title: Upper-limb lymphedema treated aesthetically with lymphaticovenous anastomosis using indocyanine green lymphography and noncontact vein visualization.
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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Todokoro
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Murai
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D001943:Breast Neoplasms / Q000150:complications; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D007259:Infrared Rays; D007834:Lasers; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology / Q000601:surgery*; D008220:Lymphography / Q000379:methods*; D008875:Middle Aged; D034941:Upper Extremity / Q000601:surgery*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green