Overview of Surgical Techniques
Key Points • Reductive procedures (direct excision with skin grafting or liposuction) alone or as an adjunct are effective in gross reduction of volume; however, they carry significant morbidity. •…
Recipient Site Choices and Donor Option Considerations for Vascularized Lymph Node Transfer
Key Points • A number of different donor sites exist for vascularized lymph node transfer that have near-equivalent success rates in improving the condition of patients suffering from lymphedema. •…
Vascularized Lymph Node Transfer from the Groin
Key Points • The vascularized lymph node flap transfer from the groin was first introduced by Clodius in 1982 in two clinical cases. • Animal studies described the vascularized lymph…
Lymphedema Risk Reduction and Management
Key Points • Lymphedema is more than mechanical insufficiency due to reduced transport capacity. Lymphedema is an inflammatory edema associated with an increase in the adipose content of the subcutaneous…
Refining Planning of Lymphedema Surgery of the Extremities Using MRI and CT Imaging Techniques
Key Points • Lymphedema (surgical) treatment is nowadays tailored to the patient’s needs and even more specifically to the local needs in one affected limb. • Lymphoscintigraphy and near-infrared fluoroscopy…
Clinical Evaluation of Lymphedema
Key Points • The clinician’s role in lymphedema treatment and management is to provide the best diagnosis, treatment plan, and advice as to what will be the most appropriate approach;…
ICG Lymphography and Its Application
Key Points • Indocyanine green (ICG) lymphography clearly visualizes superficial lymph flows in real time without ionized radiation exposure. • Dynamic ICG lymphography, dual-phase fluorescent image observation, is important to…
Animal Study and Cadaver Dissection of Lymphedema
Key Points • Lymphangiogenesis occurs in four distinct regular phases: lymphatic competence, lymphatic commitment, lymphatic speciation, and lymphatic maturation. • Vascular endothelial growth factor C and vascular endothelial growth factor…
Lymphoscintigraphy Interpretation, Staging, and Lymphedema Grading
Key Points • Lymphoscintigraphy is an objective and reliable imaging modality for diagnosing lymphedema, categorizing its severity, and guiding appropriate treatment. • The diagnostic utility of lymphoscintigraphy depends upon meticulous…
Primary Lymphedema with Concomitant Vascular and Lymphatic Lesions
Key Points • Primary extremity lymphedema is a debilitating disease with a reported incidence of 1–3 in every 10,000 births, and it may present with concomitant vascular lesions or retroperitoneal…
