Reverse Lymphatic Mapping
Dr. Mark Smith and his colleague Dr. Joseph Dayan were the first to describe the use of reverse lymphatic mapping in vascularized lymph node transfer. One of the major concerns regarding lymph node transfer is the risk of causing lymphedema at the site where lymph nodes are removed. These lymph nodes are typically harvested from the groin or under the arm. Some of these lymph nodes drain the limb while others drain lymph from the trunk, but anatomy and drainage patterns can vary. Reverse lymphatic mapping involves injected separate dyes into the limb and the trunk which allow us to differentiate lymph nodes draining the limb which must be avoided, from lymph nodes draining the trunk which can be safely removed. This technique allows for precise lymph node harvest specific to each individual's anatomy without sacrificing critical lymph nodes that may cause lymphedema in the limb.