Page 49 - Journal of World Association of Laparoscopic Surgeons

Laparoscopic Management of Median Arcuate Ligament Syndrome: Single Center Experience
abdominal pain, which was not responding to conventional Despite the acceptable satisfaction rates, a subset of MALS
PPI therapy. The mean weight loss of 12.33 kg was reported patients may remain refractory with partial or no relief of symptoms
(10–15 kg). The length of symptoms at presentation was a mean of or may have recurrent symptoms, requiring further intervention
12 months (6–24). like angioplasty or stenting.
On evaluation with CT angiography, all 3 revealed significant Limitations of our study is the small number of cases, owing to
compression of the celiac trunk at its origin from aorta. All three rarity of the disease.
patients underwent laparoscopic division of MAL fibers. None of
the patients required conversions to open.
The length of the postoperative stay ranged from 3 to 4 conclusIon
days, with all patients being discharged with no postoperative MALS is a rare clinical disease, requiring high clinical suspicion
complications or morbidity. On average, followup of 15 months for diagnosis. Management includes surgical division of MAL
(9–24) showed that all three patients remained symptom free and fibers. Laparoscopic management is gaining popularity and
tolerated diet well. recommended owing to the basic advantages of minimal invasive
approach clubbed with acceptable learning curve and ease of
performing, along with excellent visualization of the celiac trunk
dIscussIon origin and the MAL.
Since the first description of MALS in 1961, there are several debates
on the diagnosis and treatment of this rare clinical entity.
The mean age of presentation in our study is around 39.3 references
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World Journal of Laparoscopic Surgery, Volume 12 Issue 1 (January–April 2019) 41