Lymphoedema is a chronic condition arising from poorly developed or obstructed lymphatics which then results in soft tissue swelling, and an increased susceptibility to infections. Lymphoedema can arise from any cause of lymphatic damage. Common causes of chronic lymphoedema in Western countries, include cancer treatments, trauma, and congenital lymphatic malformations. Parasite infections are responsible for a large portion of chronic lymphoedema in developing countries, but rarely seen in Australia.
The usual of treatment for lymphoedema is with compression and lymphatic massage. In some instances, however, surgery may be considered if conservative measures fail to adequately control the condition or the patient's circumstance makes it difficult for them to comply with optimal physical therapy.
The currently accepted surgical procedures for treating lymphoedema are divided into physiological procedures and reductive procedures. The former involves using microsurgery and super-microsurgery to improve lymphatic drainage either by transplanting functioning lymph nodes from another part of the body into the affected area, or diverting lymphatic flow into veins. The latter involves removal of the oedematous tissue using liposuction or direct excision. These procedures are not curative and are designed to improve the ability of the patient to manage their condition. While they can very effectively reduce swelling (to normal dimensions in many cases), patients undergoing reductive surgery will need to stay on strict garment regiments.
Dr Ngo is one of only a few surgeons in Australia who have completed further training in microsurgical techniques to treat lymphoedema. He works at the Australian Lymphoedema Education, Research, and Treatment centre (ALERT) at Macquarie University Hospital in Sydney. ALERT is the only multidisciplinary lymphoedema clinic in Australia that features close collaborations between physicians, surgeons, and therapists under the same roof and banner. It has won many major research grants and produced several internationally recognised publications, furthering the understanding of lymphoedema. Each year approximately 400 patients from all across Australia and New Zealand come to ALERT for treatment.