We have been interested in the surgical therapy of various types of lymphedema for the last 20 years and have operated on more than 150 patients with this disease. It is both epidemic and endemic. More recently we have described and discussed an operation for lymphedema of the lower extremities which, in most patients, has proved quite satisfactory.1-4 Lymphedema of the upper extremity, because of its location, the obvious necessity for the use of the hands, and because of the extent of the physical and psychic damage this condition causes, poses a special surgical problem. Owing to the time factor, no history or details of previous therapy on lymphedema is included in this discussion.
The lymph system originates, like the vascular system, by a transformation from venous endothelium into paired tubes or sacs which fuse into the jugular and iliac lymph channels from the jugular and iliac veins.