{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:31:36Z","timestamp":1780385496471,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T00:00:00Z","timestamp":1571961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lymphedema surgery was not widely known in Austria before the introduction of lymphovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) in 2014. This study shares the experience and process of establishing and institutionalizing lymphedema surgery service in Austria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The purpose of introducing reconstructive lymphedema surgery in Austria was to improve lymphedema patients\u2019 quality of life and provide them surgical therapy as an adjuvant treatment to complete decongestive therapy. To initialize reconstructive lymphedema surgery in Austria, LVA and VLNT had to be presented and introduced, in the manner of branding and advertizing a new product. Surgeries were performed with quality control by standardized documentation, pre\u2010 and postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Aligned with branding and marketing, presentations were given externally and internally to share knowledge and experience of lymphedema surgery. Lymphedema surgery service was introduced as a new brand in the medical service in Austria. After several communications with the Austrian Health Insurance Fund and with the final application, LVA and VLNT were listed as novel surgical therapies in its 2020 reimbursement catalog. Since 2014, more than 300 lymphedema patients were consulted, and 102 reconstructive lymphedema surgeries were performed. Circumference reduction of extremities after surgery was between 20% and 43%, postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acceptance of surgery in lymphedema patients varies among continents, hospitals, and surgeons. Evaluation of the requirement of the surgical setup and insurance conditions for lymphedema surgery is essential to establish lymphedema surgery, providing targeted marketing and branding to spread knowledge of the novel technique and grant patients access to therapeutic treatment of their chronic disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25740","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T07:09:16Z","timestamp":1571987356000},"page":"91-99","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Institutionalization of reconstructive lymphedema surgery in Austria\u2014Single center experience"],"prefix":"10.1002","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-801X","authenticated-orcid":false,"given":"Chieh\u2010Han John","family":"Tzou","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Surgery Hospital of Divine Savior  Vienna Austria"},{"name":"Faculty of Medicine Sigmund Freud University  Vienna Austria"},{"name":"Lymphedema Center Vienna Tzou Medical  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Steinbacher","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Surgery Hospital of Divine Savior  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5118-4696","authenticated-orcid":false,"given":"Manon","family":"Czedik\u2010Eysenberg","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Surgery Hospital of Divine Savior  Vienna Austria"},{"name":"Department of Surgery Hospital of Divine Savior  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Brandstaetter","sequence":"additional","affiliation":[{"name":"Institute for Physical Medicine and Rehabilitation, Hanusch Hospital Vienna Regional Health Insurance Fund (Wiener Gebietskrankenkasse\u2010WGKK)  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiology KFJ Hospital  Vienna Austria"},{"name":"Center for Anatomy and Cell Biology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schuetz","sequence":"additional","affiliation":[{"name":"Institute of Radiology and Nuclear Medicine, Hanusch Hospital Vienna Regional Health Insurance Fund (Wiener Gebietskrankenkasse\u2010WGKK)  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Macho","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Hospital of Divine Savior  Vienna 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Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-9704","authenticated-orcid":false,"given":"Joon Pio","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Asan Medical Center University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,25]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Foeldi's Textbook of Lymphology: For Physicians and Lymphedema Therapists","author":"Foeldi M","year":"2012"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-03470-8.00096-X"},{"key":"e_1_2_8_4_1","unstructured":"Gesundheit.gv.at 2019 Austrian Ministry of Health InVienna"},{"key":"e_1_2_8_5_1","first-page":"1","article-title":"The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of 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