Microsurgery: Vascularized Lymph Vessel Transfer

Lymphaticovenular anastomosis (LVA) and vascularized lymph node transfer (VLNT) are the main established reconstructive treatments for fluid-predominant lymphedema. Both, however, have limitations. LVA is most effective for early disease with preserved functionality of lymphatic vessels, and VLNT carries a risk of donor site lymphedema as well as contour deformity. Vascularized lymph vessel transfer (VLVT) is a novel technique that can be utilized in more advanced, fluid-predominant lymphedema, does not have the risk of donor site lymphedema, and does not have associated contour deformity. In this chapter, the senior author (WFC) describes this novel technique, including patient selection, surgical planning, surgical technique, surgical outcomes, and postoperative care. After reading this chapter, the reader should gain both clinical and technical knowledge to begin incorporating VLVT into their lymphedema practice.