Micro-lymphatic bypass in the treatment of obstructive lymphoedema of the arm: case report of a new technique

A report is presented of a case of secondary lymphoedema of the upper limb successfully treated by microlymphatic bypass with a composite graft containing three lymphocollectors from the lower limb to bypass the ablated portion of the pathway. To ensure success the surgery must be carried out before the peripheral lymphatics have been damaged or destroyed by increasing pressure and recurrent infection. Pre-operative lymphangiography is mandatory to assess suitability for the bypass procedure. Other methods of treatment are reviewed.