therapy are therefore particularly important for those affected. In the Center for Internal Medicine / Fünf Höfe, Dr. Gerson Strubel M.D. will be at your disposal with his proven medical expertise. We have established a so-called lymphological network with trusted contacts in the disciplines of radiology, nuclear medicine, dermatology and plastic surgery, and we will develop a treatment concept tailored to your individual needs with specialized lymphatic therapists and medical specialty shops. An experienced nutritional consultation in the Center completes our offer.


Lymphedema develops as a result of an accumulation of protein-rich fluid in the intercellular space. This is due to damage to the lymphatics, often due to surgical intervention and / or radiation of malignant tumors. In addition, also limbs, genitals, torso, abdominal wall, face and throat can be affected. Left untreated, the protein richness of the edema fluid leads to chronic inflammatory reactions with increased connective tissue formation (fibrosis) in the subcutaneous tissue, which may cause impaired mobility. With the help of a basic lymphological diagnosis, the diagnosis can generally be corrected if the physician carrying out the examination has sufficient experience. This is completed by volume measurement, photo documentation and ultrasound examination. Treatment is usually conservative using manual lymphatic drainage and compression therapy. Supplemented by a gymnastic exercise treatment, skin care and patient training, they form the pillars of the so-called complex physical decongestion therapy. Surgical procedures (e.g. lymph node transplantation, creation of short circuits between the lymphatic vessel and the vein) complete the therapeutic options.

Lipoedema is a disproportionate, always painful increase in the subcutaneous fatty tissue on the legs and possibly also on the arms. If the symptoms are lacking this is called “lipohypertrophy”. Other symptoms include a feeling of heaviness and tension, swelling and the tendency to bruise after minor injuries. Differentiating it from adiposity due to poor diet and lack of exercise is not always easy. Even with lipoedema, basic lymphological diagnostics are of crucial importance. Especially for the evaluation of early stages, a long-term lymphological expertise is required. An ultrasound examination of the soft tissue as well as a volume determination and a photo documentation complete the diagnostic measures. The conservative therapy includes, in addition to a consistent compression therapy, the manual lymphatic drainage, sports activities (preferably water sports) and nutritional advice. It is also desirable to have normal weight when affected by this disease. As a surgical solution, liposuction has been established as the proper measure with tumescent local anesthesia, which is used when the conservative approach fails.