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J Reconstr Microsurg 2012; 28(05): 327-332
DOI: 10.1055/s-0032-1311691
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Upper-Limb Lymphedema Treated Aesthetically with Lymphaticovenous Anastomosis using Indocyanine Green Lymphography and Noncontact Vein Visualization

Makoto Mihara
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
2   Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
*   These authors contributed equally to this work.
,
Hisako Hara
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
*   These authors contributed equally to this work.
,
Yohei Hayashi
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Takuya Iida
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Jun Araki
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Takumi Yamamoto
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Takeshi Todokoro
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Mitsunaga Narushima
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
,
Noriyuki Murai
2   Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
,
Isao Koshima
1   Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

23 September 2011

22 December 2011

Publication Date:
19 April 2012 (online)

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Abstract

We have described a procedure to minimize surgical wounds, in which lymph vessels and skin venules are identified by indocyanine green (ICG) lymphography and the AV300 noncontact visualization system (AccuVein, Cold Spring Harbor, NY), respectively. This approach allows accurate decisions regarding sites of incision for lymphatic venous anastomosis (LVA). This method was applied in a patient with right upper-limb lymphedema after breast cancer therapy. The low-invasive procedure can be used before and during surgery. The incision size is minimal, and the incision site is at the joint area. Thus, we aim to establish this approach as a standard method for identifying lymph vessels and veins that are suitable for LVA. This innovative vascular-imaging machine makes LVA less invasive and more effective without side effects.

Keywords

LVA - lymphatic-venous anastomosis - upper-limb lymphedema - AccuVein - ICG fluorescent lymphography - noncontact vein visualization machine
 

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