right lower limb before and after LVA (lympho-venous bypass/lymphatico-venous anastomosis)-significant reduction post surgery with patient not wearing compressive garments

Modern technology allows high power magnification with super microscope (42x) to perform connection (anastomosis) between less than 0.8mm size lymphatic pathways and nearby small veins (LVA bypass procedure). Only 2 of these super-microscopes exist in UK, one of them being used by mr Kosutic and his team for lymphatic reconstructions in lymphoedema patients.

Improve the quality of life

Early-stage lymphedema, especially involving upper limb, can be successfully treated with Lympho-Venous Anastomosis (LVA). Technique introduced by Koshima in 1996, also known as super-microsurgery, involves connecting lymphatic vessels less then 0.8mm in diameter to small superficial veins under the skin. Procedure, which can be performed as a day-case, requires a high-resolution microscope, super-fine microsurgical instruments and sutures as well as super-microsurgical skills. Mr Kosutic has been trained in this technique by prof. Cheng, a pioneer in microsurgical treatment for Lymphoedema from Taiwan as well as prof. Masia from Barcelona. Procedure, performed through a 2-3cm small skin incision leaves minimal scars and can reduce the volume of Lymphoedema affected extremity up to 61% in patients with early onset and early stage lymphedema.

LVA supermicrosurgery performed through small incisions – minimal scar




lympho-venous anastomosis

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