Lymphovenous Bypass Post-Operative Care

Lymphovenous bypass (LVB), also known as lymphovenous anastomosis (LVA) is a microscopic surgery where the lymphatic vessels are connected to nearby veins. Using imaging with indocyanine green dye, a suitable lymphatic vessel is identified and connected to a vein. This surgery is being used as an option for patients undergoing an axillary or groin lymph node dissection. It is especially recommended for patients that will be receiving adjuvant radiation. When combined with seeing a certified lymphedema therapist, use of
compression garments, and exercise, LVB has been shown to improve quality of life.

With any surgery comes a standard for post-operative and rehabilitative care. Although all surgeons and health care facilities have their own rehab guidelines, the following evidence-based guidelines are a general outline of the recommended progressions of lymphovenous bypass post-operative care.

 

For the first 2 weeks post-surgery:

  • Avoid wrapping or massaging affected limb
  • Avoid lifting, pushing, pulling of anything heavier than 5lbs
  • Keep affected limb elevated as often as possible, rest limb on 2 pillows while sitting or sleeping
  • If the surgery was performed on the arm, refrain from raising arm higher than 90 degrees

 

Starting 2 weeks post-surgery:

  • Affected limb can be wrapped
  • Affected limb can be massaged (but not over incisions)
  • May return to wearing compression garment(s)
  • Avoid lifting, pushing, or pulling anything heavier than 5lbs

 

Starting 4 weeks post-surgery:

  • Can wrap and massage over incisions
  • No movement restrictions; may gradually return to all usual activities
  • Continued extremity circumference measurements are recommended

 

For any ongoing concerns about your lymphovenous bypass surgery visit your surgeon or certified lymphedema therapist.

 

Chang, E. I., Skoracki, R. J., & Chang, D. W. (2018). Lymphovenous Anastomosis Bypass Surgery.Seminars in plastic surgery, 32(1), 22–27. https://doi.org/10.1055/s-0038-1636510

Coriddi, M., Mehrara, B., Skoracki, R., Signhal, D., & Dayan, J. H. (2021). Immediate Lymphatic Reconstruction: Technical Points and Literature Review. Plastic and Reconstructive Surgery – Global Open, 9(2), e3431. doi:10.1097/GOX.0000000000003431

Memorial Sloan Kettering Cancer Center. (2021, January 6). About your Lymphovenous Bypass (LVB) Surgery for Lymphedema. https://www.mskcc.org/cancer-care/patient-education/about-your-lymphovenous-bypass-lvb-surgery-lymphedema