Adipose Veno-Lymphatic Transfer for Management of Post-Radiation Lymphedema

Abstract

In a patient who had post-radiation lymphedema after excision of liposarcoma, a method is described that is called adipose veno-lymphatic transfer. The technique involves transferring adipose tissue containing lymphatic vessels that surround the long saphenous vein, from the normal, healthy leg to the irradiated leg, with the creation of an arteriovenous fistula.

History of Microsurgery

“…154 Pho et al described an interesting approach to the treatment of lymphadema using an adipose-venolymphatic transfer from the normal leg, across the groin, to the lymphadematous lower extremity as a subcutaneous pedicle. 155 A pedicle of subcutaneous tissue and fat around the long saphenous vein on the normal side is elevated from the medial malleolus proximally to the groin, where the venous pedicle with its adipose tissue and lymphatic vessels is then transferred subcutaneously across to the other groin and tunneled down to the medial aspect of the knee on the lymphadematous side. This is a major dissection but based on sound physiological principles.…”