Robot Assisted Laparoscopy for Median Arcuate Ligament Syndrome Relief

Objective: To evaluate the outcomes of robot assisted laparoscopic surgery for median arcuate ligament syndrome (MALS) relief. Methods: This was a single centre and retrospective study, including all consecutive patients with symptomatic MALS treated with robot assisted laparoscopic surgery. Symptom relief and quality of life (QoL) were evaluated post-operatively. A comparison between the peak systolic velocity (PSV) of the coeliac artery (CA) measured preoperatively and post-operatively was carried out. Results: Nine interventions were performed. No conversion to laparotomy was required. There was postoperative abdominal pain relief in eight patients and QoL was improved in seven patients. Post-operatively, the CA PSV decreased (175 (IQR 160 - 195) cm/s vs. 365 (IQR 350 - 419) cm/s; p <.001). Conclusion: MALS relief with robot assisted laparoscopy is safe and provides satisfactory outcomes in terms of symptom relief and CA compression release. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Vascular Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).