For 59-year-old Angela Sutphin, surviving breast cancer was only part of the battle.
After her mastectomy at Smilow Cancer Hospital at Yale New Haven Hospital in 2023, a new and relentless challenge gradually emerged – crippling lymphedema pain in her right arm that turned even simple tasks into daily hurdles.
“I went to a lymphedema clinic hoping to control the pain, but it never went away,” said Angela.
Within months, the discomfort evolved into persistent pain. The once-simple routines of life – being at work, taking care of her home, and engaging in family activities, became agonizing efforts.
“I was so fatigued,” added Angela.
She had reached a breaking point after one year of managing the pain on her own.
Desperate for answers – she sought care elsewhere and was referred to Luccie Wo, MD, a plastic reconstructive surgeon at Smilow who specializes in lymphedema treatment and is an assistant professor of plastic and reconstructive surgery at Yale School of Medicine.
What is lymphedema?
“Lymphedema commonly occurs after breast cancer treatment, especially when the cancer has gone to the axillary lymph nodes,” said Dr. Wo. “The lymph nodes have to be removed, and the patient gets radiation.”
Radiation prevents cancer from spreading, but it also destroys the lymphatic system in the upper arm leading to fluid retention. As a result, patients experience pain, swelling, occasional and recurrent skin infections, which are all lymphedema symptoms.
According to Dr. Wo, the most common cause of lymphedema in the United States is cancer ablation which is a minimally invasive treatment that uses heat, cold, or other energy sources to destroy tumors. It can happen in 50 to 80 percent of patients after lymph nodes are removed from the underarm through radiation therapy.
Dr. Wo utilized the Symani Surgical System robot and performed a few lymphovenous bypasses (LVB) in her right forearm and arm. LVB is a microsurgical procedure where lymphatic vessels are connected to nearby veins to improve drainage.
Yale New Haven Hospital became the first in New England and only the fifth center in the United States to use the Symani Surgical System robot earlier this year. This was also the first robotic lymphatic case in New England.
The capabilities go well beyond lymphedema treatment but allow for micro and super microsurgical precision.
“The Symani helps me be more precise, especially on the extreme spectrum of microsurgery where I am sewing vessels that are less than one millimeter in diameter,” added Dr. Wo.
Angela was confident the Symani would help her pain subside.
“It’s high technology. I’m happy to be a part of it and I know it will work out,” added Angela.
Dr. Wo performed five anastomoses on Angela, a surgical connection between two tubular structures, such as blood vessels, leaf veins or streams.
The procedure lasted six hours and Angela stayed in the hospital for one day.
She was instructed to do intensive therapy with specialized lymphedema therapists for several weeks after to increase lymphatic flow through the bypass and lymphatic drainage.
“I’m glad I was referred to a good institution like Smilow Cancer Hospital I think those suffering with lymphedema should find out if they can be a candidate for the Symani,” added Angela.
