Excisional Procedures: Liposuction
Key Points • If there is significant pitting (>8–10 mm in depth) of the lymphedematous limb, conservative treatment (combined physiotherapy) is indicated to remove the lymph and transfer the lymphedema…
Immediate Lymphatic Reconstruction
Key Points • The Lymphatic Microsurgical Preventative Healing Approach, or immediate lymphatic reconstruction (ILR), is a surgical procedure for the prevention of lymphedema (LE). • This procedure is performed by…
The Campisi Approach for Lymphatic Surgery
Key Points • Lymphedema staging • Surgical treatment of lymphedema & lymphatic microsurgery • SS-MLVA/single site – multiple lymphatic-venous anastomoses • MLVLA – multiple lymphatic-venous-lymphatic anastomoses (autologous interpositioned vein graft)…
Microsurgical Procedures: Lymphovenous Anastomosis Techniques
Key Points • Lymphovenous bypass (LVB) usually requires anastomosing lymphatic vessels less than 0.8 mm in diameter to small subdermal venules. • A high-resolution microscope, super-fine instruments and sutures, and…
Microsurgical Procedures: Vascularized Lymph Node Transfer from the Thoracodorsal Axis
Key Points • The axillary donor site has the highest reported incidence of lymphedema. • Preoperative imaging facilitates surgical planning and establishes a baseline for postoperative comparison. • Reverse lymphatic…
Microsurgical Procedures: Minimizing Donor Site Morbidity Following Vascularized Lymph Node Transfer
Key Points • Superficial inguinal lymph nodes targeted for harvest lie between the groin crease and inguinal ligament. • The vascular supply of these nodes is typically the superficial circumflex…
Mesenteric Vascularized Lymph Node Transfer
Key Points • The small bowel mesentery represents a donor site for vascularized lymph node transfer that contains numerous and redundant lymph nodes and has reliable anatomy with minimal donor…
Treatment of Lymphedema: Vascularized Omental Lymphatic Transfer
Key Points • Intraoperative mapping of the right gastroepiploic lymphosome is valuable to identify critical flap components. • No-touch flap elevation will prevent damage to the flap lymphatics and microvasculature….
Microsurgical Procedures: Vascularized Lymph Node Transfer from the Supraclavicular Region
Key Points • Harvesting lymph nodes from the axillary or groin region may cause secondary lymphedema of the upper or lower extremity. • The main advantage of supraclavicular nodes harvest…
Microsurgical Procedures: Vascularized Lymph Node Transfer from the Submental Region
Key Points • The upper margin of the flap is designed at the lower border of the mandible to result in an inconspicuous scar. • Preoperative Doppler ultrasound and magnetic…
