Lymphoedema treatment palmieri beniamino
Transcript of Lymphoedema 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 ARMRIGHT
FOREARMLEFT 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!