Strategic Incision Placement to Facilitate Successful Supermicrosurgical Lymphaticovenular Anastomoses

Hawkes, Patrick J.; McNurlen, Maria; Bowen, Mindy; Chen, Wei-Fan

doi:10.24983/scitemed.imj.2018.00049

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…These engineered lymphatic vessels may be applicable for enhancing supermicrosurgical lymphaticovenular anastomosis, a sophisticated surgical technique in which precise anastomoses are performed between lymphatics and venules. The anastomoses create additional outflow conduits to improve lymphatic drainage, and the technique has been used to treat varying stages of lymphedema with good efficacy ( 36 ). Implantation of engineered lymphatic vessels around the surgically anastomosed lymphatics and venules may increase the overall number of anastomoses between the lymphatic and venous systems, thus increasing lymphatic drainage.…”

Section: Discussionmentioning

confidence: 99%

Investigating lymphangiogenesis in vitro and in vivo using engineered human lymphatic vessel networks

Landau

Newman

Edri

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

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The lymphatic system is involved in various biological processes, including fluid transport from the interstitium into the venous circulation, lipid absorption, and immune cell trafficking. Despite its critical role in homeostasis, lymphangiogenesis (lymphatic vessel formation) is less widely studied than its counterpart, angiogenesis (blood vessel formation). Although the incorporation of lymphatic vasculature in engineered tissues or organoids would enable more precise mimicry of native tissue, few studies have focused on creating engineered tissues containing lymphatic vessels. Here, we populated thick collagen sheets with human lymphatic endothelial cells, combined with supporting cells and blood endothelial cells, and examined lymphangiogenesis within the resulting constructs. Our model required just a few days to develop a functional lymphatic vessel network, in contrast to other reported models requiring several weeks. Coculture of lymphatic endothelial cells with the appropriate supporting cells and intact PDGFR-β signaling proved essential for the lymphangiogenesis process. Additionally, subjecting the constructs to cyclic stretch enabled the creation of complex muscle tissue aligned with the lymphatic and blood vessel networks, more precisely biomimicking native tissue. Interestingly, the response of developing lymphatic vessels to tensile forces was different from that of blood vessels; while blood vessels oriented perpendicularly to the stretch direction, lymphatic vessels mostly oriented in parallel to the stretch direction. Implantation of the engineered lymphatic constructs into a mouse abdominal wall muscle resulted in anastomosis between host and implant lymphatic vasculatures, demonstrating the engineered construct's potential functionality in vivo. Overall, this model provides a potential platform for investigating lymphangiogenesis and lymphatic disease mechanisms.

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Section: Discussionmentioning

confidence: 99%

Investigating lymphangiogenesis in vitro and in vivo using engineered human lymphatic vessel networks

Landau

Newman

Edri

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

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show abstract

“…With recent technical breakthroughs, supermicrosurgical lymphaticovenular anastomosis (LVA) is no longer limited to early lymphedema [1][2][3][4] . However, performing LVA in late disease is frequently challenging due to difficult lymphographic identification of the functioning lymph vessels.…”

Section: Introductionmentioning

confidence: 99%

Distal- to- proximal sequential ICG injection technique (DOPSIT) for lymphatic vessels mapping

Chen¹,

Pandey²

2023

Plast Aesthet Res

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Supermicrosurgical lymphaticovenular anastomosis (LVA) is the most sought-after procedure among lymphedema patients. However, the same enthusiasm is currently not shared among lymphedema surgeons due to the lackluster results of LVA. The common unfavorable experience with this famed procedure is at least partially caused by the difficulty in finding the lymph vessels. We share our time-tested indocyanine green-based lymph vessel mapping technique, which has helped us establish LVA as our procedure for all fluid-predominant lymphedema.

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Strategic Incision Placement to Facilitate Successful Supermicrosurgical Lymphaticovenular Anastomoses

Cited by 2 publications

References 12 publications

Investigating lymphangiogenesis in vitro and in vivo using engineered human lymphatic vessel networks

Investigating lymphangiogenesis in vitro and in vivo using engineered human lymphatic vessel networks

Distal- to- proximal sequential ICG injection technique (DOPSIT) for lymphatic vessels mapping

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