ABSTRACT
The key for lymphatic grafting lay in the development of microsurgery, which made it possible to handle the small vessels accurately, using refined equipment and high magnification operating microscopes. After extended experimental studies, microsurgical autologous grafting of lymphatic vessels was first performed on patients in 1980. Lymphedemas due to a local interruption of the lymphatic system are the main indication for lymph-vessel grafting. These secondary lymphedemas are mostly due to surgical procedures and occur often after additional radiation therapy. In the case of an edema of the arm, lymphatic vessels are searched for at the medial aspect of the upper arm in order to create the peripheral end to end anastomoses with the grafts. The mean interval between mastectomy and lymphatic grafting was 10 years, ranging from 17 months to 20 years. The mean interval between onset of edema and lymphatic grafting was 8 years, ranging from 12 months to 20 years.
