Laparoscopic Median Arcuate Ligament Release


Laparoscopic Median Arcuate Ligament Release

presented by Tatiana Hoyos, MD, at the SAGES 2014 Meeting; Panel – Concurrent Session SS1 V004

Tatiana Hoyos, MD, John Stauffer, MD, Albert Hakaim, MD,
Horacio Asbun, MD; Mayo Clinic, Florida

Points of interest:
overview of MAL syndrome–7 sec
clinical manifestations–20 sec
case presentation–28 sec
angiogram & MRA–41 sec
provocative visceral arteriogram with papaverine–57 sec

Keyword(s): 5mm port, 8a lymph node, access, anatomy, angiography, anteriorly, aorta, avoid injuring, band, baseline study, blunt dissection, cannulation, caudate lobe, causes, cava, celiac ganglionic fibers, celiac plexus nerve fibers, celiac trunk, cephalad, chronic ABD pain, clinical manifestations, complete resolution, compression, constipation, created, deep muscle fibers, disappear, displaced, divided, documented, dopplar ultrasound, epigastric bruit, esophageal hiatus, excised, exposed, exposure, extensive GI work-up, female, fibrofatty tissue, fibrous bands, flow measurement, freed, gastric vessels, gastrocolic omentum, goal, Harmonic scalpel, Hasson, hepatic artery, hepatic artery lymph node, high celiac artery origin, lateral, left diaphragmatic crus, left gastric artery, left gastric vein, lesser sac, liver retraction, longitudinal fiber muscles, loss of collateralization, low dia, low diaphragmatic insertion, MAL release, MAL syndrome, maneuvers, Maryland dissector, MRA, muscle bands, muscle fibers, myotomy, N&V, neuro fibers, non-active blade, nonspecific GI symptoms, origin, overlying, pancreas, Papaverine, peritoneal layer, placebo injection, POD, port placement, posteriorly, postprandial epigastric pain, present, preserving, provocative visceral arteriogram, refractory to medical treatment, reproduction of symptoms, root, safer, saline, sensitive diagnostic modality, separated, sharp blade, SMA, splenic artery, split, stomach, subxiphoid port, superficial application, superficial manner, superior edge, supine, surrounding, tight band, tips rotated, tributaries, ultrasonic shears, uneventful, vascular structures, weight loss, window

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