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Updated: May 22, 2026

Integrating Augmented Reality Tools in Breast Cancer Related Lymphedema Prognostication and Diagnosis
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Barcelona Consensus Paper on Reconstructive Lymphedema Surgery: A Delphi Study.

Jaume Masià1, Ali M Al Sakkaf2, Joon Pio Hong3

  • 1From the Department of Plastic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona.

Plastic and Reconstructive Surgery
|May 13, 2025
PubMed
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Expert consensus was reached on surgical management for lymphedema (lymphatic system fluid accumulation). Recommendations cover patient preparation, clinical assessment, preventive surgery, and follow-up to improve treatment outcomes.

Area of Science:

  • Lymphedema Surgery
  • Lymphatic System Research
  • Surgical Management

Background:

  • Lymphedema is a chronic condition caused by lymphatic system dysfunction.
  • Surgical intervention is a key therapeutic option for lymphedema.
  • Improving surgical management remains a clinical challenge.

Purpose of the Study:

  • To establish expert consensus on recommendations for enhancing lymphedema surgical management.
  • To provide evidence-based guidelines for surgeons and clinicians.

Main Methods:

  • International consensus study utilizing a modified nominal group and Delphi process.
  • Involved 5 experts in a nominal group and 31 international experts in a two-round Delphi process.
  • Consensus defined as ≥70% agreement among panelists.

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Main Results:

  • High consensus (79.6% agreement) achieved on seven preliminary recommendations.
  • Strongest agreement on reconstructive surgery techniques, lymphedema prevention, clinical assessment, and follow-up.
  • Recommendations finalized through expert evaluation and revision.

Conclusions:

  • Consensus highlights the importance of preoperative patient preparation and thorough clinical assessment.
  • Recommends preventive surgical procedures, combining reconstructive and reductive techniques.
  • Emphasizes multidisciplinary monitoring and follow-up, with a need for further implementation and outcome studies.