Year: 2026
Type: article
Abstract: Median arcuate ligament syndrome (MALS, Dunbar syndrome) is caused by compression of the celiac trunk and the autonomic nerve plexus surrounding the artery by the median arcuate ligament of the diaphragm. The condition is a diagnosis of exclusion because its symptoms are nonspecific. These include postprandial abdominal pain and dyspeptic symptoms leading to anorexia and eating disorders. Diagnostic imaging is based on Doppler ultrasonography and computed tomography. Surgery is the treatment of choice. Its aim is to decompress the celiac trunk using open or, increasingly, minimally invasive techniques, including laparoscopic or robotic surgery. The aim of this paper is to present the correct technique for laparoscopic decompression of the celiac trunk, taking into account our own tips and tricks. Furthermore, the most common complications and a comparison of open, laparoscopic, and robotic methods in terms of early and long-term outcomes are presented. In summary, laparoscopic management is safe and feasible for well-selected patients with MALS at experienced centers. To establish it as a standard of care, future clinical studies comparing the three approaches — open, laparoscopic, and robotic — should be undertaken.
Source: Acta Angiologica
DOI: 10.5603/aa.112014
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223304070