Vascularized Lymph Node Transfer
Vascularized lymph node transfers can be extremely effective for the treatment of lymphedema of the arm and upper extremity. The technique replaces lymph nodes lost through surgery and/or radiation with healthy, functioning lymph nodes and tissues taken from elsewhere in the body.
Lymph nodes usually are harvested from the groin area with their supporting artery and vein and moved to the axilla (armpit). Using specialized microsurgical techniques, Dr. Granzow then reconnects the artery and vein to recipient blood vessels in the axilla to provide vital support to the lymph nodes during the initial healing phase.
The newly transferred lymph nodes heal and bridge the damaged tissue. They then serve as a new and permanent conduit or filter to remove the excess lymphatic fluid from the arm and return it to the body's natural circulation.
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Dr. Granzow in the operating room with Dr. Corinne Becker in Paris, France |
Vascularized lymph node transfer was first pioneered by Dr. Corinne Becker who has performed this type of procedure for many years in Paris, France.
Lymph node transfer from a donor site such as the groin carries the theoretical risk of new lymphedema in or around that site or leg. Dr. Granzow has had no patients get worse from their procedure or have a new lymphedema. All patients to date have had a moderate to significant improvement in their symptoms with this technique.
Most often the lymph node transfer is performed in conjunction with a DIEP flap breast reconstruction. This allows for treatment of the arm lymphedema and the simultaneous creation of a natural appearing and soft breast in one surgery.
The lymph node transfer begins to remove the excess lymphatic fluid to return form and function to the arm. The DIEP flap provides tissue for the reconstruction of a shapely breast reconstruction combined with the abdominal contouring very similar to a tummy tuck.
For this technique to be successful, the swelling in the extremity must be composed of mostly lymphatic fluid. Individuals with deposition of solid in the form of fat or protein require lymphatic liposuction to reduce the size of the limb
In some cases, the lymph nodes independently may be transferred together with only their supporting artery and vein but without the associated abdominal skin and fat for breast reconstruction.
Lymph nodes and healthy tissue from the groin can be transferred together with abdominal skin and fat both to treat the lymphedema of the arm and also create the natural look and feel of a breast with a DIEP flap.
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