Short correspondence: reverse lymphatic mapping without radioisotope in the surgical treatment of lymphedema

Lymphatic mapping of the extremity using lymphoscintigraphy incorporates injection of radioisotope (technetium) into the web space of the hand or foot to assess lymphatic transit and drainage pathways. Reverse lymphatic mapping (RLM), a technique originally described for selective axillary lymphadenectomy in cancer and subsequently adopted for vascularized lymph node transfer procedures, utilizes a dual tracer approach to delineate lymphatic drainage pathways from individual anatomic regions in order to reduce incidence of iatrogenic lymphedema (1-2).