Tracking Outcomes Following Lymphedema Treatments
Key Points • Surgical success can be defined as the downgrading of the patient’s lymphedema grades with improved symptoms, at least a 10% decrease in circumferential difference, a decrease in…
Future Perspectives in Lymphatic Microsurgery
Lymphedema Milestons and Globalization Lymphedema Milestones in Diagnosis and Treatment The surgical and microsurgical treatment of lymphedema is rapidly evolving with new techniques, improved outcome reporting, and descriptions of more…
Excisional Procedures: Debulking Procedures
Key Points • Treatment of advanced lymphedema remains a challenge in reconstructive surgery. Surgical management with excisional procedures is indicated in select patients when conservative measures have failed. • Based…
Evidence-Based Assessment and Outcomes Following Lymphedema Treatment
Key Points • Complete decongestive therapy remains the only lymphedema treatment that is supported at the highest level of evidence. • Health-related quality of life (QOL) is a multidimensional construct…
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…
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)…
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…
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…
