Lymphedema Surgery
Vascularized Lymph Node Transfer

Vascularized lymph node transfer is one of the methods used in the surgical treatment of lymphedema (arm swelling). The procedure involves replacing lymph nodes damaged or removed by previous breast cancer treatment with healthy lymph nodes from another part of the body. This can help restore the lymphatic drainage of the arm and can improve arm lymphedema. 

Now vs Later
How Vascularized Lymph Node Transfer Is Performed

Lymph nodes can be transplanted to the axilla (armpit) at the same time as breast reconstruction with a DIEP flap, or as a stand-alone procedure. Lymph nodes transplanted with a DIEP flap are typically found along the superficial epigastric vein. Groundbreaking work performed at PRMA has also identified nodes along the Deep Inferior Epigastric blood vessels (the same blood vessels that are used in the DIEP flap procedure). Lymph nodes transferred as a stand-alone block of tissue can be harvested from different parts of the body but are most commonly taken from the superficial groin area, using great care to preserve the nodes that drain the leg. Lymph node groups are found along the circumflex iliac vessels or branches off the femoral vessels. The lymph node group is transplanted to the arm. The blood supply to the transplanted lymph nodes is connected to blood vessels in either the wrist, antecubital area (inner elbow), or more commonly the axilla (underarm).

Both methods can permanently reduce or even eliminate lymphedema in some cases. Currently, PRMA offers the procedure in conjunction with DIEP flap reconstruction or as a stand alone procedure.

Vascularized lymph node transfer will only be considered for patients who have already maximized control of their lymphedema through therapy. Patients must also return to lymphedema therapy after vascularized lymph node transfer to ensure the best results.

It is important for patients to know not all insurance providers cover this procedure and patients may be responsible for all surgeon, hospital and anesthesia fees. At PRMA, we verify insurance coverage and obtain authorization prior to surgery so patients can be informed of their cost estimates up front. For easy financing options, Care Credit is available.

Vascularized Lymph Node Transfer, Lymphedema, microsurgery

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