Advanced Lymphedema Treatment in India: What Patients Should Know

Advanced lymphedema treatment

Lymphedema is a long-term illness to which excess lymph fluid accumulates in the body tissues leading to swelling (edema), with the arms or legs usually affected, however, there are also such possibilities as chest, abdominal and genital areas.

What Occurs?

• The lymphatic system (network system of lymph nodes and vessels) drains tissues / body by normal modes of fluid, proteins and waste products and also aids in providing infection protection.
• The fluid is unable to drain normally when there is a blockage, destruction or absence of lymphatic vessels → so the fluid gathers in tissues → and causes chronic swelling.

Most cases lack a permanent solution although most cases can be managed through treatment of lymphedema concentrating on reducing swelling, avoidance of complications and promoting the quality of life.

Advanced lymphedema treatment in India

The following is a specific description of advanced lymphedema treatment options today.

Progressive Therapies on Lymphedema

Gold standard Complete Decongestive Therapy (CDT)

• Manual lymphatic drainage (MLD): Massage to activate lymph circulation.
• Compression therapy: Bandages layers or garments, which are custom-made to avoid fluid accumulation.
• Physical therapy: Physical movements that are non-demanding and stimulate lymphatic flow.
• Skin care: Helps to avoid infections (cellulitis), which further increase lymphedema.
• Preliminary often.

Elaborate Compression Devices

• Pneumatic compression intermittent pumps which act as a pseudolymphatic drainage device.
• Newer models have multi-chambered sleeves to allow more natural-looking patterns of drainage.
• Now available as portables and home based.

Drugs: pharmacological Therapies (Emerging)

None of these drugs are FDA-approved, although they are under trial with:

• Ketoprofen (anti-inflammatory that has been found to decrease skin alterations).
• Fibrosis/inflammation-targeted immunomodulators.
• Lymphangiogenesis based therapies of VEGF-C (to promote lymph vessel development).

Surgical / Microsurgical Procedures

Lymphovenous Bypass (LVB):

• Microsurgery is making direct connections between lymphatic system and the nearby veins.
• Assists in re-routing the fluids movement and swelling.

Vascularized lymph node transfer (VLNT):

• Implantation of the lymph nodes of another part of the body to the site of occurrence.
• Tooling of novel lymphatic routes.

Suction- Assisted Lipectomy (Liposuction Lymphedema):

• Eliminates the fibrotic tissue, and fat accumulation in chronic lymphedema.
• Following that, lifelong compression is required.
• Better results are achieved by hybrid techniques (VLNT + LVB or VLNT + liposuction).

Laser /Regenerative Therapies (Experimental /Advanced Centers)

• Low-Level Laser Therapy (LLLT): Enhances lymph circulation, and prevents or improves fibrosis in subjective patients.
• Stem cell therapy: Safety and efficacy to regenerate damaged lymphatic vessels was investigated.
• 3D imaging & indocyanine green lymphography: Stepped upon with the purpose of accurate charting prior to microsurgery.

Supportive and Integrative Therapies

• Aquatic therapy: The water pressure will facilitate lymph drainage.
• Kinesio taping: special taping to activate lymph drainage.
• Nutritional treatment: Anti-immune diet and eating plan lower severity of symptoms.

Best lymphedema treatment hospitals in India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Top doctors for lymphedema treatment in India

• Dr. Himanshu Verma
• Dr. (Col) Kumud Rai
• Dr. Surinder Singh Khatana

Factors Affecting Cost of lymphedema treatment in India

This is a revisited outline of the most critical elements that determine the price of lymphedema treatment in India, with elaboration and data-backed analysis:

Type of Treatment & Complexity

• Compression (e.g. Manual Lymphatic Drainage, compression bandages) and manual therapies are less costly.
• The more surgical procedures such as microsurgery (Lymphaticovenous Anastomosis/LVA) or liposuction will be more expensive

Healthcare Facility Type/ Geographic Location

• Prices in the private hospitals are much higher, while the prices published in the metropolitan cities (Delhi, Mumbai, Bangalore) are incomparably higher than in other cities or the countryside. Key cities usually show a greater price and cost of operation. 
• Specialty clinics and private hospitals may charge high premium rates and the opposite may be true with some, but not all of the public hospitals that may have more subsidized or regulated packages. 

