Lymphovenous anastomosis (LVA) is a highly specialized technique in modern lymphatic surgery. In this procedure, tiny lymphatic vessels with impaired drainage are meticulously connected to small superficial veins using advanced microsurgical methods.

This connection creates a new pathway for lymphatic fluid, allowing it to drain directly into the venous system. As a result, swelling in the affected area can be significantly reduced, and symptoms can be sustainably improved.

The Procedure

Because the target veins are located just beneath the skin, only very small incisions of approximately 1–3 cm are required. In selected cases, the procedure can also be performed under local anesthesia.

The lymphatic vessels involved are extremely delicate, measuring only 0.3 to 0.8 mm in diameter, and are barely visible to the naked eye. Performing this procedure requires exceptional microsurgical precision, specialized instruments, and ultra-fine sutures.

Diagnostics

Visualizing these fine lymphatic vessels has long been a major challenge. Today, advanced imaging techniques allow for significantly improved diagnostics.

Using an infrared camera system with ICG – indigo cyanic green, lymphatic vessels can be visualized in real time without exposing the patient to radiation.

In case of lower extremity lymphedema we always perform a functional MR-lymphography in collaboration with Prof.Pieper at the University Hospital in Bonn or in a private setting in Düsseldorf.

Indications and Outcomes

The best results are achieved in patients with early-stage lymphedema, when the condition is still at least partially reversible. (stage 2)

Conservative treatments such as regular manual lymphatic drainage and consistent use of compression garments can slow disease progression. At the same time, they help preserve lymphatic vessel function and extend the window during which LVA can be performed successfully.

Risks

Due to its minimally invasive nature and very small incisions, the overall surgical risk is low.

Patients with impaired lymphatic drainage generally have an increased susceptibility to infections. However, as the procedure is performed under strictly sterile conditions and with antibiotic prophylaxis, the risk of complications remains minimal.

Individual Consultation

A personal consultation is essential to determine whether lymphovenous anastomosis is the right treatment option for you. Based on your individual condition, we will develop a tailored treatment plan to achieve the best possible outcome.