Safe laparoscopic surgery in median arcuate ligament syndrome.

Aday, Ulaş; Böyük, Abdullah; Gültürk, Barış; Bozan, Mehmet Buğra

doi:10.5114/wiitm.2018.76116

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Alternatively, a 50° laparoscope or traction of the left gastric artery and common hepatic artery with tape can be used to facilitate the free dissection of the CA. 13 CTA scans may help to plan the optimal trocar position for the laparoscope.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for Median Arcuate Ligament Syndrome (MALS): A Prospective Cohort of 52 Patients

Kazmi¹,

Safi²,

Berge³

et al. 2022

VHRM

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for Median Arcuate Ligament Syndrome (MALS): A Prospective Cohort of 52 Patients

Kazmi¹,

Safi²,

Berge³

et al. 2022

VHRM

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“…There have been reported some other case reports and several small series of patients who underwent laparoscopic division of the MAL. [ 25 26 27 ] In the largest of these, Tulloch et al . [ 28 ] published a retrospective review of outcomes in patients with the MALS and compared laparoscopic versus open coeliac ganglionectomy over a 10-year period.…”

Section: Discussionmentioning

confidence: 99%

Median arcuate ligament (Dunbar) syndrome

Kafadar

Oğuz

Aday

et al. 2021

Journal of Minimal Access Surgery

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Background: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. Aim: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. Materials and Methods: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. Results: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.

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“…[13] While it was achieved by this open method initially, it is now performed more prominently by minimally invasive methods (laparoscopic or robotic). [2,8,14] There is still no standard surgical technique as this disease is quite rare, studies on the subject are generally limited to case reports, and there are no large case series. Studies in literature generally offer three different surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

“…There has been an upsurge in the number of publications on the laparoscopic approach recently, and physicians have been trying to standardize the technical details of the procedure in direct proportion to the increase in such reports. [6][7][8] Median arcuate ligament (MAL) narrows the truncus coeliacus even more clearly during the expiration. [9] Because of that, MAL relaxation is the main goal of surgery.…”

Section: Introductionmentioning

confidence: 99%

"Step-by-Step" principles of safe laparoscopic approach with technical details in "Median Arcuate Ligament Syndrome"

Gülmez¹

2020

Ulus Travma Acil Cerrahi Derg

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The median arcuate ligament syndrome (MALS) is a rare cause of postprandial pain and weight loss. The median arcuate ligament (MAL) is a fibrous band of the diaphragmatic crura. Abnormally downward located MAL or high take off of the celiac artery result in external compression the celiac trunk. MAL narrows the truncus coeliacus even more clearly during the expiration. The chronic compression of the celiac artery reduces blood flow and causes symptoms. Symptomatic patients receive surgical treatment, in recent years, an increasing rate, especially laparoscopic. The rate of conversion to open surgery is 10.3% due to vascular injury in hemorrhage, which generally occurs during dissection. A maneuver is needed to continue with the surgical procedure safely here because of the close neighboring of the aorta, truncus coeliacus, and one of its branches. Technical standardization can reduce the complication rate. There is still no standardized and established laparoscopic method in the world. There are no randomized controlled studies in the literature, which show the superiority of these techniques over one another. The maneuver in this case report, through traction with a tape towards caudal, allows a brilliant view on the celiac axis with shortened operation time. It also makes the operation even safer because of its enabling mastery over the celiac artery and easy dissection.

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Safe laparoscopic surgery in median arcuate ligament syndrome.

Cited by 6 publications

References 9 publications

Laparoscopic Surgery for Median Arcuate Ligament Syndrome (MALS): A Prospective Cohort of 52 Patients

Laparoscopic Surgery for Median Arcuate Ligament Syndrome (MALS): A Prospective Cohort of 52 Patients

Median arcuate ligament (Dunbar) syndrome

"Step-by-Step" principles of safe laparoscopic approach with technical details in "Median Arcuate Ligament Syndrome"

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