Surgeons at the St. Anne’s University Hospital in Brno have successfully performed the first combined breast reconstruction and lymphovenous anastomosis in a single procedure. According to lead surgeon Martin Knoz, the operation integrates tissue-based reconstruction with lymphatic vessel repair to prevent post-oncological lymphedema, a common complication for cancer survivors. The hospital performs roughly 120 such procedures annually, though this marks the first time both techniques have been synchronized in one session.
How does the combined surgical technique work?
The procedure relies on two surgical teams working in parallel. According to Dr. Andrej Berkeš, one team harvests tissue from the patient’s abdomen to reconstruct the breast, while the second team simultaneously prepares the recipient site and lymphatic vessels. Dr. Knoz, a plastic surgeon and deputy head of the clinic, explains that the lymphovenous anastomosis involves connecting lymphatic vessels—often one millimeter or less in diameter—directly to veins. This connection allows the lymphatic fluid to drain into the venous system, significantly lowering the risk of limb swelling following the removal of lymph nodes during cancer treatment.
Did you know? Lymphovenous anastomosis is a microsurgical technique. Because surgeons work with vessels as small as one millimeter, they utilize surgical microscopes to ensure successful integration.
What is the expected recovery timeline for patients?
Patients typically remain in the hospital for eight to ten days following the procedure, provided no complications arise within the first 48 hours. Dr. Knoz states that because the lymphatic connections are performed on the skin surface, the rehabilitation process follows a standard recovery path. Patients are generally expected to return to daily activities quickly, with a potential return to work within three weeks.
Why is this clinical advancement important?
By combining them, the clinic can reduce the total number of operations a patient must endure. According to the hospital, this combined approach will now be offered as an option for a wider spectrum of patients who face risks of lymphedema after radiation or lymph node removal.
Comparison of Surgical Approaches
| Feature | Sequential Surgery | Combined Surgery |
|---|---|---|
| Anesthesia exposure | Twice | Once |
| Recovery duration | Extended | Streamlined |
| Lymphedema risk | Managed separately | Proactively minimized |
Frequently Asked Questions
- Is this surgery covered by insurance? Yes, according to the St. Anne’s University Hospital, the combined operation is covered by health insurance.
- Who is a candidate for this procedure? It is intended for breast cancer patients who have undergone lymph node removal or radiation and are at risk of developing arm swelling.
- How long does the surgery take? The reconstruction typically takes five hours, with an additional three to four hours for the lymphatic vessel procedure.
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