Lymphedema surgery

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Editors-in-Chief: Benoit Blondeau, M.D. [1]; C. Michael Gibson, M.S., M.D. [2]

Surgical techniques

Surgical techniques for correcting lymphedema may be excisional or physiological. Excisional techniques include:

• Circumferential excision of the lymphedematous tissue followed by skin grafting (Charles technique); longitudinal removal of the affected segment of skin and subcutaneous tissue and primary closure (Homans technique); excision of subcutaneous tissue and tunneling of a dermal flap through the fascia into a muscular compartment of the leg (Thompson technique).

Physiological techniques include:

• Lympholymphatic anastomosis (autologous lymphatic grafts to bridge obstructed lymphatic segments); lymphovenous shunt (anastomosis of lymphatic channels to veins); lymphangioplasty enteromesenteric flap omental transfer (pedicled portion of omentum transposed to the affected limb).