Vascularized Lymph Node Transfer Surgery

Vascularized lymph node transfer (VLNT) surgery is a breakthrough in the treatment of arm and leg lymphedema. This technique replaces lost lymph nodes with healthy ones. When correctly employed as part of the Granzow SystemSM, VLNT can tremendously improve drainage of lymph from an affected area and decrease the need for compression garment use and lymphedema therapy.

Using precision microsurgery, Dr. Granzow transfers a small number of the patient’s healthy lymph nodes to the lymphedema-affected area to drain the affected limb. The lymph nodes’ blood supply is surgically reattached, and the lymph nodes begin to drain the excess lymphatic fluid. Dr. Granzow employs Reverse Lymphatic Mapping (see below) to avoid injury to the lymphatics at the donor site.

Using VLNT surgery, our patients have seen significant improvements in their symptoms, and some have been able to completely eliminate routine use of compression garments.

VLNT addresses the fluid component of lymphedema swelling and should be used for patients with Stage 0 or Stage 1 lymphedema.

Innovative Granzow 2-Phase ApproachSM

Dr. Granzow pioneered the Granzow 2-phaseSM use of VLNT and LVA surgery after Granzow SAPLSM surgery to both normalize the size of the affected arm or leg and also greatly reduce the need for lymphedema therapy or compression garment use.
Click here for success stories of patients treated using the Granzow 2-phase approachSM 

Understanding VLNT

Diagram of Female Torso In Blue Showing Green Circle On Leg With Arrow To Breast
Lymph nodes can also be moved from the groin to the axilla (armpit) to improve lymphedema symptoms in the arm, breast and torso.
Diagram of Female Torso In Blue Showing Green Arrow Pointing From Armpit to Leg
Lymph nodes can also be moved from the side of the torso to the groin area or leg to improve drainage in the leg.
Diagram of Female Torso Showing Pink Cut Line Along Belly

VLNT also can be performed in conjunction with a DIEP flap breast reconstruction. This allows for treatment of the arm lymphedema and the simultaneous creation of a natural appearing and soft breast in one surgery. Abdominal contouring, similar to a tummy tuck, is also achieved while sparing the abdominal musculature and maximizing function.

VLNT Safety Using Reverse Lymphatic Mapping

Reverse Lymphatic Mapping allows Dr. Granzow to map the lymph nodes that drain the arm or leg that is adjacent to the VLNT lymph node donor site. He then uses sophisticated imaging in the operating room during the VLNT surgery to identify and protect these important lymph nodes and minimize the risk of lymphedema at the donor site.

Nuclear medicine imaging allows identification of donor site lymphatics.

Intraoperative probe used to map vascularized lymph node transfer flap

Intraoperative imaging reveals 0 counts in VLNT flap, improving patient safety.

To learn more about how the Vascularized Lymph Node Transfer treatment can help you treat arm and leg lymphedema, contact our Center of Excellence today for a consultation.

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