The majority of the clinical conditions that are considered to be primary lymphedema are due to truncular lymphatic malformations that arise during the final stages of the lymphangiogenesis when there is the formation of the lymphatic trunks, vessels, and nodes. These malformations result in hypoplasia, hyperplasia, or aplasia of the lymphatic vessels and/or the lymph nodes and may clinically
... [Show full abstract] manifest as obstruction or dilatation. When the malformations result in the absence or defectiveness of the endoluminal valves, reflux of lymph is the main clinical manifestation; e.g. primary lymphedema. Lymphatic microsurgery represents a means to restore lymphatic drainage in lymphedema by bypassing the obstruction in the lymphatic pathway and directing the flow of lymph into the veins (MLVA) or, in the case of an associated venous pathology, by using an autologous vein graft to bridge the gap in the lymphatic collectors around the obstruction (MLVLA). Lymphatic microsurgery offers excellent outcomes when applied early in the disease process where a complete resumption of lymphatic flow in the long-term is possible.