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Surgical Strategy for Intractable Inguinal Lymphorrhea Using Combined Indocyanine Green Imaging and Negative Pressure
Airi Tsutsumi1, Yushi Suzuki1,2, Riho Takayanagi1,2
1From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
Plastic and Reconstructive Surgery. Global Open
|July 15, 2026
Summary
This study presents a minimally invasive technique using indocyanine green (ICG) fluorescence imaging and negative pressure wound therapy (NPWT) to effectively treat persistent inguinal lymphatic leakage after surgery.
Area of Science:
- Vascular Surgery
- Wound Healing
- Medical Imaging
Background:
- Refractory inguinal lymphatic leakage is a difficult complication following groin surgery.
- It can lead to prolonged healing, infection, and serious vascular issues.
Purpose of the Study:
- To establish a reliable, minimally invasive strategy for managing persistent lymphatic leakage.
- To combine indocyanine green (ICG) fluorescence imaging with negative pressure wound therapy (NPWT).
Main Methods:
- Four patients with refractory lymphatic leakage received treatment.
- Indocyanine green (ICG) was administered to visualize lymphatic pathways via near-infrared imaging.
- Negative pressure wound therapy (NPWT) was applied postoperatively.
Main Results:
- ICG fluorescence precisely identified leaking lymphatic vessels for ligation and cauterization.
- All four patients achieved complete wound healing.
- The mean duration for NPWT was 18 days and for epithelialization was 48 days, with no recurrence.
Conclusions:
- Combining ICG-guided lymphatic mapping and NPWT is a practical and effective strategy.
- This technique reliably identifies lymphatic leaks and promotes wound healing.
- It offers an innovative solution for complex postoperative lymphatic complications.
