Omental Transposition in the Control of Chronic Lymphedema

Chronic lymphedema of an extremity has persisted over the years as an unsolved surgical problem. The multiple operations that have been attempted for this condition indicate a continued search for an ideal procedure. Lymphedema appears to be the result of lymphatic flow obstruction in association with varying degrees of venous blockage.1Successful treatment of lymphedema would therefore require the introduction of new lymphatic and venous channels into an involved extremity in order to bypass the area of lymphatic and venous obstruction. A new one-stage operation has been devised whereby the omentum, with its rich lymphatic and vascular supply, is used to bridge discontinuity in the lymphatic system of a lymphedematous extremity. In order to test the technical feasibility of mobilizing the omentum for long distances, ten dogs had their omentum fashioned into a pedicle graft with preservation of the gastroepiploic arcade. The length of the omentum was extended so