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Preparatory Intravascular Stenting Technique: An Easier Method of Supermicrosurgical Lymphaticovenular Anastomosis

Nuri, Takashi MD; Ueda, Koichi MD; Yamada, Akira MD; Hara, Mai MD

doi: 10.1097/SAP.0b013e3182551670
Microsurgery
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Recent supermicrosurgical techniques have made it possible to anastomose lymph vessels to the subdermal venular system. However, because the lymphatic fluid is clear and the vessel is translucent, soft, and fragile, with a thinner wall than blood vessels, supermicrosurgical lymphaticovenular anastomosis is a demanding technique. One difficulty of lymphaticovenular anastomosis is identification of the lumen to pass the suture into it. This report describes a preparatory intravascular stenting technique to identify the lumen and perform lymphaticovenular anastomosis accurately. In this technique, we placed 9-0 or 10-0 nylon thread into the lymphatic lumen before transecting the lymph vessel. The end of the nylon was pushed through to appear from the lymphatic lumen, then advanced into the vein to stabilize the 2 vessels. This technique allows supermicrosurgical lymphaticovenular anastomosis to be performed quickly and efficiently.

From the Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.

Received January 5, 2012, and accepted for publication, after revision, March 10, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Takashi Nuri, MD, Department of Plastic and Reconstructive Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686, Japan. E-mail: pla042@poh.osaka-med.ac.jp.

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© 2013 by Lippincott Williams & Wilkins