{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:51:28Z","timestamp":1788393088725,"version":"build-2803163510"},"reference-count":14,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T00:00:00Z","timestamp":1552608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The management of lymphatic malformations (LMs) is challenging, particularly for large and complex lesions involving anatomical structures in the adjacent tissue. While lymphovenous anastomosis (LVA) has been reported as an effective treatment for lymphedema, it has hardly been described as a treatment for LM. Virtual reality has the ability to visualize human structures in three dimensions and can be used for the preoperative planning of complex cases. Here, we describe the first case of the management of an LM by LVA preoperatively planned with virtual reality. A young woman presented with an LM previously treated by gross excision. Following persistent complaints of swelling, a minimally invasive microsurgical intervention was planned. The results of the single photon emission tomography with computed tomography (SPECT-CT) and lymphoscintigraphy were analyzed using a virtual reality program, and a 3D patient-specific model was constructed. Based on the combined findings of this 3D model and lymphography with a fluorescent marker, a precise skin incision could be determined and one lymph vessel was anastomosed to a nearby vein. The swelling of the thigh reduced and the discomfort disappeared. Although more reports are needed to confirm its efficacy, LVA planned with virtual reality constructed images appears to be a valuable treatment option for complex lesions, including LMs.<\/jats:p>","DOI":"10.3390\/jcm8030371","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T04:06:55Z","timestamp":1552882015000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0117-7345","authenticated-orcid":false,"given":"Guido","family":"Giacalone","sequence":"first","affiliation":[{"name":"Department of Lymphatic Surgery, Sint-Maarten Hospital, 2800 Mechelen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine (NCGM), Tokyo 162-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Belva","sequence":"additional","affiliation":[{"name":"Department of Lymphatic Surgery, Sint-Maarten Hospital, 2800 Mechelen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akitatsu","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Breast Center, Kameda Medical Center, Chiba 296-8602, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Dori","sequence":"additional","affiliation":[{"name":"Center for Lymphatic Imaging and Interventions, Children\u2019s Hospital of Philadelphia\/Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menekhem M.","family":"Zviman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke","family":"Gysen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Heilig Hartziekenhuis, 2400 Mol, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah H.","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Jolley","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"},{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital of Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoi","family":"Kato","sequence":"additional","affiliation":[{"name":"Saitama Children\u2019s Medical Center, Department of Plastic and Reconstructive Surgery\/Lymph Clinic, Saitama 330-8777, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1001\/archfaci.2011.795","article-title":"Current knowledge and management of vascular anomalies, II: Malformations","volume":"13","author":"Hochman","year":"2011","journal-title":"Arch. 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Nuclear Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/3\/371\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:38:18Z","timestamp":1760186298000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/3\/371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,15]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["jcm8030371"],"URL":"https:\/\/doi.org\/10.3390\/jcm8030371","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,15]]}}}