fig3

Figure 3. Supermicrosurgical one-hand suture technique for severe lymphedema. In the one-hand suture technique, the left hand is working both as a traction maker and a sensor of the special senses. An adequate tension of the left-hand traction is the only way to control the shape of the vessels and fluid movement in the anastomosing vessel to feel intima and fluid movement in the vessel by the microsurgeon’s finger sensations (right). The range of adequate direction and tension of the left-hand traction is very narrow for performing one-hand suture technique. Intima-to-intima anastomosis of a small vessel is difficult if the surgeon’s left hand cannot create proper retraction (left).