Surgery Today

, Volume 44, Issue 6, pp 1184–1187 | Cite as

A new operative strategy for refractory microcystic lymphangioma

  • Shigeru Ono
  • Yuki Tsuji
  • Katsuhisa Baba
  • Yoshiko Usui
  • Satohiko Yanagisawa
  • Kosaku Maeda
How to Do It


The optimal management of microcystic lymphatic malformations (LMs) in children has not been established. We describe how we used the Ligasure™ Vessel Sealing System (LVSS) to achieve partial resection of refractory microcystic LMs in a 1-year-old boy. The child was admitted in respiratory distress caused by infection and swelling of cervical LMs. The LMs had been diagnosed prenatally, but had not decreased in size despite three treatments with OK-432 sclerotherapy. We performed direct dissection of the microcystic LMs using the LVSS with minimal intraoperative blood loss or lymphatic leakage. The LMs were resected as completely as possible without damage to the jugular vein or major nerves. His postoperative course was uneventful. Histological examination revealed complete sealing of the lymphovascular channels with obliterated lumens. Resection using the LVSS is effective and easy to perform for partial resection of microcystic LMs. We recommend the combination of initial OK-432 injection therapy and subsequent partial resection using the LVSS for refractory microcystic LMs.


Lymphatic malformations Ligasure Vessel sealing system 


Conflict of interest

We have no conflicts of interest to declare.


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Shigeru Ono
    • 1
  • Yuki Tsuji
    • 1
  • Katsuhisa Baba
    • 1
  • Yoshiko Usui
    • 1
  • Satohiko Yanagisawa
    • 1
  • Kosaku Maeda
    • 1
  1. 1.Division of Pediatric Surgery, Department of SurgeryJichi Medical University School of MedicineShimotsuke-CityJapan

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