Lymphedema treatment palmieri beniamino

41

Click here to load reader

Transcript of Lymphedema treatment palmieri beniamino

Page 1: 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

Page 2: Lymphedema treatment palmieri beniamino

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

Page 3: Lymphedema treatment palmieri beniamino

I° Treatment

Page 4: Lymphedema treatment palmieri beniamino

Right arm (lymphoedema) pre treatment, diameter 36 cm

Left arm (control), diameter 30 cm

Page 5: Lymphedema treatment palmieri beniamino
Page 6: Lymphedema treatment palmieri beniamino
Page 7: Lymphedema treatment palmieri beniamino

Lidocain injection

Page 8: Lymphedema treatment palmieri beniamino

The fiber optic and the laser

Page 9: Lymphedema treatment palmieri beniamino

Power: 14 W

Energy: 145 mJ

Page 10: Lymphedema treatment palmieri beniamino

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

Page 11: Lymphedema treatment palmieri beniamino
Page 12: Lymphedema treatment palmieri beniamino

Removal of the fiber optic

Page 13: Lymphedema treatment palmieri beniamino

Increased arm motility soon after the treatment

Page 14: Lymphedema treatment palmieri beniamino
Page 15: Lymphedema treatment palmieri beniamino

Principle: 20 MHz, 3.7 mm penetration

Page 16: Lymphedema treatment palmieri beniamino
Page 17: Lymphedema treatment palmieri beniamino

LYMPHOEDEMA CONTROL

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

Page 18: Lymphedema treatment palmieri beniamino

LYMPHOEDEMA CONTROL

Page 19: Lymphedema treatment palmieri beniamino

1° Follow up

Page 20: Lymphedema treatment palmieri beniamino

BEFORE

AFTER

Diameter – 2 cm

Page 21: Lymphedema treatment palmieri beniamino

BEFORE AFTER

Page 22: Lymphedema treatment palmieri beniamino

BEFORE AFTER

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

Page 23: Lymphedema treatment palmieri beniamino

2°Treatment

Page 24: Lymphedema treatment palmieri beniamino

BEFORE AFTER

Page 25: Lymphedema treatment palmieri beniamino
Page 26: Lymphedema treatment palmieri beniamino

BEFORE AFTER

Page 27: Lymphedema treatment palmieri beniamino
Page 28: Lymphedema treatment palmieri beniamino

Lidocain injection

Page 29: Lymphedema treatment palmieri beniamino

Cooling arm

Page 30: Lymphedema treatment palmieri beniamino
Page 31: Lymphedema treatment palmieri beniamino
Page 32: Lymphedema treatment palmieri beniamino

The fiber optic

Page 33: Lymphedema treatment palmieri beniamino

PENETRATION POINT OF THE FIBER OPTIC

END-POINT OF THE FIBER OPTIC

Page 34: Lymphedema treatment palmieri beniamino

Arm appearance at the end of the treatment

Page 35: Lymphedema treatment palmieri beniamino

2° Follow up

Page 36: Lymphedema treatment palmieri beniamino
Page 37: Lymphedema treatment palmieri beniamino

BEFORE AFTER 2 LASER TREATMENTS

Page 38: Lymphedema treatment palmieri beniamino

Before: 33 cm

After 2 treatments: 30 cm

Page 39: Lymphedema treatment palmieri beniamino

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

Page 40: Lymphedema treatment palmieri beniamino

MOVIE

Page 41: Lymphedema treatment palmieri beniamino

Thank you!