Topic: Recent Advances in Microsurgery for Lymphedema

It’s said that the treatment of lymphedema is mainly conservative therapy and that the surgical therapy that has been performed so far should not be performed. Even now, that tendency is still strong for physiotherapists. However, conservative therapy cannot be expected to cure it completely, and daily compression therapy in the hot summer is a heavy burden on patients. It is physically and mentally unbearable to continue this for a lifetime, and patients have high expectations for surgical treatment. The ultimate goal of treatment for lymphedema is to break away from compression therapy, cure it, and prevent it. Since 1996, dysfunction of lymphatic vessels in lymphedema has been revealed by us, and minimally invasive lymphvenular anastomosis using a newly developed supermicrosurgery has been developed. Then, the latest surgical techniques such as vascularized functional lymph channel and node transfers are being improved and developed for the relief of patients. It has become common knowledge that surgical treatment can not only alleviate edema but also completely cure it even in severe cases, and it has become possible to prevent edema. This technique was developed and reported by the author, and workshops (live demonstrations) have been held all over the world in the past 25 years, making it quickly spread to the world. It was first introduced in Singapore, Barcelona, and other countries. After that, the fluorescence lymphangiography developed in Japan in 2007 made it possible to easily confirm the location of lymphatic vessels and the remaining drainage function. Regarding the recent amazing topic, we continue to report the angiosarcoma arising in the affected limb (Stewart-Treves syndrome) disappears by previous or immediate LVA. Other groups also have succeeded in curing huge congenital lymphatic malformations with intraabdominal bypass surgery.With the rapid progress of such surgical treatment methods, the number of requests for information from patient groups, various academic societies (vascular society, lymphatic society, gynecological society, etc.) and the media is increasing. There is a feeling that it has become the most recent significant topic in the field of plastic reconstructive surgery.In this Special Issue, outstanding lymphatic surgeons will contribute to share their valuable experience in the treatment of lymphatic diseases, which is advancing rapidly. This Special Issue can be considered to be the most advanced in the world at the moment. Due to the corona illness since March 2020, the training workshops on surgical techniques have been stopped. On the contrary, online webinar seminars are held frequently, and it is becoming a new and more effective seminar method. I am convinced and hope that this corona sickness will become a chance in the future and that lymphatic surgery treatment will spread worldwide in a short period of time.

15 Apr 2021