Fluorescence Mapping of Greater Omentum Lymphatic Flow and Changing the Concept of Lymphedema Surgical Treatment: A Novel Experimental Study

Abstract

Lymphedema is a debilitating condition caused by impaired lymphatic drainage. Surgical techniques like vascularized omental lymphatic transplant (VOLT) are used for treatment, but questions remain regarding optimal harvesting techniques. This study aimed to establish methods for in vivo imaging and quantification of lymphatic flow characteristics in the canine greater omentum to improve VOLT procedures. Martials and method: Twelve healthy adult dogs will be randomly divided into two groups (n=6 of each group) to assess lymphatic flow direction and velocity in the right and left gastroepiploic vessels using near-infrared indocyanine green (ICG) lymphangiography.Result: statistically significant differences were found in lymphatic flow towards the lower free omental border, with Group B demonstrating significantly higher flow (8.42 ± 0.23 cm/min) compared to Group A (6.47 ± 0.72 cm/min). No significant difference in lymphatic flow velocity was observed between groups along the upper gastric border (Group A: 4.22 ± 0.42 cm/min; Group B: 4.36 ± 0.14 cm/min) Also, the lymphatic flow directed to the left epiploic region in both groups. Conclusion: This research will contribute to a better understanding of lymphatic drainage patterns in the omentum, potentially leading to advancements in VOLT for lymphedema treatment.