Standardized approach to median arcuate ligament syndrome and laparoscopic release: A case series

Background: Median arcuate ligament syndrome (MALS) is a rare disorder characterized by compression of the celiac axis. Recently, laparoscopic approaches to median arcuate ligament release (MALR) have been described. The purpose of this study is to evaluate our institutional experience and outcomes with laparoscopic MALR. Methods: Retrospective analysis of all patients who underwent laparoscopic MALR between January 2018 and April 2019 at a single institution. A 14-question postoperative survey was administered via telephone. Peri-operative morbidity and mortality, as well as operative times were assessed. Results: Nine patients underwent laparoscopic MALR. Five patients were discharged on post-operative day one. Average length of stay was 2.1 days (+/-1.96). There were no reported intra-operative complications. Average procedure time was 92.4 min (+/-31.4), which decreased over time (p=0.046). Conclusions: This study describes a standardized approach to laparoscopic MALR that is safe and provides early relief of symptoms.