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Updated: Aug 27, 2025

A Revised Method for Inducing Secondary Lymphedema in the Hindlimb of Mice

A Revised Method for Inducing Secondary Lymphedema in the Hindlimb of Mice

Published on: November 2, 2019

Super-microsurgery technique for lymphaticovenular anastomosis.

Satoshi Onoda¹, Toshihiko Satake¹, Erika Hamada²

¹Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan.

Journal of Vascular Surgery. Venous and Lymphatic Disorders

|October 1, 2022

Summary

This study presents a safe, quick, and accurate super-microsurgery technique for lymphaticovenular anastomosis (LVA). The described method improves outcomes for lymphedema patients by ensuring precise vessel connection and long-term patency.

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Area of Science:

Vascular Surgery
Microsurgery
Lymphedema Treatment

Background:

Super-microsurgery, including lymphaticovenular anastomosis (LVA), presents challenges due to small vessel diameters and difficulty in managing surgical instruments.
Confirming postoperative anastomosis success and learning LVA techniques are difficult compared to standard free-flap transfers.

Purpose of the Study:

To describe a safe, quick, and accurate technique for lymphaticovenular anastomosis (LVA).
To provide guidance for improving outcomes in patients with lymphedema through a sophisticated LVA method.

Main Methods:

Preoperative marking of lymphatic vessels and veins using indocyanine green fluorescence angiography and a vein viewer.
Utilizing super-microsurgical titanium needles and scissors for end-to-end anastomosis.

Keywords:

Lymphaticovenular anastomosis Super-microsurgery Surgical procedure

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Employing the involved stitch technique for anastomosis to avoid damaging vessel walls, with specific steps for anterior and posterior wall suturing.

Main Results:

The described technique allows for precise dissection and anastomosis of small lymphatic vessels and veins.
The involved stitch technique is highlighted as a safer alternative to forceps countertraction for lymphatic vessel anastomosis.
Successful application of the technique in several hundred cases at the institution.

Conclusions:

Key points and precautions for performing LVA quickly, accurately, and maintaining long-term patency have been reported.
This sophisticated LVA technique offers a valuable approach to improve patient outcomes in lymphedema management.