Laparoscopic versus robot-assisted surgery for median arcuate ligament syndrome

Do, Michael V., Smith, Taylor A., Bazan, Hernan A., Sternbergh, W. C., III, Abbas, E. and Richardson, William S. (2013) Laparoscopic versus robot-assisted surgery for median arcuate ligament syndrome. Surgical Endoscopy and Other Interventional Techniques, 27 11: 4060-4066. doi:10.1007/s00464-013-3061-x

Author Do, Michael V.
Smith, Taylor A.
Bazan, Hernan A.
Sternbergh, W. C., III
Abbas, E.
Richardson, William S.
Title Laparoscopic versus robot-assisted surgery for median arcuate ligament syndrome
Journal name Surgical Endoscopy and Other Interventional Techniques   Check publisher's open access policy
ISSN 0930-2794
Publication date 2013-11-01
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s00464-013-3061-x
Open Access Status Not yet assessed
Volume 27
Issue 11
Start page 4060
End page 4066
Total pages 7
Place of publication New York, United States
Publisher Springer
Language eng
Formatted abstract
Median arcuate ligament syndrome (MALS) is an uncommon disorder characterized by postprandial abdominal pain, weight loss, and vomiting related to the compression of the celiac artery by the median arcuate ligament. This syndrome has been classically treated with an open surgical approach. More recently, laparoscopic and robotic approaches have been used. We present our outcomes with laparoscopic and robot-assisted treatment of MALS.


We performed a retrospective review of all patients treated for MALS from March 2006 to August 2012 at a single institution.


A total of 16 patients with MALS were treated: 12 patients via a laparoscopic approach and 4 patients via a robot-assisted approach. Patient characteristics and comorbidities were similar between groups. We experienced no intraoperative or perioperative conversions, complications, or deaths. The mean operative time for the laparoscopic approach was significantly shorter than for the robotic approach (101.7 vs. 145.8 min; P = 0.02). However, we found no significant difference in length of hospital stay (1.7 vs. 1.3 days, P = 0.23). The mean length of follow-up for laparoscopically treated patients was 22.2 months and for robotically treated patients it was 20 months. Eight patients (67 %) in the laparoscopic group and two patients (50 %) in the robotic group had full resolution of their abdominal pain. Three patients in the laparoscopic group and two patients in the robotic group ceased chronic narcotic use after surgery.


Both laparoscopic and robotic approaches to MALS treatment can be performed with minimal morbidity and mortality. The laparoscopic approach was associated with a significantly shorter operative time. While innovative, the true advantages to robot-assisted MALS surgery are yet to be seen.
Keyword Laparoscopic surgery
Median arcuate ligament syndrome
Robot-assisted surgery
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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