New Standards of Care in Lymphedema Surgery

How advances in visualization are transforming lymphatic supermicrosurgery and what to consider when choosing a supermicrosurgery microscope

There are several surgical options for the treatment of lymphedema. Lymphaticovenular anastomosis (LVA) is the less invasive method, and the procedure can be performed on an outpatient basis. However, performing minimally invasive lymphedema surgery can be challenging as lymphatic vessels are very small structures (usually less than 0.7 millimeters in diameter). As such, this procedure requires both excellent visualization and technical skills.



Recent advances in visualization technologies are transforming lymphedema surgery, facilitating supermicrosurgery procedures and opening up new possibilities for plastic and reconstructive surgeons. Not only do surgical microscopes provide high resolution optics and magnification helping to operate on small vessels, they also come with embedded technologies that can improve the visualization without compromising on workflow efficiency.

Three recent studies have highlighted the benefits of visualization technologies from Leica Microsystems for lymphatic supermicrosurgery.

Surgical Microscopes

Surgical microscopes offer the magnification required to have a clear view of the superficial tissue vein vessels and lymphatic vessels during supermicrosurgery procedures. Unlike binocular glasses, the zoom is progressive and can be adjusted as needed. Leica surgical microscopes also have an ergonomic design, minimizing the surgeon’s strain and fatigue. In addition, video recording allows to capture HD surgical videos or still images, in 2D or 3D, and share them with OR staff or peers.

A team of surgeons from the Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital in Istanbul, Turkey, performed minimally invasive lymphaticovenular anastomosis using the microscopes from Leica Microsystems. The outcome of the operation was successful. As such, the authors point out that lymphaticovenular anastomosis and minimally invasive supermicrosurgery techniques are favorable alternatives for lymphedema treatment.

Learn more about the study

Choosing a Microscope for Supermicrosurgery: What to Consider

When selecting a microscope to perform supermicrosurgery and lymphedema surgery in particular, it is important to consider 5 critical aspects:

  • Magnification: an adequate level of magnification of the operating field is required for optimal visualization of small vessels and details
  • Light: smart features such as the Leica BrightCare for patient safety and a Gaussian distribution of light intensity ensure adequate illumination without damage
  • Visualization comfort: a comfortable depth perception ensures vessels stay in focus when the heart beats and causes vessel movement
  • Comfort of usage: small details such as a footswitch, fine focus for the opposite observer and XY movements can significantly enhance comfort
  • Video recording: the possibility to capture high quality images and videos can support teaching, communication with peer and scientific publications.

If you would like to learn more about Leica solutions for your plastic and reconstructive surgery practice, contact a Leica representative. We have a wide range of microscopes adapted to your needs providing performance for the eye, precision for the hand and ergonomics for the body.

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