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Billrothstrasse 78
Vienna 1190
Austria

+43.1.36036.5900

Plastische und Rekonstruktive Chirurgie

Plastischer Chirurg

Professor Dr. Chieh-Han John Tzou was trained at the Medical University of Vienna, Austria (MUW) and at the Chang Gung Medical University Taipei-Linkou, Taiwan. He was a visitor at the Asan Medical Center, Seoul, South Korea and the Medical University of Tokyo, Japan. He is specialist in Plastic, Aesthetic and Reconstructive Surgery and his research focus is in facial palsy, lymphedema and the peripheral nerve.
He has been invited to numerous international conferences; moreover as a mentor and teacher he has trained plastic reconstructive surgeons, medical students and medical nurses at the Medical University Hospital of Vienna, Austria.

Lymphedema LVA VLNT Prof. Dr. Tzou

Surgery Lymphedema Supermicrosurgery diameter LVA LVAs VLNTs Lymphflap Flap compression Mikrosurgery Mikropscope lymphovenous anastomosis super lymphatic vessel vessels microscope surgery restoration lymphatic flow suture of lymphatic tissue transplantation lymphnodeflap lymph node vessel duct

Liposuction
Liposuction is used to treat severe, non-pitting lymphedema when the swollen extremities do not indent when pressed with a finger. When these patients contain large volume of fat tissue, it can be significantly reduced by liposuction. This technique is a symptomatic treatment and does not cure the lymphedema. Conservative therapy, as bandaging and wearing compression garments, needs to be carried on after liposuction.

 

LVA
LVA (Lympho-Venous-Anastomosis) is a supermicrosurgical procedure, in which shortcuts between lymphatic ducts and veins are performed (diameter between 0.2 and 0.8mm). Patients with lymphedema of extremities and genitals at stage I and II are suitable for this therapy. LVAs are performed under the microscope. These shortcuts provide the lymph fluid a new pathway to flow out of the arm, leg or genitals and may permanently reduce the lymphedema of the extremities significantly.

 

VLNT
VLNT (Vascularized Lymph Node Flap Transfer) is a microsurgical technique to replace lymph nodes from an area of the body not affected by previous surgery, cancer, or trauma and place them where they are missing. This technique can be utilized in combination with LVA. In this approach, lymph nodes from the submental, supraclavicular, thoracica lateralis, or groin region are harvested and transplanted. This VLNT can offer relief from severe swelling. The mechanism behind this procedure suggests that the lymph nodes in the flap can induce lymphangiogenesis and effectively pump lymph fluid from the interstitial space to the venous system.

 

CDT
CDT (Complete Decongestive Therapy), also called complex decongestive therapy, is an intensive program that combines many various conservative treatments, such as bandaging, compression garments, manual lymphatic drainage, exercise, and self-care,… to improve lymphedema symptoms.
Institute for Physical Medicine and Rehabilitation at Hanusch Krankenhaus Vienna

 

LYMPHEDEMA

TM_Lypmhoedem.jpg
 
 

CDT

CDT (Complete Decongestive Therapy), also called complex decongestive therapy, is an intensive program that combines many various conservative treatments, such as bandaging, compression garments, manual lymphatic drainage, exercise, and self-care to improve lymphedema symptoms. Before the evaluation for surgical lymphedema therapy, we recommend patients to have underwent at least six months of CDT therapy. We cooperate with Primaria Dr. Silvia Brandstaetter at Institute for Physical Medicine and Rehabilitation in Hanusch Krankenhaus Vienna, Austria.

 

LVA

LVA (Lympho Venous Anastomosis) is a supermicrosurgical procedure, in which shortcuts between lymphatic ducts and veins are performed (diameter between 0.2 and 0.8 mm). Patients with lymphedema of extremities and genitals at stage I, II and III are suitable for this therapy. LVAs are performed under the microscope. These shortcuts provide the lymph fluid a new pathway to flow out of the arm, leg or genitals and may permanently reduce the lymphedema of the extremities significantly.

 

VLNT

VLNT (Vascularized Lymph Node Flap Transfer) is a microsurgical technique to replace lymph nodes from an area of the body not affected by previous surgery, cancer, or trauma and place them where they are missing. This technique can be utilized in combination with LVA. In this approach, lymph nodes from the submental, supraclavicular, thoracic wall, or groin region are harvested and transplanted. This VLNT can offer relief from severe swelling. The mechanism behind this procedure suggests that the lymph nodes in the flap can induce lymphangiogenesis and effectively pump lymph fluid from the interstitial space to the venous system.

 

Liposuction

Liposuction is used to treat severe, non-pitting lymphedema when the swollen extremities do not indent when pressed with a finger. When these patients contain large volume of fat tissue, it can be significantly reduced by liposuction. This technique is a symptomatic treatment and does not cure the lymphedema. Conservative therapy, as bandaging and wearing compression garments, needs to be carried on after liposuction.

Lymphocele

A lymphocele is the accumulation of lymphatic fluid within the soft tissues not bordered by epithelial lining. It is usually as a result of the surgical removal of lymph nodes, especially when the afferent lymphatic vessels of the removed lymph nodes are leaking or have not been ligated. The lymphatic fluid leaks and accumulates in the soft tissue, which fills up after each drainage. In most cases, lymphocele does not require surgical treatment, since they usually recede after weeks of conservative compression therapy. Only in a few cases, if the lymphocele still persists after six months of conservative compression therapy, surgical intervention may be evaluated to ligate the afferent lymphatic vessels or divert them into veins with lymphovenous anastomoses (LVA).

ICG Lymphangiography

Indocyanine green (ICG) lymphangiography is a minimally invasive diagnostic procedure for imaging superficial lymphatic vessels. ICG is a fluorescent dye, which has been used in medicine as an indicator substance for cardiac, circulatory, liver and eye diseases, e.g. for photometric liver function diagnostic and fluorescence angiography of retina and brain. For visualization of the superficial lymphatic vessels, ICG is administered subcutaneously in the inter-finger or inter-toe spaces and detected with a fluorescence machine.

High Resolution Ultrasound

High-resolution ultrasound diagnostic is used to localize the deep lymphatic vessels, which cannot be visualized using ICG. With this precise examination, the lymphatic vessels and veins for the LVA operation will be determined. Ultrasound examination takes place one ortwo days before the operation and is performed in cooperation with Priv.-Doz. Dr. Stefan Meng.