The August Research Roundtable welcomed Dhruv Singhal, MD, Director of Lymphatic Surgery at Beth Israel Deaconess Medical Center and Associate Professor of Surgery at Harvard Medical School, for an in-depth conversation about the rapidly evolving understanding of the lymphatic system.
Dr. Singhal joined Dr. Karen Herbst to explore why lymphatic anatomy remains far less understood than the arterial and venous systems, and how new research is helping clinicians identify the pathways the body may use to reroute lymphatic fluid after injury. The discussion examined the superficial and deep lymphatic systems, collateral drainage pathways, and the “double hit” hypothesis—the possibility that an initial disruption may leave a person dependent on alternative pathways that can later be compromised by surgery, radiation, injury, or other interventions.
The conversation also addressed lymphedema risk following lymph node removal and radiation, the importance of surveillance for patients at elevated risk, and ongoing efforts to prevent lymphedema through immediate lymphatic reconstruction. Dr. Singhal described how lymphatic mapping, volume measurements, bioimpedance, and long-term follow-up can support earlier identification of changes before symptoms become more advanced.
Additional topics included breast lymphedema and drainage, precautions involving blood draws and blood pressure cuffs, ICG-guided manual lymphatic drainage, the limitations of current lymphatic imaging, and the potential role of medications, wearables, pneumatic compression, and other emerging technologies.
Throughout the discussion, Dr. Singhal emphasized that lymphatic care is entering a new era of precision medicine—one in which prevention and treatment may increasingly be tailored to each patient’s individual anatomy and physiology. The Roundtable closed with a message of hope, reflecting the growing investment, collaboration, technology, and research transforming the future of lymphedema care.
This Roundtable was originally recorded live on August 3, 2026. The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of Lympha Press. The content is for educational purposes only and not intended as medical advice.
Watch more Roundtables from our Lympha Press Research Roundtables playlist on YouTube.