LymphoedemaSurgery Centre
Lymphaticovenous anastomosis
LVA creates tiny new drainage pathways by connecting functioning lymphatic vessels directly to nearby veins.
The procedure
What is LVA?
Lymphaticovenous anastomosis—often shortened to LVA—is a minimally invasive supermicrosurgical operation. Through several small incisions, the surgeon identifies tiny lymphatic vessels and nearby venules.
Under very high magnification, vessels that may measure less than one millimetre are joined using exceptionally fine sutures. This allows lymph fluid to bypass an obstructed area and drain into the venous circulation.
Suitability
Who may benefit?
LVA is most likely to help when there are still functioning lymphatic channels available to bypass. It is often considered for fluid-predominant lymphoedema, recurrent cellulitis or symptoms that persist despite well-managed compression and therapy.
It may be used for upper- or lower-limb lymphoedema and, in selected cases, other anatomical areas. Assessment and imaging are needed before any recommendation is made.
Planning
Mapping the useful channels.
Before surgery, indocyanine green (ICG) lymphography and near-infrared imaging can be used to map lymphatic flow beneath the skin.
The scan helps identify functioning channels, understand the pattern of lymphatic dysfunction and select useful sites for the smallest possible incisions.
Treatment day
A local-anaesthetic procedure for suitable patients.
LVA is usually carried out under local anaesthetic in the dedicated operating theatre at the Penarth clinic. You remain awake while the operative areas are numb.
Several small incisions are made at the pre-mapped sites, and one or more lymphatic-to-vein connections are performed. Most patients go home the same day.
Recovery
Improvement is gradual and individual.
Recovery is usually quicker than after larger reconstructive operations. You will receive specific advice about wounds, activity and when to restart compression.
Some patients notice a softer or lighter limb, reduced swelling, fewer episodes of cellulitis or less dependence on compression; others experience more modest change. LVA cannot remove established fatty tissue, so a different or additional procedure may be recommended when solid tissue enlargement predominates.
A considered recommendation
LVA at the Lymphoedema Surgery Centre can be undertaken in the Penarth clinic operating theatre, subject to clinical suitability.
Arrange an assessment
Discuss whether LVA may fit your plan.
A consultation is the starting point for understanding suitability, alternatives, risks and likely recovery.
Start your enquiry