Baumeister, Rüdiger

Seifert, Jürgen

English

Universität München: Elektronischen Publikationen

Volume 14 No. 2 June 1981 Page 41-90 ΙΠ 
Lymphology 
Official Organ of the International Society of Lymphology 
Editors: 
A. E . Dumont, New York, N.Y. 
P. E . Peters, Köln 
Associate Editors: 
R. A. Castellino, Stanford, Calif. 
L . Clodius, Zuridi 
J . Davidson, Hamilton, Ont. 
A . Engeset, Oslo 
W . A. Fuchs, Berne 
0. Ishida, Osaka 
S. Kubik, Zurich 
J . Lauweryns, Leuven 
K. Lennert, Kiel 
R. C. Mayall, Rio de Janeiro 
B. Morris, Canberra 
W. Olszewski, Warsaw 
N. C . Staub, San Francisco 
G . Szabo, Budapest 
S. A. Threef'oot, Augusta, Ga. 
B. Tjernberg, Stockholm 
K. zum Winkel, Heidelberg 
Ch. L . Witte, Tucson, Ariz. 
Microsurgery of Lymphatic Vessels 
Edited by W.L. Olszewski 
With contributions by 
Olszewski, W.L.: 
Editorial 41 
Olszewski, W.L.: 
Physiology and Microsurgery of 
Lymphatic Vessels in Man 44 
Degni, M. : 
New Microsurgical Technique of 
Lymphatico-venous Anastomosis for the 
Treatment of Lymphedema 61 
Jamal, S.: 
Lymphovenous Anastomosis in Filarial 
Lymphedema 64 
Clodius, L . , N.B. Piller, J.R. Casley-Smith: 
The Problems of Lymphatic Microsurgery 
for Lymphedema 69 
Machleder, HJ., Η. Paulus: 
Maintenance of Long-term Thoracic Duct 
Fistulas for the Achievement of Immuno­
suppression in Man 77 
Perloff, L.J., CF. Barker: 
Alymphatic Pedicles 81 
Olszewski, W.L., T. Ryffa, St. Stepkowski, 
W. Ro win ski: 
Microsurgical Techniques for Transplanta-
taion of Organs Containing Lymphoid 
Tissue 86 
Baumeister, R.G.H., J. Siefen: 
Microsurgical Lymphvessel-transplanta-
tion for the Treatment of Lymphedema: 
Experimental and First Clinical Ex­
periences 90 
Georg Thieme Verlag Herdweg 63 P.O. Box 732 D-7000 Stuttgart 1 
90 
Short Communication Lymphoiogy 14 (1981) 90 
Microsurgical Lymphvessel-Transplantation for the Treatment of 
Lymphedema: Experimental and First Clinical Experiences 
Rüdiger G.H. Baumeister* and Jürgen Seifert** 
*Surgical Department 
** lnst . for Surgical Research, University of Munich, Klinikum Großhadern, 
D-8000 München 70, Marchioninistr. 15 
At the aid of the operating microscope it was 
possible to prepare lymphcollectors over a dis­
tance up to 25 cm. In order to perform the 
anastomoses we developed a tension free tech­
nique (1) using absorbable suture material 
(Polyglactin 910, size 10-12x0). The patency 
of 13 end to end anastomoses in rats was 
proved in all 13 anastomoses by histology and 
in 11 anastomoses by dye application. The 
mean observation time was 65 days. 
In 10 dogs an experimental lymphedema had 
been induced (Method of Clodius and Wirth 
(2)) with a total blockage of the deep and 
the superficial system. Without therapy the 
animals die after this operation within 3 
weeks. After the analogous lymphvesseltrans-
plantation the animals survived. The increased 
circumference of about 50 % of the affected 
legs was reduced to 10% within 7 weeks. 
When the transplants were removed, the cir­
cumferences reached values as before the 
transplantation. The intralymphatic "end-
pressure", which was 2.5 torr in controls, 
rose to 12.5 torr during the edematous phase 
and diminished to normal levels with 3.5 torr 
after the transplantation. 
In all 10 dogs the patency of at least one 
transplant could be demonstrated by histolo­
gy. In 8 out of 10 dogs the patency of the 
transplants could be proved by inspection, 
lymphography and isotope-injection 
In 3 patients, 2 women and one man we treat­
ed a secondary lymphedema at the arm and 
the lower leg by autologous lymphvesseltrans-
plantation. The circumferences diminished 
quickly after the operation. The improved 
lymphatic transport could be seen also by in­
jection of isotopes. The positive result has re­
mained unchanged over a period of one year 
now in the first patient. 
Autotologous lymphvesseltransplantation is 
effective for treating a secondary lymphedema 
due to a blockade in a distinct area at the root 
of an extremity. 
References 
1 Baumeister, R.G.M., J. Seifert, Β. Wiebecke: 
Transplantation of lymphvessels on rats as well 
as a first application on the experimental lymph-
edema of the dog. Eur. Surg. Res. 12 Suppl. 2, 
7, 1980 
2 Clodius L . , W. Wirth: A new experimental model 
for chronic Lymphedema of the Extremities. 
Chir. Plastica (Berl.) 2: 115, 1974 
J. Seifert, Inst, for Surgical Research, University of 
Munich, Klinikum Großhadern, D-8000 München 70, 
Marchioninistr. 15 
0024-7766/81 1400-0090 $02.00 © 1981 Georg Thieme Verlag Stuttgart · New York 


