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<p>Lipoedema syndrome is a&#xa0;chronic, painful fatty-tissue disease with disproportionate distribution to the extremities, the aetiology of which remains unclear. It is neither a&#xa0;vascular nor a&#xa0;lymphatic disorder, which is why the role of vascular surgery lies primarily in the differential diagnosis from leg and arm swellings. The new S2k guideline corrects the key myths of the previous S1 guideline: neither oedema nor a&#xa0;tendency towards haematoma is considered a&#xa0;reliable criterion; the focus is on pain and psychosocial burdens. Conservative treatment is based on movement with medical compression as well as interdisciplinary pain therapy and psychotherapy. According to the current German Federal Joint Committee decision, liposuction will be covered by statutory health insurance at all stages from 2026, but is subject to strict criteria and requires two signatures. Given limited resources and high time intensity, the question remains as to how vascular surgery practice can position itself between reliable differential diagnosis, interdisciplinary cooperation and adequate care in the future.</p>

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Das Lipödem-Syndrom in der Gefäßchirurgie: Status quo und Ausblick auf 2026

  • 期刊论文

  • 发表日期：

    2025年10月1日

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  • Hans-Walter Fiedler,
  • Andreas Knauf,
  • Pavlos Tsantilas,
  • Siamak Pourhassan

摘要

Lipoedema syndrome is a chronic, painful fatty-tissue disease with disproportionate distribution to the extremities, the aetiology of which remains unclear. It is neither a vascular nor a lymphatic disorder, which is why the role of vascular surgery lies primarily in the differential diagnosis from leg and arm swellings. The new S2k guideline corrects the key myths of the previous S1 guideline: neither oedema nor a tendency towards haematoma is considered a reliable criterion; the focus is on pain and psychosocial burdens. Conservative treatment is based on movement with medical compression as well as interdisciplinary pain therapy and psychotherapy. According to the current German Federal Joint Committee decision, liposuction will be covered by statutory health insurance at all stages from 2026, but is subject to strict criteria and requires two signatures. Given limited resources and high time intensity, the question remains as to how vascular surgery practice can position itself between reliable differential diagnosis, interdisciplinary cooperation and adequate care in the future.