Endoscope-Assisted Lymphatic Microanastomoses: Concept, Results, Expectations, and Applications

Autologous lymph-vessel transplantation is one of the microsurgical procedures that should be performed with good magnification and visualization of the fine lymphatic vessels. It is the preferable surgical intervention in the authors' institute for patients with secondary lymphedema. Although this technique has been performed under the operating microscope, in this study, the authors have experimentally investigated the possibility of performance of lymphatic vessel anastomoses of the rat thoracic duct with the visual assistance of the endoscope, and compared it with the conventional operating microscope, not for its replacement, but as an alternative operating tool which may be preferred in certain situations. There were minimal technical differences between the microscope and the endoscope; however, they have recorded significantly shorter operating time and lymphatic vessel preparation time by using the endoscope. The endoscope seems to be a promising new tool in performing microsurgery, with more ease in handling and more physical comfort for the surgeon.