Valvuloplasty for Venules to Prevent Venous Reflux at the Site of Lymphaticovenular Anastomosis

High-flow lymphatic vessels and veins without reflux must be selected to maximize the surgical effect of lymphaticovenular anastomosis (LVA) and minimize the risk of anastomotic thrombosis. It has been reported that the prevention of venous reflex reduced not only the incidence of short-term complications but also the incidence of cellulitis in the long-term postoperative course. A variety of venoplasty can be performed using super-microsurgical techniques. Among these, external valvuloplasty for venules is invaluable in stopping the venous reflex at the LVA site. This chapter introduces the optimal preoperative preparation and operative techniques to minimize venous reflux in LVA and external valvuloplasty for venules. Prevention of venous reflux is a skill that should be mastered by all means to improve the outcome of LVA.