A patient who had developed elephantiasis in his left leg post an accident almost a decade ago, has started to walk again after around 10 years following a procedure that involved micro-surgical technique.

The patient had met with an accident 10 years ago, had undergone an operation on his left groin which resulted in disruption of the lymph nodes (lymphatics). After the surgery, he started developing elephantiasis due to the accumulation of excessive fluid.

After the recent micro-surgery at a private hospital in Delhi, followed by multiple reduction surgeries and non-surgical means to reduce the swelling on his left leg, its weight has now come down to 25-kg from 45-kg earlier.

The leg had swollen to 120 cm in width when the patient first came to the hospital, which has reduced to 65 cm now. The normal leg circumference of an adult male ranges from 35-40 cm.

According to the team of doctors led by Manoj Johar and his associate Pradeep K. Singh, the highly-specialised and superfine microsurgery -- Lympho-venous anastomosis (LVA) -- is a one-of-its-kind treatment for treating lymphedema that could be caused due to trauma and/or common in patients of cancer surgeries or filariasis.

Talking about the case, Johar said, "Lymphedema was traditionally treated with debulking, ablative treatments in which the excess volume of fat and fluid was immediately excised or eliminated via liposuction. These methods are far from physiological and are frequently disfiguring or only provide brief relief. LVA is relatively new, and is now considered one of the gold standard therapies for lymphedema."

Johar said that conservative management with manual lymphatic drainage therapy, triple bandaging, and other methods was adopted to achieve optimal status.

"He was taken up for multiple lymph-venous anastomoses, and his leg circumference came down from 120 cm to 112 cm, and all the compartments softened up two months post-surgery. Then we planned reduction surgeries, and after two stages of reduction surgeries, his limb girth is now 65 cm, and the weight of his leg has now reduced to 25-kg. Using highly specialised microscopes, we were able to magnify the operating area by 40 times. This was a highly-challenging case," said Johar.