Lymphaticovenous Anastomosis (LVA)

Lymphoedema can be a challenging side effect of cancer treatment and can result in permanent swelling of the limb and an increased risk of skin infections. Whilst the mainstays of lymphoedema treatment involves maintaining a healthy lifestyle, meticulous skin care and compression garment therapy novel surgical techniques, such as LVA, can have a positive effect in reducing limb swelling.

How does it work?

Lymphaticovenous Anastomosis (LVA) is a specialized surgical technique that has gained prominence in recent years as an effective treatment for lymphedema. LVA offers a minimally invasive approach to addressing lymphedema and has the potential to significantly improve the quality of life for those suffering from this condition. In this article, we will explore the key aspects of LVA, including its principles, benefits, candidacy, and potential complications.

LVA works by bypassing the lymphatic channels within the limb into adjacent veins to offload the accumulation of lymphatic fluid in patients who have lymphoedema. Assessing your suitability for LVA includes imaging to assess other factors that might contribute to limb swelling and fluorescent imaging to assess the pattern of lymphatic flow within the affected limb. As a technique, it is best suited to patients who have only had lymphoedema for a short time as, once the condition progresses, LVA may not be the best option for you.


General anaesthetic

Surgery Time

2 Hours




Recovery garments

Compression garments starting 2-weeks after surgery

Hospital stay



1 week and 2 weeks after discharge

Return to desk-based work

1-2 weeks

Return to driving

2-4 weeks

Return to sport

6-8 weeks

Key Principles of Lymphaticovenous Anastomosis (LVA)

Identifying Suitable Candidates: LVA is most effective for patients with early-stage lymphedema or those experiencing mild to moderate symptoms. Candidates are typically evaluated by a team of medical professionals, including a lymphedema specialist and a microsurgeon, to determine their suitability for the procedure.

Precise Microsurgery: LVA is a delicate microsurgical procedure that requires a high level of precision. The surgeon uses specialized instruments and a microscope to identify and connect tiny lymphatic vessels to veins. These connections allow lymphatic fluid to enter the venous system, reducing swelling.

Minimally Invasive Approach: LVA involves small incisions, typically less than one centimeter in size. This minimally invasive technique results in reduced scarring, less postoperative pain, and a shorter recovery period compared to more invasive surgical options.

Lymphatic Mapping: Before the procedure, lymphatic vessels in the affected area are carefully mapped using specialized imaging techniques. This mapping is crucial for identifying the optimal locations for LVA connections.

Benefits of Lymphaticovenous Anastomosis (LVA)

LVA offers several notable benefits for individuals with lymphedema:

Reduction in Swelling: The primary objective of LVA is to reduce the swelling associated with lymphedema. By creating direct connections between lymphatic vessels and veins, excess fluid can be effectively drained from the affected area.

Minimally Invasive: LVA is a minimally invasive procedure, which means it typically involves smaller incisions, shorter hospital stays, and quicker recovery times compared to more extensive surgical options.

Early Intervention: LVA is most effective when performed at an early stage of lymphedema. Early intervention can prevent the progression of the condition and improve long-term outcomes.

Improved Quality of Life: Reduction in swelling and discomfort can significantly improve the quality of life for individuals with lymphedema. Patients often experience increased mobility, decreased pain, and enhanced self-esteem.

Long-Lasting Results: LVA can provide long-lasting results when performed by experienced surgeons. Many patients experience sustained improvements in their condition, reducing the need for ongoing conservative management.

Fewer Complications: LVA is associated with a relatively low risk of complications when compared to more invasive surgical procedures. It offers a safer alternative for eligible candidates.

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Candidates for Lymphaticovenous Anastomosis (LVA)

Not all individuals with lymphedema are suitable candidates for LVA. The procedure is most effective for those with early-stage lymphedema or mild to moderate symptoms. The ideal candidates for LVA generally meet the following criteria:

Early-Stage Lymphedema: Patients with early-stage lymphedema who have not yet experienced extensive fibrosis (thickening and hardening of tissues) are often the best candidates for LVA. 

Mild to Moderate Symptoms: LVA is most effective for individuals with mild to moderate lymphedema symptoms, as opposed to severe or advanced stages of the condition.

Good Overall Health: Candidates should be in good general health, without significant comorbidities that may increase surgical risks.

Realistic Expectations: Candidates should have realistic expectations about the potential outcomes of LVA, as the procedure may not eliminate all symptoms, especially in more advanced cases.

Potential Complications and Considerations

While LVA is considered a safe procedure with minimal risk, potential complications can include:

Incomplete Resolution: LVA may not completely eliminate all symptoms, particularly in cases of advanced lymphedema. Patients should have realistic expectations about the potential outcomes.

Infection: As with any surgical procedure, there is a risk of infection at the surgical site. Proper postoperative care and monitoring can help mitigate this risk.

Recurrence: Lymphedema can sometimes recur, even after successful LVA. Regular follow-up and continued management may be necessary.

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A Promising Solution for Lymphedema

Lymphaticovenous Anastomosis (LVA) offers a promising solution for individuals with lymphedema, particularly those in the early stages of the condition. By creating direct connections between lymphatic vessels and veins, LVA can significantly reduce swelling and improve the quality of life for eligible candidates. As with any medical procedure, it is essential for patients to work closely with their healthcare team to determine the most appropriate treatment plan, considering individual circumstances and expectations. LVA represents a valuable addition to the treatment options available to those affected by lymphedema, offering the hope of a more comfortable and fulfilling life.