Laparoscopic Median Arcuate Ligament Release for Celiac Artery Decompression

Median arcuate ligament syndrome is a rare cause of abdominal pain that results from the celiac artery being narrowed by the insertion of the muscle fibers of the diaphragm or fibrous bands of the celiac nerve plexus. Patients typically have symptoms of weight loss, postprandial abdominal pain, and nausea or vomiting. Operative management, laparoscopic or open, involves completely dividing these fibers to release the compression of the celiac artery. There have been few reports to date of laparoscopic treatment of this condition. In this video, laparoscopic release of the median arcuate ligament is shown in a 36 year old female who had a one year history of abdominal pain and a 35 pound weight loss resulting in a BMI of 17.5 kg/m2. The patient had a history of MALT lymphoma but an extensive workup was otherwise negative. She ultimately had an MR angiogram which showed a celiac artery stenosis with post-stenotic dilatation and collateral pancreatoduodenal vessels. Laparoscopic exploration and decompression of the celiac artery was performed. Intraoperative ultrasound showed improved flow in the celiac artery after decompression. The patient was discharged the day after surgery without any complications. At follow-up, her symptoms were significantly improved.

Session: Podium Video Presentation

Program Number: V027

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