Seconds from disaster: lessons learned from laparoscopic release of the median arcuate ligament |
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Authors: | Kevin P. Riess Luke Serck Sigurd B. Gundersen III Michael Sergi Shanu N. Kothari |
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Affiliation: | (1) Surgery Residency, Gundersen Lutheran Medical Foundation, La Crosse, WI, USA;(2) Department of Surgery, Gundersen Lutheran Health System, 1900 South Avenue, La Crosse, WI, 54601, USA;(3) Department of Internal Medicine, Aurora Health Center, Fond du Lac, WI, USA;(4) Present address: Yankton Medical Clinic, Yankton, SD, USA |
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Abstract: | Median arcuate ligament syndrome (MALS) is a rare entity that manifests as abdominal pain, nausea, vomiting, and diarrhea. The median arcuate ligament is a fibrous band that connects the crura of the diaphragm. In some people, the ligament is positioned in a way that compresses the celiac axis, which in a subset of individuals causes the symptoms associated with MALS. Surgical release of the ligament can relieve these symptoms. After viewing a video that described the laparoscopic median arcuate ligament release technique at the 2006 SAGES meeting and reviewing the online video, we report our experience with two cases and discuss the lessons learned in performing the procedure within a training program. We also discuss the extent to which surgical resident participation contributes to intraoperative complications during a new and complex surgery. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. |
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Keywords: | Median arcuate ligament syndrome Celiac artery compression syndrome Laparoscopic arcuate ligament release |
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