fig1

Figure 1. Mechanism of the dynamic LVA method. The dynamic LVA method is based on the patient’s natural hand movements in daily life. At the incision point, which is detected by preoperative dynamic US findings, the patient’s natural hand motions propel lymphatic fluid into the anastomosed vein instead of the degenerated lymphatic vessels’ smooth muscle power. Negative pressure in the large pumping vein (> 1.0 mm) in the diastolic phase draws lymphatic fluid via LVA. The original source of this figure is from Ref.^[20] with permission for reuse. LVA: Lymphaticovenular anastomosis; US: ultrasonography.