ArticlePlastic and reconstructive surgery. Global open2026
Lymphatic Ultrasound Works: Time-efficient Planning and Decision-making for Lymphaticovenous Anastomosis-A Narrative Review With Workflow Analysis.
Article in Plastic and reconstructive surgery. Global open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Preoperative lymphatic ultrasound has been increasingly used for lymphaticovenous anastomosis (LVA) to identify suitable lymphatic vessels. The purpose of this study is to quantify the time efficiency of ultrasound-guided LVA. Methods: Twenty-four women (41 limbs) undergoing LVA were retrospectively evaluated. Preoperative lymphatic ultrasonography was performed using an 18-MHz linear probe, and a maximum of 4 anastomoses per operation were planned based on ultrasonographic findings. Examination time was recorded and compared between patients with and without prior indocyanine green lymphography. Intraoperatively, the time to identify the recipient veins and lymphatic vessels was recorded. Results: LVA was performed at 83 sites, with a mean of 2.1 anastomoses per limb (range, 1-4). The mean duration of ultrasonography was 26.4 minutes (range, 16-48 min), with no significant difference between patients with and without prior indocyanine green lymphography ( Conclusions: Preoperative lymphatic ultrasound enables structured, time-efficient LVA planning and rapid intraoperative identification of lymphatic vessels, even in advanced lymphedema. By quantifying workflow metrics and surgical decision-making, this study supports lymphatic ultrasound as a practical standard for LVA planning.
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