Lymphaticovenous anastomosis
Lymphaticovenous anastomosis is a supermicrosurgical procedure used to treat chronic lymphatic edema of the hand resulting from trauma, surgery, or postmastectomy syndrome. During the procedure, lymphatic vessels in the back or palm of the hand are connected to venules that drain excess lymph directly into the venous system. This reduces edema severity and slows lymphedema progression.
Before the procedure, an examination of the lymphatic system is performed (e.g., ICG lymphography). Prior to the examination, any swelling in the limb should be reduced as much as possible using nonsurgical treatment methods. ICG lymphography is contraindicated in cases of iodine allergy. Custom-made compression garments for the hand and forearm must also be prepared in advance.
The procedure is performed under local anesthesia and takes two to three hours. Lymphatic vessels and venules are isolated through micro-access points (less than 2 cm). These vessels are then connected with ultra-thin monofilament sutures using an advanced surgical microscope. The number of anastomoses on one hand can range from two to six, depending on the patient's anatomical features and the stage of the disease.
The procedure requires an advanced microscope, ultra-thin smooth sutures, and super-microsurgical instruments.
After surgery, patients are monitored for two hours. If their condition is stable, they are discharged home. A custom-made compression garment is fitted immediately after surgery. It is important to follow all medical recommendations during the rehabilitation period.
Benefits
Minimally invasive
Performed under local anesthesia on an outpatient basis
Highly accurate
Uses microinstruments and a microscope with up to 40x magnification
Quick recovery
The patient returns to their normal life within 2 hours, with minimal risk of complications
Compatible with other methods
Can be combined with subsequent lymph node transfer or liposuction in cases of progressive lymphedema
Врачи
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Plastic surgeon, reconstructive surgeon, microsurgeon. Member of the Association of Lymphologists of Russia.
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