Lymphatic vessel transplantation is a direct approach to the lymphatic vascular system performing a bypass procedure like in other fields of vascular surgery. In lymphedemas due to a localized compromised lymphatic outflow, e.g., after a tumor therapy major, lymphatic collectors in front and behind the interruption are connected using the patient’s own lymphatic vessels, harvested from the ventromedial bundle at the thigh which contains up to 16 vessels. Long-term volume reduction up to normal sizes, significant improvement of the lymphatic outflow, measured by lymphatic scintigraphies, and the proof of patent lymphatic bypasses after more than 10 years by indirect lymphographies and MRI lymphangiographies have been achieved.