Efficacy of Lymphovenous Bypass in the Treatment of Extremity Lymphedema

"Lymphovenous bypass will be performed under general anesthetic. Indocyanine green lymphangiography will be performed by injecting indocyanine green into each finger / toe web of the lymphedematous limb and mapping the lymphatic system with the NOVADAQ SPY Fluorescence Imaging (Mississauga, Canada).~Subdermal dissection of lymphatics and venules will be carried out under a surgical microscope. Lymphatic vessels will be anastomosed to adjacent recipient venules to create the bypass between the lymphatic and the venous systems. In total, 1-5 anastomoses will be performed. This will require 1-5 incisions, each with a length of 2-3 cm.~Postoperatively, the limb will be wrapped loosely with compression bandages. No special postoperative monitoring is required.~The surgery will be performed on an outpatient basis with no planned hospital stay."