Prophylactic LVA in Singapore
Why Choose Astrid for Prophylactic LVA
- Our plastic surgeons have experience in reconstructive microsurgery involving the lymphatic system and the small vessels used to create lymphatic bypasses.
- Prophylactic LVA is planned around the lymph node procedure and the patient’s individual risk of developing lymphoedema, with the aim of supporting lymphatic drainage after surgery.
What Is Prophylactic LVA?
Prophylactic lymphovenous anastomosis (LVA) is a microsurgical procedure performed to reduce the risk of lymphoedema in patients whose lymphatic drainage may be disrupted by lymph node surgery.
Rather than waiting for lymphoedema to develop, LVA creates alternative pathways for lymphatic fluid to drain into the bloodstream.
Why Can Lymphoedema Develop After Lymph Node Surgery?
Lymph nodes form part of the body’s lymphatic drainage system. In some cancer treatments, lymph nodes may need to be removed to determine whether cancer has spread or as part of the treatment itself. This can include lymph node surgery for cancers such as breast cancer, melanoma and certain gynaecological cancers.
When lymph nodes are removed, some of the pathways that normally carry lymphatic fluid away from the affected area may be disrupted. If lymphatic drainage is reduced, fluid can accumulate and lead to lymphoedema. The risk varies depending on the location and extent of lymph node surgery, as well as other aspects of the patient’s cancer treatment.
How Does Prophylactic LVA Work?
Using microsurgical techniques, functioning lymphatic vessels are connected to nearby small veins. These connections allow lymphatic fluid to bypass disrupted pathways and drain directly into the venous circulation.
The procedure creates an alternative route for lymphatic drainage, with the aim of reducing the risk of lymphoedema after lymph node surgery.
When Is Prophylactic LVA Performed?
Prophylactic LVA is performed before lymphoedema has developed and is typically planned in connection with lymph node surgery. It may be performed during the same operation as lymph node removal, allowing affected lymphatic vessels to be redirected to nearby veins when their usual drainage pathways are disrupted.
Who May Be Suitable for Prophylactic LVA?
Prophylactic LVA may be considered for patients undergoing lymph node surgery that places them at increased risk of developing lymphoedema, including some patients having lymph nodes removed as part of cancer treatment. Not every patient undergoing lymph node removal will require the procedure, so suitability is assessed individually.
Factors that may be considered include:
- The type and extent of lymph node surgery being performed
- The expected risk of lymphoedema following treatment
- Whether suitable lymphatic vessels are available for bypass
- The patient’s overall treatment plan and suitability for microsurgery
Prophylactic LVA vs LVA for Existing Lymphoedema
Both procedures use microsurgical connections between lymphatic vessels and nearby veins to improve lymphatic drainage. The main difference is when they are performed and what they aim to achieve.
| Prophylactic LVA | LVA for Existing Lymphoedema | |
|---|---|---|
| When It Is Performed | Prophylactic LVA Before lymphoedema develops | LVA for Existing Lymphoedema After lymphoedema has developed |
| Main Aim | Prophylactic LVA Reduce the risk of lymphoedema developing | LVA for Existing Lymphoedema Improve lymphatic drainage in an affected area |
| Treatment Context | Prophylactic LVA In connection with lymph node surgery | LVA for Existing Lymphoedema As a treatment for existing lymphoedema |
| Existing Lymphoedema | Prophylactic LVA No | LVA for Existing Lymphoedema Yes |
Need-to-Know
1–2 hours
General anaesthesia
Depends on accompanying procedure
Up to 2 weeks
Up to 6 weeks
FAQs About Prophylactic LVA
Does prophylactic LVA guarantee that I will not develop lymphoedema?
Will I still need to take precautions against lymphoedema after prophylactic LVA?
What happens if I develop lymphoedema despite prophylactic LVA?
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