Lymphaticovenous anastomosis (LVA) to treat lymphoedema

Those struggling with stage 0, 1 and 2 lymphoedema in whom nonsurgical treatment does not offer improvement are eligible for an LVA.

Course of surgery

LVA is done mostly under general anaesthesia.

In this LVA operation, the surgeon makes a connection or shunt (anastomosis) between a functioning lymph vessel and a vein. By making the connection before a blockage of a lymphatic channel, the lymph fluid is drained through the blood circulation, reducing swelling.

The lymphatic vessel blockage is thus bridged. Several LVAs can be applied  per limb, depending on the (remaining) function of the lymphatic vessels and the function of the blood vessels. Some imaging studies are always performed before surgery to assess this situation.

Duration of surgery and hospitalisation

A single LVA takes about two hours. Depending on the number of connections made the surgery can last for several hours. The patient remains in the hospital for 1 night afterwards.

Aftercare

Intense physical activity of the operated limb should be reduced for several weeks, but light mobilisation is allowed (specific instructions are always given by the surgeon).

An initial postoperative consultation is scheduled 10 days after surgery and the dressing should remain in place until then. Thus, no (or little) wound care is required after surgery. Manual lymphatic drainage is usually discontinued for about two or three weeks, until the scars have healed properly.