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Skladman et al. Plast Aesthet Res 2023;10:66 Plastic and
DOI: 10.20517/2347-9264.2022.107
Aesthetic Research

Review Open Access

Vascularized omental tissue transfer for the
treatment of lymphedema: a review

Rachel Skladman, William R. Moritz, Elijah J. Tenenbaum, Joani M. Christensen, Justin M. Sacks
1
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63108, USA.
Correspondence to: Prof. Justin M. Sacks, Division of Plastic and Reconstructive Surgery, St. Louis School of Medicine
Department of Surgery, Washington University, Box 8238, 660 South Euclid Avenue, St. Louis, MO 63110, USA. E-mail:
jmsacks@wustl.edu
How to cite this article: Skladman R, Moritz WR, Tenenbaum EJ, Christensen JM, Sacks JM. Vascularized omental tissue transfer
for the treatment of lymphedema: a review. Plast Aesthet Res 2023;10:66. https://dx.doi.org/10.20517/2347-9264.2022.107

Received: 20 Sep 2022 First Decision: 29 Jan 2023 Revised: 13 Jun 2023 Accepted: 28 Sep 2023 Published: 30 Nov 2023

Academic Editor: Hiroo Suami Copy Editor: Dan Zhang Production Editor: Dan Zhang

Abstract
Lymphedema is a debilitating disorder caused by impaired drainage of the lymphatic system. In the Western world,
lymphedema most often arises secondary to the treatment of malignancy. Patients with lymphedema experience
progressive swelling, pain, numbness, and tingling, and decreased quality of life. Those with persistent symptoms
may be subject to chronic cellulitis. The advent of microsurgery has enabled clinicians to transplant donor lymph
nodes and their blood supply from a healthy site to the affected area in a procedure known as vascularized lymph
node transplant (VLNT). One donor region is the omentum. Vascularized omental lymph node transfer (VOLT) has
been shown to decrease limb volume, circumference, and subjective symptoms of lymphedema. The immunologic
properties of the omentum make it a particularly useful lymph node donor site for patients with lymphedema-
related cellulitis. The omentum may be harvested laparoscopically, with robotic assistance, or through a small
laparotomy incision. In this review, we describe the relevant anatomy and history of VOLT as well as operative
techniques. The risks, benefits, and relevant outcome studies will be reviewed. Recent applications of robotic
surgery to VOLT will be addressed.

Keywords: Lymphedema, VOLT, VLNT, laparoscopy, laparotomy, gastroepiploic vessels, cellulitis

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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