German

Microsurgical Lymphvessel-Transplantation for the Treatment of Lymphedema

Open Access LMU

Volume 14 No. 2 June 1981 Page 41-90 ΙΠ Lymphology Official Organ of the International Society of Lymphology Editors: A. E . Dumont, New York, N.Y. P. E . Peters, Köln Associate Editors: R. A. Castellino, Stanford, Calif. L . Clodius, Zuridi J . Davidson, Hamilton, Ont. A . Engeset, Oslo W . A. Fuchs, Berne 0. Ishida, Osaka S. Kubik, Zurich J . Lauweryns, Leuven K. Lennert, Kiel R. C. Mayall, Rio de Janeiro B. Morris, Canberra W. Olszewski, Warsaw N. C . Staub, San Francisco G . Szabo, Budapest S. A. Threef'oot, Augusta, Ga. B. Tjernberg, Stockholm K. zum Winkel, Heidelberg Ch. L . Witte, Tucson, Ariz. Microsurgery of Lymphatic Vessels Edited by W.L. Olszewski With contributions by Olszewski, W.L.: Editorial 41 Olszewski, W.L.: Physiology and Microsurgery of Lymphatic Vessels in Man 44 Degni, M. : New Microsurgical Technique of Lymphatico-venous Anastomosis for the Treatment of Lymphedema 61 Jamal, S.: Lymphovenous Anastomosis in Filarial Lymphedema 64 Clodius, L . , N.B. Piller, J.R. Casley-Smith: The Problems of Lymphatic Microsurgery for Lymphedema 69 Machleder, HJ., Η. Paulus: Maintenance of Long-term Thoracic Duct Fistulas for the Achievement of Immuno­suppression in Man 77 Perloff, L.J., CF. Barker: Alymphatic Pedicles 81 Olszewski, W.L., T. Ryffa, St. Stepkowski, W. Ro win ski: Microsurgical Techniques for Transplanta-taion of Organs Containing Lymphoid Tissue 86 Baumeister, R.G.H., J. Siefen: Microsurgical Lymphvessel-transplanta-tion for the Treatment of Lymphedema: Experimental and First Clinical Ex­periences 90 Georg Thieme Verlag Herdweg 63 P.O. Box 732 D-7000 Stuttgart 1 90 Short Communication Lymphoiogy 14 (1981) 90 Microsurgical Lymphvessel-Transplantation for the Treatment of Lymphedema: Experimental and First Clinical Experiences Rüdiger G.H. Baumeister* and Jürgen Seifert** *Surgical Department ** lnst . for Surgical Research, University of Munich, Klinikum Großhadern, D-8000 München 70, Marchioninistr. 15 At the aid of the operating microscope it was possible to prepare lymphcollectors over a dis­tance up to 25 cm. In order to perform the anastomoses we developed a tension free tech­nique (1) using absorbable suture material (Polyglactin 910, size 10-12x0). The patency of 13 end to end anastomoses in rats was proved in all 13 anastomoses by histology and in 11 anastomoses by dye application. The mean observation time was 65 days. In 10 dogs an experimental lymphedema had been induced (Method of Clodius and Wirth (2)) with a total blockage of the deep and the superficial system. Without therapy the animals die after this operation within 3 weeks. After the analogous lymphvesseltrans-plantation the animals survived. The increased circumference of about 50 % of the affected legs was reduced to 10% within 7 weeks. When the transplants were removed, the cir­cumferences reached values as before the transplantation. The intralymphatic "end-pressure", which was 2.5 torr in controls, rose to 12.5 torr during the edematous phase and diminished to normal levels with 3.5 torr after the transplantation. In all 10 dogs the patency of at least one transplant could be demonstrated by histolo­gy. In 8 out of 10 dogs the patency of the transplants could be proved by inspection, lymphography and isotope-injection In 3 patients, 2 women and one man we treat­ed a secondary lymphedema at the arm and the lower leg by autologous lymphvesseltrans-plantation. The circumferences diminished quickly after the operation. The improved lymphatic transport could be seen also by in­jection of isotopes. The positive result has re­mained unchanged over a period of one year now in the first patient. Autotologous lymphvesseltransplantation is effective for treating a secondary lymphedema due to a blockade in a distinct area at the root of an extremity. References 1 Baumeister, R.G.M., J. Seifert, Β. Wiebecke: Transplantation of lymphvessels on rats as well as a first application on the experimental lymph-edema of the dog. Eur. Surg. Res. 12 Suppl. 2, 7, 1980 2 Clodius L . , W. Wirth: A new experimental model for chronic Lymphedema of the Extremities. Chir. Plastica (Berl.) 2: 115, 1974 J. Seifert, Inst, for Surgical Research, University of Munich, Klinikum Großhadern, D-8000 München 70, Marchioninistr. 15 0024-7766/81 1400-0090 $02.00 © 1981 Georg Thieme Verlag Stuttgart · New York 

A new experimental model for chronic Lymphedema of the Extremities.

Wiebecke: Transplantation of lymphvessels on rats as well as a first application on the experimental lymphedema of the dog.

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Microsurgical Lymphvessel-Transplantation for the Treatment of Lymphedema

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