"Overlapping Lockup" Lymphaticovenous Anastomosis: A Useful Addition for Supermicrosurgeons.

BACKGROUND: Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. This surgical procedure anastomosing the superficial lymphatic vessels to nearby veins to establish lymphatic-venous pathways. One of the most common challenges encountered by lymphatic surgeons while carrying out a lymphaticovenous anastomosis is a mismatch in sizes of the vein and lymphatic vessels as well as effectiveness limited by technical constraints. We conducted a pilot study to evaluate the feasibility of a Overlapping Lockup anastomosis (OLA) LVA technique in addressing the above problems.

METHOD: In this sturdy, we present a novel OLA technique for LVA that addresses the challenges of conventional techniques, which was used in 10 lymphedema patients between September 2022 and March 2023, for OLA and E-E anastomosis. Time anastomosis, method anastomosis, and patency rates, and lymphedematous volume was evaluated in this study.

RESULTS: We performed 44 LVAs using the OLA technique out of 123 LVAs in ten patients, and ICG imaging revealed unobstructed drainage. There was a single case of slight fluid leakage, which was resolved by reinforcing the sutures. The average anastomosis time for OLA was 5.55 minutes, while the average anastomosis time for E-E was 12.1 minutes. The wounds of the patients healed without infection, and the subjective limb circumference decreased.

CONCLUSION: The OLA technique could serve as a valuable addition to the current LVA technique, especially for cases where there is a mismatch in sizes of the lymphatic vessels and venous. This technique has the potential to promote the broader application of LVA in the treatment and prevention of lymphedema.