ArticleSurgical endoscopy2022
Robotic versus laparoscopic median arcuate ligament (MAL) release: a retrospective comparative study.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Outcomes in laparoscopic versus robotic-assisted surgery for median arcuate ligament syndrome: a systematic review and meta-analysis.Journal of robotic surgery · 2026Pooled it
- Feasibility and safety of robotic-assisted surgical approach in median arcuate ligament syndrome-a systematic review.Journal of robotic surgery · 2024Pooled it
- Laparoscopic Approach to Median Arcuate Ligament Syndrome: A Single-Center Experience.Medicina (Kaunas, Lithuania) · 2026Observational
- Robotic Median Arcuate Ligament Release May Offer Superior Symptom Improvement to Laparoscopic Release.Annals of vascular surgery · 2026Article
- Robotic-Assisted Vascular Surgery: Current Landscape, Challenges, and Future Directions.Journal of clinical medicine · 2025Review
- Intraoperative evaluation of median arcuate ligament syndrome using a transit-time flowmeter: a case report.BMC surgery · 2025Article
- Technique and outcomes of robotic median arcuate ligament release in 52 patients: a multidisciplinary experience.Journal of robotic surgery · 2025Article
- Short and longterm outcome of minimally invasive therapy of median arcuate ligament syndrome.Langenbeck's archives of surgery · 2024Article
- Robotic median arcuate ligament release: a video vignette.Journal of minimally invasive surgery · 2024Article
- Robot-assisted vascular surgery: literature review, clinical applications, and future perspectives.Journal of robotic surgery · 2024Review
- Median Arcuate Ligament Syndrome: A Case Report on a Rare Disease and Variant Hepatic Arterial Anatomy.Cureus · 2024Article
- