Lambda-shaped anastomosis with intravascular stenting method for safe and effective lymphaticovenular anastomosis

Area of Science:

• Microsurgery
• Vascular Surgery
• Lymphedema Treatment

Background:

• Lymphaticovenular anastomosis (LVA) is a common treatment for lymphedema.
• Supermicrosurgical techniques are crucial for successful LVA.
• Increasing the number of LVAs correlates with improved therapeutic efficacy.

Purpose of the Study:

• To evaluate the efficacy of lambda-shaped anastomosis assisted by intravascular stenting for lower extremity lymphedema.
• To assess the impact of this technique on the number of lymphaticovenular anastomoses performed.

Main Methods:

• Retrospective assessment of 20 patients with lower extremity lymphedema undergoing LVA.
• Procedures performed under local anesthesia using 2-4 surgical microscopes.
• Application of lambda-shaped anastomosis with intravascular stenting in select cases.

Main Results:

• A total of 186 LVAs were performed (average 9.3 per patient).
• Lambda-shaped anastomosis resulted in a significantly higher number of anastomoses (10.2) compared to standard techniques (8.2).
• Average operation time was 4.1 hours using an average of 3.3 microscopes.

Conclusions:

• Lambda-shaped anastomosis with intravascular stenting is a safe and accessible supermicrosurgical technique.
• This method facilitates efficient, simultaneous LVAs by a surgical team.
• The technique leads to an increased number of bypasses, potentially improving lymphedema outcomes.