Autotransplantation of lymphatic vessels.

SIR,-No treatment is available for tackling the underlying cause of secondary lymphoedema due to dissection of the lymphatic pathway at a specific site.’ A bypass within the lymphatic system seems the most promising way to eliminate the cause for swollen legs in the early stages of the disease, but materials other than lymphatic collectors cannot maintain an adequate lymph flow over a long period. Microsurgical techniques permit transplantation of the lymphatics. In rats and dogs we demonstrated long term function of transplanted lymph vessels, and experimental lymphoedema in dogs was effectively treated in this way. We have now done a lymphatic autotransplantation in a 38-yearold patient with secondary lymphoedema ofthe right leg caused by a groin injury. Conservative therapy had not been successful. Superficial lymph collectors 25 cm long from the left thigh were transposed to the right side via the symphysis. End-to-end