Recipient Vessels for Vascularized Lymph Node Transplant

Vascularized lymph node transplant (VLNT) can be performed at the proximal and/or distal level of the affected extremity. VLNT in the axilla or groin helps to release the scars secondary to lymphadenectomy, bridges the lymphatic defect, and provides better cosmesis. It is hypothesized that the lymph node flap works by absorbing and shunting the excess lymph fluid. Placing lymphoid tissue at a distal level (e.g., wrist, ankle) may facilitate absorptive action by increasing the pressure gradient. Good results have been achieved with both distal and proximal transplantation. There is no study until to date which shows the superiority of one approach to another. In this chapter, we explain the anatomy and dissection of all commonly used recipient vessels for vascularized lymph node transplantation.