Outcomes of Median Arcuate Ligament Release: A Single Institution Retrospective Review

Chen, Alina; Yeh, Savannah L.; Dhindsa, Yasmeen; Lawrence, Peter F.; Woo, Karen

doi:10.1016/j.avsg.2023.02.030

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…Of the 23 studies, 8 were case-reports [8, 9,10,11,12,13,14,15], 5 were case-series [16,17,18,19,20], and 10 were retrospective cohorts [4,6,21,22,23,24,25,26,27,28]. Detailed characteristics of studies are provided in Table 1.…”

Section: Summary Of Studiesmentioning

confidence: 99%

“…Finally, available data of total 290 patients from 8 from case-reports, 24 patients from 5 case-series, 258 patients from 9 retrospective-cohorts were included (Table 2). Gender: All studies mentioned gender distribution except 2 retrospective-cohorts [22,27]. And there were 57 males and 214 females.…”

Section: Characteristics Of Patientsmentioning

confidence: 99%

“…Intra-operative complications: [4,6,21,25,26,27,28] reported EBL. In majority of the cases blood loss ranged from 5-30ml.…”

Section: Rate Of Conversions: All Studies Categorically Looked For Ra...mentioning

confidence: 99%

“…included 12laparoscopic cases, Khrucharoen U et al[24] included 16-laparoscopic cases, Shin TH et al [26] 24-laparoscopic cases, DeCarlo C et al[4] included 227-open and 235-laparoscopic cases, Chen AJ et al[27] included 14-laparoscopic and 16-open cases.Study by Stadler P et al[22] performed only robotic assisted vascular interventions in 310 cases with aorto-iliac-femoral diseases and included only 2 cases of r-MALR.…”

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confidence: 99%

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Feasibility and Safety of Robotic Assisted Surgical Approach in Median Arcuate Ligament Syndrome – A Systematic Review

Gunjiganvi,

Marthandam,

Murugesan

et al. 2024

Preprint

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Median arcuate ligament syndrome (MALS) is rare syndrome and is diagnosis of exclusion. Though first robotic median arcuate ligament release (MALR) was described in 2007, there are only a few case reports (CR), case series (CS) and retrospective cohort studies (RCS) published in literature. The purpose of this study was to assess the feasibility and safety of robotic assisted MALR (r-MALR). PubMed, Embase and Cochrane databases were searched (last search December 2023) for articles reporting R-MALR. All studies including CR, CS, RCS reporting technical feasibility (operating time and rate of conversions; safety (intraoperative complications, blood loss, post-operative complications), and outcome (length of stay [LoS]) were included (PROSPERO: CRD42024502792). A total of 23 studies (8-CR, 5-CS, 10-RCS) with total 290 patients were available in literature. Except 1-RCS, all studies reported age and mean age for CR was 40.38 ± 17.7, for CS 36.08 ± 15.12, for RS 39.72 ± 7.35 years; except 2-RCS, all studies reported gender distribution and there were 57 males and 214 females. Operating time – 3-CR, 4-CS, 9-RCS reported operating time and mean time was 111 ± 54, 131.69 ± 7.51, 117.34 ± 35.03 min respectively. Conversion rate: All studies reported data on conversion and only 4 (1.37%) cases were converted – 1 to laparoscopic approach, 3 to open approach (1-inadvertent celiac arteriotomy, 2-reasons not mentioned). Intra-operative complications: only 5-CR, 4-CS and 9-RCS reported data on intra-operative complications and there were only 6 complications (1.5%): 1-inadvertent celiac arteriotomy converted to open; 3- unnamed vascular injuries (2 managed robotically, 1-converted to open); 1-bleeding managed robotically; There were no other reported injuries. Estimated blood loss ranged from 5-30ml. Post-operative complications: 5-CR, 4-CS, 8-RCS described post-operative complications in 21 (7%) patients. 20 cases were grade I, 1 was grade IIIa and all managed successfully. LoS stay: 2-CR, 4-CS, 10-RCS reported LoS and overall, it was 2 days. R-MALR is reasonable, technically feasible, safe and has acceptable outcomes. Additionally robotic approach provided superior vision, improved dexterity, precise and easy circumferential dissection. PROSPERO registration: the protocol was registered in the PROSPERO database (CRD42024502792).

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Section: Summary Of Studiesmentioning

confidence: 99%

Section: Characteristics Of Patientsmentioning

confidence: 99%

“…Intra-operative complications: [4,6,21,25,26,27,28] reported EBL. In majority of the cases blood loss ranged from 5-30ml.…”

Section: Rate Of Conversions: All Studies Categorically Looked For Ra...mentioning

confidence: 99%

mentioning

confidence: 99%

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Feasibility and Safety of Robotic Assisted Surgical Approach in Median Arcuate Ligament Syndrome – A Systematic Review

Gunjiganvi,

Marthandam,

Murugesan

et al. 2024

Preprint

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“…In another study by Gerull et al testing the effectiveness of robotic surgery for MALS, 74 patients received this procedure, with 90.3% reporting symptom relief at a one-year follow-up [ 35 ]. In a separate study by Chen et al comparing open, laparoscopic, and robotic surgery for MALS, the cohort of 16 patients who underwent open surgery reported 62% symptom relief, while the laparoscopic cohort of 12 patients reported 20% symptom relief, and the robotic cohort of 17 patients reported 43% symptom relief, with all follow-ups being conducted one year after surgery [ 36 ]. Other perioperative variables from these studies, including operation time, hospital stay, and blood loss, are listed in Table 1 .…”

Section: Reviewmentioning

confidence: 99%

Overview of Median Arcuate Ligament Syndrome: A Narrative Review

Upshaw,

Richey,

Ravi

et al. 2023

Cureus

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Median arcuate ligament syndrome (MALS) is a rare disorder caused primarily by compression of the celiac trunk by the median arcuate ligament (MAL). This disorder typically results in patients presenting with bloating, weight loss, nausea, vomiting, and abdominal pain. The MALS diagnosis is one of exclusion, as the disorder has no specific diagnostic criteria. Imaging modalities are often utilized to assist in making the diagnosis, such as ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). These imaging modalities typically reveal a stenosed celiac artery with post-stenotic dilation in patients. This disorder is usually treated by dividing the MAL, thus relieving the compression of the celiac artery. The surgery may be done through either an open approach or a minimally invasive approach, which can be either laparoscopic or robot-assisted. Most patients respond well to this treatment, though certain factors that predict a poorer response to treatment include elderly age, a history of alcohol abuse, and psychiatric illness.

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Feasibility and safety of robotic-assisted surgical approach in median arcuate ligament syndrome—a systematic review

Gunjiganvi,

Marthandam,

Murugesan

et al. 2024

J Robotic Surg

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Outcomes of Median Arcuate Ligament Release: A Single Institution Retrospective Review

Cited by 4 publications

References 9 publications

Feasibility and Safety of Robotic Assisted Surgical Approach in Median Arcuate Ligament Syndrome – A Systematic Review

Feasibility and Safety of Robotic Assisted Surgical Approach in Median Arcuate Ligament Syndrome – A Systematic Review

Overview of Median Arcuate Ligament Syndrome: A Narrative Review

Feasibility and safety of robotic-assisted surgical approach in median arcuate ligament syndrome—a systematic review

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