Vascularized
Lymph Node Transfer (VLNT)

It is believed that the only effective solution for lymphedema patients with removed lymph nodes is a vascularized lymph node transplant. That’s false. This procedure is only indicated for those with 2nd to 4th stages of the disease when the lymphatic system is severely damaged. In the first two stages, we always start treatment with anastomosis.

If lymphovenous anastomosis cannot be performed, we proceed to lymph node transplantation. The core of the procedure is to transplant a tissue complex, including nodes and lymph vessels, from the patient’s donor area (usually inguinal) to the area affected by lymphedema. An important question is whether there will be edema in the donor leg. There won’t. Lymphography can help in preventing that if an experienced doctor correctly selects the donor lymph nodes. It is known that there is a superficial group of inguinal lymph nodes that normally serves as a backup and doesn’t take part in leg drainage. Using this group as donor tissue minimizes the risk of edema.

It is performed under general anesthesia. It lasts 3-3.5 hours. The day after surgery, patients can move freely around the clinic without any significant discomfort. Discharge is possible on the third day after surgery The noticeable effect becomes evident 6 to 10 months after the surgery. The effectiveness of the procedure strongly depends on various factors, including the duration of edema and the severity of tissue damage after radiation therapy.