Lymphatic-venous anastomosis in a rat model: A novel exercise for microsurgical training

Background and Objectives: Lymphedema is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. Lymphaticovenular anastomoses (LVA) and multiple lymphatic-venous anastomoses (MLVAs) have been recognized as efficient methods to treat chronic lymphedema. Because few models for lymphatics microsurgical training have been described, the aim of this study is to present a new training model for MLVA in a rat. Methods: Ten norvegicus rats were used for this study. After a longitudinal xifo-pubic incision, lumbar nodes were injected with blue patent violet (BPV) to identify from two to four lymphatic vessels (LVs). MLVAs were carried out inserting lymphatics into the right lumbar vein. Results: The mean weight of the rats was 511.4 g. The average diameter of the abdominal LVs used for MLVA was 0.26 mm, and the mean size of the right lumbar vein was 0.84 mm. The average time to perform MLVA was 49.8 minutes. Anastomosis patency rate was 70% based on the passage of BPV from the lymphatics into the vein. Conclusions: The rat is still a feasible resource to train microsurgeons, and the MLVA model proposed is simple and reliable and could be very useful for microsurgeon training.