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Size adjustment suture technique for lymphaticovenular anastomosis
Satoshi Onoda1, Kahori Tsukura2, Toshihiko Satake2
1Department of Plastic and Reconstructive, Aesthetic Surgery, Toyama University Hospital, Toyama, Japan. satoshiprs18@gmail.com.
Journal of Plastic Surgery and Hand Surgery
|December 22, 2023
Summary
This super microsurgical technique allows precise connection of small lymphatic vessels to larger veins in lymphaticovenous anastomosis (LVA). The method ensures long-term vessel patency and minimizes leakage, proving useful for LVA surgery.
Area of Science:
- Microsurgery
- Vascular Surgery
- Lymphedema Treatment
Background:
- Connecting lymphatic vessels to veins (lymphaticovenous anastomosis or LVA) is crucial for lymphedema treatment.
- A common challenge in LVA is the significant difference in caliber between the small lymphatic vessels and larger veins.
Purpose of the Study:
- To describe a super microsurgical technique for effective anastomosis between small lymphatic vessels and larger veins.
- To evaluate the efficacy of a suture size adjustment technique in managing caliber discrepancies during LVA.
Main Methods:
- The suture size adjustment technique was applied to 30 lymphaticovenous anastomoses where lymph ducts were at least half the diameter of the veins.
- Parameters analyzed included lymphedema type, vessel calibers, caliber ratios, vein wall thickness, and anastomosis time.
Main Results:
- The study involved vessels with average diameters of 0.61 mm (lymphatic) and 1.43 mm (vein), with a mean caliber ratio of 2.3.
- The average anastomosis time was 9.1 minutes, and no additional procedures were needed due to leakage.
- The technique successfully managed the caliber difference, maintaining long-term patency and suppressing leakage.
Conclusions:
- The described super microsurgical technique effectively addresses the challenge of caliber mismatch in lymphaticovenous anastomosis.
- This method offers a valuable therapeutic option for LVA surgery, particularly when dealing with commonly encountered size differences between lymphatic vessels and veins.
