Surgical resection of the right lower extremity in an adult with severe lymph-edema of the extremity required intensive coordination of multiple services and specialists because of the medical and surgical complexity of the patient’s condition, massive limb size, and surgical location in a children’s hospital. Early and prolonged planning was necessary to anticipate problems and provide optimal care. The patient had a successful surgical outcome, improvement in medical comorbid conditions postoperatively, and improvement in the quality of life upon discharge. This coordinated effort will be used in the future as a template for patients with complex conditions whose care requires lengthy planning and involves multiple services and specialists.

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