Surgical Endoscopy

, Volume 27, Issue 11, pp 4060–4066 | Cite as

Laparoscopic versus robot-assisted surgery for median arcuate ligament syndrome

  • Michael V. Do
  • Taylor A. Smith
  • Hernan A. Bazan
  • W. C. SternberghIII
  • Abbas E. Abbas
  • William S. Richardson



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.


Laparoscopic surgery Median arcuate ligament syndrome Robot-assisted surgery 



This research was funded solely though departmental resources.


Michael V. Do, Taylor A. Smith, Hernan A. Bazan, W. C. Sternbergh III, Abbas E. Abbas, and William S. Richardson have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael V. Do
    • 1
  • Taylor A. Smith
    • 2
    • 3
  • Hernan A. Bazan
    • 2
    • 3
  • W. C. SternberghIII
    • 2
    • 3
  • Abbas E. Abbas
    • 4
  • William S. Richardson
    • 1
  1. 1.Department of SurgeryOchsner Clinic FoundationNew OrleansUSA
  2. 2.Department of Vascular SurgeryOchsner Clinic FoundationNew OrleansUSA
  3. 3.The University of Queensland School of MedicineOchsner Clinical SchoolNew OrleansUSA
  4. 4.Section of Thoracic Surgery, Department of Surgery, Temple University HospitalTemple University School of MedicinePhiladelphiaUSA

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