Healthcare Technology & infrastructure

• Highly advanced equipment, imported medical equipment and the use of microsurgery adds overheads and the costs of treatment. 
• The technological advancement is also an important factor in pricing particularly the complex procedures that are prevalent in the lymphedema management. 

Medical Inflation & Market Dynamics

• The rate of medical inflation in India is quite steep- probably in the range of 14%-15 percent on yearly basis which is much higher in comparison with overall inflation. 
• The causes of inflation are an increase in demand (medical tourism is not excluded), high-priced technologies, and the overall increase in healthcare costs.

Lymphedema therapy in India

This is a general overview of the treatment of lymphedema in India, including the possible treatments, top centres, financing, and resources that can help:

Lymphedema treatments that can be found in India

Conservative and Non-Surgical Treatment

Complete Decongestive Therapy (CDT), the most significant evidence-based combination of:

• Manual Lymphatic Drainage (MLD): Gentle massage of the surface of the skin to encourage lymph drainage, which is usually available in big cities provided by trained physiotherapists.
• Compression Therapy: Applied either with bandages, garments or pumps (pneumatic) aggressively in the reduction phase and tend to be long-term in the maintenance phase.
• Extremely important are skin care, the exercise regime, and self-management.
• Exercise & Lifestyle Support: Scheduling programs, water, dieting (particularly less salt), and weight control aid with the symptoms.

Surgical and advanced therapies

Microsurgical Procedures:

• Lymphovenous Anastomosis (LVA): Lymph vessels are anastomosed to the neighboring veins as an increase in drainage is expected.
• Vascularized Lymph Node Transfer (VLNT): It implants healthy lymph nodes to the diseased site.
• Debulking or Liposuction Surgeries: In severe cases debulking by liposuction or excision (e.g., Charles procedure) of excess tissue is undertaken.

Diagnostic and Imaging equipment:

• To perform ICG Lymphography to map lymphatic structures as they arise to enable real time precision treatment planning.

Emerging Interventions:

• Super microsurgery with robot assistance.
• New technologies such as lymphangiogenesis stimulated by nanoparticles, artificial-intelligence-enabled compression devices and stem-cell therapies.

Factors Affecting Affordable lymphedema treatment in India

The following is an organized list of the influencing factors in regards to lymphedema treatment affordability in India:

Type of Treatment & Stage of Treatment

• As mild lymphedema is frequently treatable with Complete Decongestive Therapy (CDT),- manual drainage, compression, skin care, and exercise), it is more affordable.
• More complicated ones that requires microsurgery (LVA, VLNT), liposuction, or use of robot are more expensive.
• Imports such as the use of compression garments or pumps or laser are more expensive.

Health Care Location & Facility

• There are the higher end hospitals on advanced microsurgical procedures in the Metro cities (Delhi, Mumbai, Bangalore, Chennai).
• Lower cost of therapy may be available at tier-2 or government hospitals in some cases even subsidized.
• Medical centers such as India Lymphedema Foundation (ILF) and Lymphedema Clinic India Portal (LCIP) assist in networking of the patients with inexpensive resources.

Technology & Equipment

• Increased cost of ICG lymphography, robotic microsurgery and improved pneumatic pumps are related to the expense of equipment and experience.
• Standard compression therapy, and manual drainage are also cost effective options that still need frequent sessions.

Skills of a therapist surgeon

• Certified Lymphedema Therapists (CLTs) are relatively scarce in India, and therefore their services are more expensive in a private-based program.
• The availability of skilled microsurgeons doing LVA or VLNT is majorly at the higher end hospitals, which influences affordability.

Advanced lymphedema treatment in India by GetWellGo

GetWellGo is a company in the industry of medical tourism facilitation operating within India and taking international patients through the access to treatment. They collaborate with NABH-certified (and internationally comparable) hospitals nationally to facilitate the planning of:

• Hospital and Doctor recommendation
• Individually tailored treatment plans with open cost estimates
• Scheduling of appointments, medical Visas and transportation assistance

Why Choose GetWellGo for Advanced Lymphedema Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for advanced lymphedema treatment.
• Expert vascular surgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food