Lymphatic bypass supermicrosurgery at James Cook Hospital

Now being used at The James Cook University Hospital in Middlesbrough, lymphatic bypass supermicrosurgery offers renewed hope to breast cancer patients at risk of developing lymphoedema, a chronic and often debilitating condition.

Lymphoedema can occur after axillary clearance surgery, a procedure to remove lymph nodes from the armpit when cancer has spread, and affects around 50 per cent of women who undergo the operation.

The new technique has dramatically reduced this risk, lowering the likelihood of developing lymphoedema to just four per cent.

Mr Mohamed Abdelrahman, a plastic and breast reconstruction surgeon at the hospital, said: "This procedure came to light very, very recently and there are very few centres in the UK currently offering it.

The first lady to have this procedure with us last year had a very high risk of developing lymphoedema.

She’s doing remarkably well now.

Therapy radiographer and lymphoedema practitioner Kate Gowans sees her regularly and, nine months on, she shows no signs of it.

The procedure only takes one and a half hours but it impacts the rest of their life."

The surgery involves connecting lymphatic vessels, which are around 0.5mm thick, to nearby veins, allowing the body to drain lymph fluid normally and preventing build-up in the arm.

The technique is performed during breast reconstruction surgery immediately after mastectomy and the removal of the armpit lymph glands.

So far, two women at James Cook University Hospital have received the surgery, thanks to collaboration between Mr Abdelrahman, Ms Gowans, and the hospital’s breast surgery team.

Ms Gowans said: "When I first heard about this procedure, my mind was just blown.

"It amazes me that surgeons have these incredible skills that can so benefit our patients.

"Lymphoedema is a horrible, painful side effect of cancer treatment.

"Patients need to buyer larger sized clothes to accommodate a swollen arm, they feel self-conscious about it, especially if they’ve lost a breast and their hair as well.

"This condition is lifelong, and only manageable – which for some patients, is devastating.

"To have this new procedure for women in Teesside is hugely exciting. It’s going to be life-changing."

The team is working to expand the service and offer the surgery to all patients undergoing axillary clearance.

They also hope to eventually make it available to women who have already developed lymphoedema following surgery.

Mr Abdelrahman said: "Kate, the breast surgeons and I talk about the service a lot.

"Short-term, we want to be able to offer it to every patient who’s undergoing axillary clearance with us.

"Once we’ve established a sustainable service, our hope is that we’ll be in the position to offer it as a secondary procedure to women who already have established lymphoedema as a result of surgery.

"If we can make life easier for these ladies, let’s do it."