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Laparoscopic Gastroepiploic Lymphovascular Pedicle Harvesting for the Treatment of Extremity Lymphedema: a Novel Technique

Michael E Johnston, MS, Juan Socas, MD, JoAnne L Hunter, MD, Eugene Ceppa, MD. Indiana University School of Medicine

Purpose: Vascularized lymph node transfers (VLNT) have multiple donor sites with risk of iatrogenic lymphedema. We sought to describe in detail a surgical technique that is safe, reproducible, and efficient in harvesting gastroepiploic vascularized lymph nodes (GE-VLN) using real-time indocyanine green (ICG) fluorescent imaging.

Methods: Photographs and video were acquired from a case to depict a step-by-step approach.

Results: ICG was endoscopically injected into the submucosa of the greater curvature of the stomach at the onset of the procedure. A laparoscopic harvest of the gastroepiploic vascular pedicle and lymph nodes ensued with the assistance of fluorescent imaging.

Conclusions: Laparoscopic gastroepiploic lymph node harvesting aided by real-time ICG fluorescent mapping technique is safe, feasible, and effective at gathering vascularized lymphatic tissue for successful lymph node transfer in patients with severe lymphedema.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79344

Program Number: V215

Presentation Session: Video Loop

Presentation Type: VideoLoop

56

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