Understanding the SAPL Surgery Procedure for Lymphedema Treatment

Understanding SAPL Surgery

Lymphedema is a chronic condition characterized by swelling in the arms or legs due to a buildup of lymph fluid. This occurs when the lymphatic system, which is responsible for draining this fluid, is damaged or impaired.

One surgical treatment option for lymphedema is known as sapl surgery, which stands for “Suction Assisted Protein Lipectomy.” This procedure aims to reduce swelling and discomfort in the affected limb.

Who is a Candidate for SAPL?

Patients with long-term lymphedema that has not responded well to other conservative treatments like compression garments or manual lymphatic drainage may be candidates. The best candidates have soft, pitting edema with no or minimal tissue fibrosis.

SAPL is generally only performed on the arms and legs. The surgeon will assess if there is enough fluid accumulation and healthy tissue elasticity remaining for the procedure to be effective.

Goals and Benefits

There are several potential benefits of sapl surgery for lymphedema patients:

• Reduces limb volume and circumference
• Alleviates discomfort, tightness, and heaviness
• Restores some shape and contour to the swollen limb
• Enables easier compression garment fitting
• Removes proteins and inflammatory fluid buildup

While sapl often successfully reduces excess fluid and swelling, results vary by individual. It generally does not cure lymphedema altogether, so compression therapy and self-care may still be needed after surgery.

What to Expect During SAPL Surgery

SAPL is performed under general anesthesia, typically on an outpatient basis. Small incisions are made in the affected limb, through which a suction cannula is inserted.

The surgeon moves the cannula through the subcutaneous fat layers, suctioning out accumulated protein-rich fluid, inflammatory cells, and excess fats. This also allows the surgeon to break up fibrous tissue bands that can restrict flow and contribute to swelling.

In most cases, sapl surgery takes 1-3 hours depending on the size of the limb. Drains may be left in place temporarily after surgery to prevent fluid reaccumulation. Bandages, compression wraps, and garments are applied following the procedure and for a period of healing.

Recovery and Post-Op Care

There will likely be bruising, swelling, and mild discomfort after surgery. Pain medication and anti-inflammatory drugs help manage this.

Restrictions on lifting, exercising, and repetitive arm/leg motion are given, along with instructions to keep the limb elevated. Some temporary change in sensation near the incision sites is common.

Follow-up compression therapy starts a few days after surgery to maintain the results achieved. Lymphedema therapy often continues long-term to prevent backsliding.

Most patients are back to normal activity within 2 weeks, though maximal swelling reduction occurs over 3-6 months. Complete healing of incision sites takes 4-6 weeks.

Is SAPL Effective for Lymphedema?

Multiple research studies over the years have found sapl surgery to successfully reduce limb size and swelling in lymphedema patients. A 2016 study published in the Journal of Reconstructive Microsurgery found an average 47% limb size reduction at one year post-op.

Improvements have been demonstrated as far out as 4 years later, though some swelling tends to recur over time without diligent at-home care. Younger patients with less pre-op tissue hardening tend to experience better outcomes.

When combined with compression therapy, self-massage, and exercise, sapl can be an excellent treatment approach for arm and leg lymphedema.

As with any surgery there are risks, which your doctor will outline. But for appropriate candidates, it is considered safe and effective way to provide lasting relief.

Basta MN, Gao LL, Wu LC. Efficacy of Suction-Assisted Lipectomy in the Treatment of Lymphedema After Mastectomy and the Importance of Compression Therapy. J Reconstr Microsurg. 2016;32(2):102-107.