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BackTable / VI / Podcast / Episode #338

Surgical Options for Lymphedema

with Dr. Kuldeep Singh

In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode.

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Surgical Options for Lymphedema with Dr. Kuldeep Singh on the BackTable VI Podcast)
Ep 338 Surgical Options for Lymphedema with Dr. Kuldeep Singh
00:00 / 01:04

BackTable, LLC (Producer). (2023, June 30). Ep. 338 – Surgical Options for Lymphedema [Audio podcast]. Retrieved from

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Podcast Contributors

Dr. Kuldeep Singh discusses Surgical Options for Lymphedema on the BackTable 338 Podcast

Dr. Kuldeep Singh

Kuldeep Singh is a vascular surgeon and associate professor with Zucker School of Medicine and Northwell Hospital in Staten Island, New York.

Dr. Aparna Baheti discusses Surgical Options for Lymphedema on the BackTable 338 Podcast

Dr. Aparna Baheti

Dr. Aparna Baheti is a practicing Interventional Radiologist in Tacoma, Washington.


Dr. Kuldeep is a Vascular Surgeon, the Director of Limb Salvage Surgery, and Program Director at Zucker School of Medicine at North Wall Hospital in Staten Island. He begins by recounting the first time he was approached by a patient suffering from Stage 3 lower extremity lymphedema, along with his initial thought process/treatment plan for the patient. He then goes on to speak on several similarities/challenges he has encountered through treating a number of patients with lymphedema, including managing/treating psychological body dysmorphia in most patients after successful surgical treatment of lymphedema.

Kuldeep underscores the gravity and risks associated with moving forward with the Charles procedure (which is also known as lymphedema debulking operation), how such a surgical option should only be considered for patients with Stage 3 lymphedema, and how to encourage and promote consistent pre-operative care.

Kuldeep goes onto discuss the operation itself in detail - explaining how the surgery is best done as a team (Vascular (dissecting soft tissue and placing Wound VAC for 1 week to promote formation of granulation tissue), Plastics (skin grafting/reconstruction after 1 week), and Pathology), working within the fascial plane (differentiating fascia, muscle, and fat), dealing with calcified fat effectively, difficulty of identifying fascia in setting of lymphedema, and working near the ankle (avoiding iatrogenic injury of anterior and posterior tibial arteries and achilles tendon).

We wrap up the episode by discussing postoperative course: admitting the patient into Burn ICU after each step of the procedure, reapplying Wound VAC after Vascular and Plastic portions, and only discharging the patient from Burn ICU to a rehab facility after evidence of good graft uptake.


Limb Salvage for “Hopeless” Lymphedema: Reviving the Charles Procedure by Singh et al.

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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