Intraoperative monitoring of lymphatic vessel characteristics using video‐capillaroscopy in the procedure of lymphaticovenular anastomosis

Abstract

tional methods. VC also avoids some shortcomings such as the strong enhancement of ICG, which limits observation of direct lymphatic flow, or the equivocal evaluation of nutrient vessels of the lymphatic vessels obtained with ultrasound and microscope.(Yamamoto et al., 2011) The incorporation of VC with conventional clinical examination and other evaluation methods may provide a more comprehensive diagnosis of patients and immediate postoperative assessment of lymphatic reconstruction.

Surgical management of breast cancer-related lymphedema: a narrative review of contemporary practices

“…At the present time, there are no solid guidelines for patient selection, timing of intervention, and type of procedure ( 1 ). However, physiologic procedures are usually assumed to generate better outcomes in the early stages of lymphedema as there is some residual physiologic flow and vessels are less fibrotic ( 2 , 20 , 23 ). On the other hand, ablative procedures are regarded to be the best alternative in very advanced lymphedema stages in which reduction of the lymphedematous limb can only be achieved by excising pathologic tissue ( 24 ).…”

“…Lymphedema is a progressive, chronic, and incapacitating disorder resulting from the accumulation of protein-rich fluid in the interstitial space secondary to impaired lymphatic fluid drainage. This pathophysiologic process generates an unremitting cycle of inflammation, adipose tissue deposition, fibrosis, and extensive and progressive cutaneous architectural changes ( 1 , 2 ). Secondary lymphedema is the most common type of lymphedema.…”

The breast cancer‐related lymphedema multidisciplinary approach: Algorithm for conservative and multimodal surgical treatment

“…The choice of the physiologic procedure (LVA or VLNT) depended on the lymphedema stage and patient's preoperative evaluation using ICG‐lymphography, as reported by other authors (Figure 2) (Chang et al, 2018; Masia et al, 2016). LVAs were performed in patients in which ICG‐lymphography confirmed the presence of suitable lymphatic vessels, in particular, areas showing linear patterns interrupted by areas of dermal backflow (Figure 3) (Chang et al, 2018; Masia et al, 2016; Matsui et al, 2022). If ICG‐lymphography did not show suitable lymphatic vessels, VLNT harvested from the GE region was performed.…”