There’s always something going on in the world of lymphedema and lymphatic research! It can be a lot to keep up with, so here’s a digest of some of the latest headlines from the past few weeks carefully curated to keep you in the lymphie loop.
“World’s First Super-Microsurgery Operation With ‘Robot Hands'”
Surgeons at Maastricht University Medical Center in The Netherlands successfully performed the world’s first robot-assisted super-microsurgical procedure using a device created by the Dutch company MicroSure.
The coolest part about this? The surgery was done on a lymphedema patient! Using the robotic device, the surgeons attached lymphatic vessels of 0.3 to 0.8 millimeters to blood vessels in the patient’s arm to restore the flow of lymphatic fluid and alleviate swelling.
Although this particular surgery for lymphedema is not new, it’s difficult and highly specialized; robotic intervention would make it easier to achieve the stabilized precision and dexterity necessary for these super-microsurgeries to be successful.
The device works by converting the surgeon’s movements into tiny, precise actions using the robot’s “hands.”
Shan Shan Oiu Shao, a plastic surgeon at Maastricht University Medical Center, is quoted in the article saying: “Microsure enables us to be very precise in our movements during procedures that need a surgical microscope. Their robot allows us to operate on minuscule lymph vessels and blood vessels with more ease, while getting better results for these complex and fatiguing interventions. Besides it is very convenient that, within microsurgery, we can operate on vessels of every size with this robot. Most importantly, of course, this is good news for the patients concerned.”
“In global first, team using glowing tumor dye to identify cancerous lymph nodes”
Surgeons at Penn Medicine are looking at the effectiveness of intraoperative molecular imaging of lymph nodes in patients with head and neck cancer.
Using a fluorescent dye that makes cancerous cells glow, surgeons are able to get real-time information to help them remove as much cancer as possible by taking out the dangerous lymph nodes while sparing non-diseased tissue during surgical procedures.
This concept is already in practice for other diseases, although this is the first study of its kind for head and neck cancers. According to the article, this study can also help doctors use imaging to understand patterns of lymph node metastasis, which could enable oncologists and surgeons to better predict which patients are at the highest risk of spread or recurrence.
“NIH researchers uncover drain pipes in our brains”
Researchers at the National Institutes of Health conducted MRI scans on the brains of healthy volunteers and found evidence that our brains may drain some waste out through lymphatic vessels located on the dura, the brain’s leathery outer coating.
In the early 1800s, Italian anatomist Paolo Mascagni reported finding lymphatic vessels on the surface of the brain, although this was dismissed and forgotten. Since then, the prevailing belief has been that the brain is immune-privileged, meaning it has an immune system different from the rest of the body.
Modern research, however, has been circling a re-discovery of the brain’s lymphatic system in recent years: a study in 2013 found that the brain appears to flush out waste products during sleep, although it still wasn’t clear how the fluid communicated with the rest of the body; in 2015, two studies of mice found evidence of the brain’s lymphatic system in the dura, dubbed the “glymphatic system.” Now, the research from the NIH has confirmed its presence in humans.
Two centuries after Mascagni’s finding, we finally know for certain that the human brain does in fact drain its fluid out through lymphatic vessels.
These findings may change the way we think about how the brain and immune system inter-relate, and could lead to a new understanding of various brain diseases like multiple sclerosis, Parkinson’s, and Alzheimer’s.
Lymphatic filariasis news
Lymphatic filariasis (commonly known as elephantiasis) is a neglected tropical disease caused by parasitic infection to the lymphatic system. It is the leading cause of lymphedema worldwide: of the over 120 million people infected, 40 million are incapacitated or disfigured by the disease.
“Kenya on verge of eradicating elephantiasis”
The World Health Organization (WHO) confirmed that Kenya is set to join the growing list of countries in sub-Saharan Africa that have successfully eliminated elephantiasis, also known as lymphatic filariasis.
The goal is to eliminate lymphatic filariasis as a public health problem by the year 2020 through various programs and mass drug administrations. These preventative treatments are designed to stop the spread of infection and alleviate the suffering of those affected.
According to WHO estimates, over 120 million people are affected by lymphatic filariasis around the globe, and 40 million of them are seriously incapacitated and disfigured by the disease.
In Kenya alone there are approximately one million people already infected, and an additional 3.7 million at risk. Through these health initiatives, though, the prevalence of lymphatic filariasis has been low, and thus hopes are high for achieving eradication of the disease.
