{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T16:29:57Z","timestamp":1772296197326,"version":"3.50.1"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Supermicrosurgical lymphaticovenular anastomosis (LVA) has become popular for the treatment of compression-refractory lymphedema. With advancement of navigation tools, LVA can be performed with more ease and safety, allowing office-based LVA at an outpatient clinic.<\/jats:p><jats:p>\n          Methods\u2003Office-based LVA was performed on patients with compression-refractory secondary extremity lymphedema by a well-experienced supermicrosurgeon (T.Y.) under local infiltration anesthesia. Indocyanine green (ICG) lymphography and vein visualizer were used to localize vessels preoperatively. A stereoscopic microscope (Leica S6E, Leica Microsystems, Germany) or a relatively small operative microscope (OPMI pico, Carl Zeiss, Germany) was used for LVA. Operative records and postoperative results were reviewed to evaluate feasibility of office-based LVA.<\/jats:p><jats:p>\n          Results\u2003LVAs were performed on 27 arms and 42 legs, which resulted in 131 anastomoses via 117 incisions. ICG lymphography stage included stage II in 47 limbs, and stage III in 22 limbs. Time required for one LVA procedure (from skin incision to skin closure in one surgical field) ranged from 13 to 37\u2009minutes (average, 24.9\u2009minutes). One year after LVA, all cases showed significant volume reduction (lymphedematous volume reduction; 0.5\u201323.6%, average 13.23%). No postoperative complication was observed.<\/jats:p><jats:p>\n          Conclusion\u2003LVA can be performed with safety and effectiveness outside an operation theater. Patient selection, precise preoperative mapping, and experience of a surgeon are key to successful office-based LVA.<\/jats:p>","DOI":"10.1055\/s-0042-1750123","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T22:47:20Z","timestamp":1657579640000},"page":"131-137","source":"Crossref","is-referenced-by-count":9,"title":["Office-Based Lymphatic Supermicrosurgery: Supermicrosurgical Lymphaticovenular Anastomosis at an Outpatient Clinic"],"prefix":"10.1055","volume":"39","author":[{"given":"Takumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan"},{"name":"Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan"},{"name":"Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.cps.2010.06.009","article-title":"Perforator flaps and supermicrosurgery","volume":"37","author":"I Koshima","year":"2010","journal-title":"Clin Plast Surg"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.ejso.2019.01.008","article-title":"Onco-reconstructive supermicrosurgery","volume":"45","author":"T Yamamoto","year":"2019","journal-title":"Eur J Surg Oncol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1097\/PRS.0b013e31820cf5df","article-title":"Characteristic indocyanine green 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