The laparoscopic right gastroepiploic lymph node flap transfer for upper and lower limb lymphedema: Technique and outcomes

Abstract

The use of the laparoscopically harvested right gastroepiploic lymph node flap may be a safe technique that improves limb measurements and quality of life in extremity lymphedema patients. © 2015 Wiley Periodicals, Inc. Microsurgery 37:197-205, 2017.

Combined double vascularized lymph node transfers and modified radical reduction with preservation of perforators for advanced stages of lymphedema

“…During the last decade, our unit has explored different surgical techniques in VLNT surgery . We have searched for the least invasive technique that minimizes donor site morbidity, avoids iatrogenic lymphedema, reduces the number of complications, and maximizes the efficacy of the procedure.…”

“…A two‐team approach with one group harvesting the gastroepiploic lymph node flap, while another group beginning the RRPP was undertaken. An experienced laparoscopic general surgeon performed the harvest of the flap under the guidance of the plastic surgery team as previously described . As shown in the Supporting Digital Content, laser‐assisted indocyanine green angiography (SPY Elite System, LifeCell Corporation, Branchburg, NJ) was used during the harvest to localize the lymph nodes within the flap (Video 1).…”

Comparison of long‐term clinical outcomes among different vascularized lymph node transfers: 6‐year experience of a single center's approach to the treatment of lymphedema

“…Excisional procedures, such a suction assisted lipectomy (SAL), radical reduction with preservation of perforators (RRPP), and Charles’ procedure, aim to decrease the lymphatic load in advanced stages by removing the diseased tissue. However, physiologic and excisional procedures have a common goal: to improve the limb size and to decrease the number of episodes of cellulitis, thus improve the patient's quality of life …”

“…VLNT has become one of the mainstays of microsurgical management of extremity lymphedema. The application of VLNT has achieved clinical success, since it has shown to be effective in reducing limb volumes and improving quality of life . Several reports have emerged in recent years pertaining to novel lymph node flaps.…”

Lymphatic‐venous anastomosis in a rat model: A novel exercise for microsurgical training

“…Surgical operations are performed only in severe cases refractory to conservative therapies. Advances in microsurgical techniques have revolutionized surgical options for treating lymphedema . Physiologic surgical procedures such as lymphaticovenular anastomosis and vascularized lymph node transfer have demonstrated promising results …”