“Plateau, Nasarawa eliminate elephantiasis”
Two states in Nigeria – Plateau and Nasarawa – have eradicated elephantiasis.
Through a partnership between the government and The Carter Center, more than 36 million medications for lymphatic filariasis and 140,000 bed nets were delivered to residents in the 30 local governments in Plateau and Nasarawa.
Dr. Frank Richards, the Director of the Carter Center’s Lymphatic Filariasis Elimination Program, is quoted in the article saying, “The successful elimination of the disease in these two states not only protects the seven million people who live there, but it also sets a pattern for similar success throughout the rest of Nigeria, as well as in other highly endemic countries.”
Nigerian Sa'adatu Toro first noticed discomfort in her leg while kicking a soccer ball with a friend. After a diagnosis of lymphatic filariasis, she was given medication immediately as part of a Carter Center-supported program. This painful disease was stopped before it became disfiguring. "Now I am better — so much better," she said. #LF #neglectedtropicaldiseases #Nigeria #BeatNTDs #NTDs
According to the World Health Organization, India and Nigeria have the highest number of people affected by the disease globally.
“Portable 3-D scanner assesses patients with elephantiasis”
When it comes to assessing the severity of elephantiasis, healthcare workers rely on using a tape measure or water displacement procedures – a process that often proves cumbersome and impractical.
A study recently published in The American Journal of Tropical Medicine and Hygiene has found an easier and more accurate method: 3D scanning.
Scientists at Washington University School of Medicine in St. Louis working alongside collaborators in Sri Lanka have found that a portable scanning device can measure limb volume and circumference faster and more easily in patients with elephantiasis than the current methods.
The article describes the device as essentially an infrared sensor mounted on an iPad to produce highly accurate, virtual 3D reconstruction of the legs. Created by the Atlanta-based company LymphaTech, it’s been used to measure lymphedema in clinical settings. Seeing an opportunity for global applications, the Washington University researchers teamed up with international partners to test the device on patients with filarial lymphedema in Sri Lanka.
Not only is using the device more accurate than the current standard, but it’s also more convenient: healthcare workers are able to take measurements in the patients’ homes or villages, whereas before many patients had to make the trip to clinics – a trip that was often difficult or near-impossible due to their severe swelling.
Although not explicitly related to lymphedema or lymphatic disease, some medical news and research breakthroughs may still be relevant to members of the lymphedema community or have potential applications in lymphedema treatment.
“New drug to supercharge immune cells in the fight against cancer”
A new cancer treatment has been developed by researchers from the University of Western Australia and the Harry Perkins Institute of Medical Research. The treatment involves a drug that generates more normal blood vessels and lymph-node-like structures within the cancer, which then enables immune cells to better reach the cancer core.
“Lymph nodes, a vital component of our immune system, normally only exist outside of the cancer and work to filter cancer cells and generate white blood cells that fight infection,” said UWA Professor Ruth Ganss, head of the Perkins Cancer and Cell Biology Division.
“Our drug strengthens the immune response against tumors by inducing these lymph-node-structures together with normalized blood vessels, producing immune cells that infiltrate deep into the cancer,” Professor Ganss continues in the article.
So far the treatment has been tested on pancreas and lung cancer models, with “very promising results.”
“New survey finds 21 percent of Americans report personal experience with medical errors”
If you feel frustrated by medical errors surrounding your lymphedema treatment or diagnosis, you’re not alone!
The survey also found that when these errors occur, they often carry a lasting impact on the patient’s physical and emotional health, financial well-being, or family relationships.
Errors related to diagnosis and patient-provider communications were the most commonly reported.
“Harvard’s Futuristic ‘Intelligent Bandages’ Can Repair Your Body”
Researchers from the University of Nebraska-Lincoln, Harvard Medical School, and MIT have developed a smart bandage whose electrically conductive fibers can be activated to dispense antibiotics, painkillers, and other medications using a mobile device.
Ali Tamayol, an assistant professor of mechanical and materials engineering at Nebraska, said in a press release: “This is the first bandage that is capable of dose-dependent drug release […] This is a platform that can be applied to many different areas of biomedical engineering and medicine.”
One potential application for these smart bandages are chronic wounds. When living with lymphedema, wounds may present a significant challenge and can lead to serious complications if left untreated – a bandage like this could really help some members of our patient community!