Full Description
The supermicrosurgical procedure known as Lymphaticovenular Anastomosis, or LVA, is a minimally invasive physiologic surgical treatment of lymphedema, which has gained attention worldwide in recent years as technical limitations were overcome and surgical indications can now apply to a larger set of patients with lymphatic disease. Complex advanced-stage lymphedema cases and patients with lymphorrea still have functional lymphatic channels, and could benefit from lymphaticovenular anastomosis. The latest technologies, such as ultrahigh frequency ultrasound, allow now to perform a detailed preoperative planning, improving efficacy and reliability of the intervention. Additional technologies that are available, as for example Rest-Stress Lymphoscintigraphy, Laser Tomography and Photoacoustic Imaging are also presented in the book, as all concur to build a complete preoperative and intraoperative set of information. Supermicrosurgical Lymphaticovenular Anastomosis is ahandy, one-of-a-kind guide built on the experience of contributors that are experts in this highly specialized field, while presenting topics in a clear and complete fashion, with the support of over 240 illustrations and chapter-related videos for a thorough understanding of preparatory steps and microsurgical techniques. This volume will be a valued companion to the modern microsurgeon dealing with lymphedema who wants to refine supermicrosurgical skills but also be of interest for professionals to gain insight in latest and more traditional technologies, through the related dedicated chapters and videos.
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Contents
Foreword.- . Preface.- Section 1. The Lymphedema.- 1. Introduction To Lymphaticovenular Anastomosis Surgery: Historical Perspectives.- 2. Applied Anatomy of the Lymphatic System.- 3. Physiologic Surgery of Lymphedema (overall description of all procedures includign LVA, LNF, VLNT).- 4. Indication for Lymphatic Surgery and Patient Selection.- Section 2. Severity Staging & Preoperative Planning.- 5. Lymphoscintigraphy.- 6. Near-Infrared Fluorescent Lymphography using ICG.- 7. Ultrasound.- 8. Magnetic Resonance Lymphography.- 9. Photoacustic Technology.- Section 3. The Dynamics of LVA.- 10. Anastomosis Configurations.- 11. The recipient Venule.- 12. Intraoperative Selection of the Lymphatic Channels.- 13. The Dynamic LVA.- 14. The Confluence Point: a new incision strategy in LVA.- Section 4. Operative Techniques.- 15. Immediate Lymphatic Reconstruction.- 16. Upper Extremity Lymphedema.- 17. Lower Extremity Lymphedema.- 18. Breast and Genital Lymphedema.- 19. Head and Neck Lymphedema.- 20. Early-Moderate Stage Lymphedema -including ELVA.- 21. Advanced-Stage Lymphedema.- 22. Lymphorrea.- 23. Lymphocele.- 24. Robotic Lymphovenous Anastomosis .- Section 5. Tip and Tricks.- 25. Clinical and Technical Pearls to Successful Lymphaticovenular Anastomosis.- 26. IVAS.- 27. Airborne, Needle Stenting and Nip Stitch.- 28. Valvuloplasty.- 29. Optimal Surgical Positions for Lymphaticovenular Anastomosis.- Section 6. Physical Therapy.- 30. Complex Decongestive Therapy.- Section 7. Ancillary Procedures.- 31. Liposuction.- 32. Biobridge in Lymphatic Surgery.- Section 8. Experimental.- 33. Experimental model of LVA in small animals.- 34. Experimental model of LVA in large animals.
