Study of lymph node vascular relationships of the inferior epigastric veins: The solve anatomical study

Summary Introduction Tissue surrounding the superficial inferior epigastric vein (SIEV) can be harvested for vascularised lymph node transfer (vLNT) for treatment of lymphoedema. The aim of this study is to define the anatomical relationship of lymph nodes surrounding the SIEV. Methods 25 fresh-frozen cadaveric groin specimens were harvested en-bloc to the level of the deep fascia along the following anatomical boundaries, yielding quadrilateral tissue blocks: pubic tubercle (medial), anterior superior iliac spine (lateral), 5cm superior and inferior to the inguinal ligament. The SIEV was marked at its entry point with the femoral vein. Specimens were orientated, secured and fixed in formaldehyde, and analysed utilizing longitudinal slices at 3mm intervals. Results A total of 86 lymph nodes were identified. The average position of lymph nodes examined were 0.4cm medial and 3.2cm inferior to the mid-inguinal point. Clinical Relevance An improved understanding of the anatomical locations of lymph nodes surrounding the SIEV will allow a more purposeful harvest during vLNT, allowing greater number of lymph nodes to be captured whilst limiting donor site morbidity.