Abstract
Recent advancements in microsurgery and supermicrosurgery have made effective lymphedema treatment a surgical reality. When comparing the 2 currently available procedures, lymphaticovenular anastomosis (LVA) and vascularized lymph node transfer, vascularized lymph node transfer is more frequently performed owing to technical unfamiliarity with supermicrosurgery and uncertainty in patient selection, technical execution, and procedural outcome. To date, the author has performed more than 250 cases of supermicrosurgical LVAs. In this article, the author shares his approach in technical acquisition, how to get over the learning curve using a simulation model, patient selection, LVA-specific technical pearls, outcome assessment, and finally how to team up with other lymphedema-related specialists. After reading this paper, the readers should have enough knowledge to get started building a surgical lymphedema program.
References
Sep 19, 2000·Journal of Reconstructive Microsurgery·I KoshimaT Moriguchi
Aug 9, 2001·Microsurgery·C CampisiF Napoli
Oct 26, 2005·International Journal of Clinical Oncology·Takashi NagaseIsao Koshima
Aug 2, 2007·Annals of Plastic Surgery·Christopher J SalgadoHung-Chi Chen
May 3, 2011·Plastic and Reconstructive Surgery·Takumi YamamotoIsao Koshima
Jun 18, 2011·Plastic and Reconstructive Surgery·Takumi YamamotoIsao Koshima
Sep 17, 2011·Plastic and Reconstructive Surgery·Takumi YamamotoIsao Koshima
Aug 23, 2012·PloS One·Makoto MiharaIsao Koshima
Dec 18, 2012·Annals of Plastic Surgery·Takumi YamamotoIsao Koshima
Mar 29, 2013·PloS One·Takumi YamamotoIsao Koshima
Sep 6, 2013·Plastic and Reconstructive Surgery·Hisako HaraIsao Koshima
Oct 30, 2013·Plastic and Reconstructive Surgery·David W ChangRoman Skoracki
Feb 8, 2014·Lymphatic Research and Biology·Sheila H RidnerMary S Dietrich
Feb 14, 2014·Annals of Surgical Oncology·Jay W GranzowChristine Dauphine
Apr 20, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Wei F ChenW Thomas Lawrence
May 7, 2014·Microsurgery·Takumi YamamotoIsao Koshima
Oct 7, 2014·Plastic and Reconstructive Surgery·Joseph H DayanMark L Smith
Dec 18, 2014·Annals of Surgical Oncology·Ketan M PatelMing-Huei Cheng
Dec 20, 2014·Lymphatic Research and Biology·Zeynep Erdogan IyigunVahit Ozmen
Jun 19, 2015·Journal of Reconstructive Microsurgery·Wei F ChenJennifer Carr
Jul 30, 2015·Journal of Reconstructive Microsurgery·Mario F ScaglioniArik Zaretski
Jun 22, 2016·Journal of Reconstructive Microsurgery·Michael SosinKetan M Patel
Oct 26, 2016·Journal of Reconstructive Microsurgery·Wei F ChenJohnson Ding
Citations
Jul 21, 2020·Head & Neck·Navdeep R SayalAru Panwar
Sep 22, 2020·Journal of Reconstructive Microsurgery·Wei F Chen, Rebecca Knackstedt
Aug 25, 2020·Mayo Clinic Proceedings·Oscar J ManriqueHung-Chi Chen
Oct 13, 2021·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Ying-Sheng Lin, Chia-Ju Liu