As super-micro surgical techniques have improved, lymphaticovenular anastomosis (LVA) has become the major treatment for lymph edema. Furthermore, indocyanine green fluorescent lymphography (ILG) can detect lymph vessels accurately1 and LVA can be performed through a small incision. However, lymph vessels which are suitable for LVA exist under the superficial fascia2 therefore an assistant has to open the surgical site or retractors are required. Another factor that makes LVA complicated is lymph fluid.
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