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Updated: Jun 25, 2025

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Nylon Suture Loop for Tagging Lymphatic Channels during Lymphaticovenular Anastomosis.

Grace Hui-Min Tan1, Jiajun Feng1, Yee Onn Kok1

  • 1Plastic, Reconstructive and Aesthetic Surgery Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India
|May 22, 2024
PubMed
Summary

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A new supermicrosurgery technique uses a nylon suture and micro-ligaclip to tag lymphatic vessels during lymphaticovenular anastomosis (LVA). This method aids in precise lymphatic identification and improves surgical success rates.

Area of Science:

  • Vascular Surgery
  • Supermicrosurgery
  • Lymphatic System Research

Background:

  • Lymphaticovenular anastomosis (LVA) is a supermicrosurgical procedure for lymphatic disorders.
  • Handling delicate lymphatic vessels (<0.8 mm) during LVA preparation is challenging, risking injury or fracture.
  • Current methods lack optimal techniques for securing and identifying small lymphatic vessels.

Purpose of the Study:

  • To introduce a novel tagging technique for lymphatic vessels during LVA.
  • To enhance the ease and safety of lymphatic vessel manipulation in supermicrosurgery.
  • To improve the success rate of lymphaticovenular anastomosis procedures.

Main Methods:

  • A new technique involving a nylon 6-0 suture and a micro-ligaclip was developed for tagging lymphatic vessels.
Keywords:
lymphaticovenous anastomosislymphaticovenular anastomosismicro-ligaclipsupermicrosurgeryvessel loop

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  • This "vessel loop" method facilitates secure handling and clear identification of target lymphatics.
  • The technique was applied in a series of LVA procedures.
  • Main Results:

    • The novel tagging technique was successfully employed in 78 lymphaticovenular anastomoses across 26 cases.
    • The average diameter of the lymphatic vessels treated was 0.3 mm, ranging from 0.15 mm to 0.8 mm.
    • The method proved effective in identifying and facilitating anastomosis with small lymphatic channels.

    Conclusions:

    • This nylon suture and micro-ligaclip tagging technique for lymphatic vessels is novel and previously undescribed.
    • The technique provides a significant benefit for lymphatic identification and handling in LVA.
    • It contributes to increased success rates in performing lymphaticovenular anastomosis.