Intra-Abdominal lymph nodes: A privileged donor site for vascularized lymph node transfer

A variety of donor options for vascularized lymph node transfer for the surgical treatment of lymphedema have been described. Intra-Abdominal harvest sites including the gastroepiploic nodes within the omental flap and the mesenteric node flap are distinguished from their extra-Abdominal counterparts by the absent risk of iatrogenic donor site lymphedema and discrete scar location, as well as the ability to harvest up to 3 vascularized nodal packets from 1 donor site. However, there are also potential morbidities including hernia and intra-Abdominal visceral injuries. Patient selection and flap harvest techniques are reviewed.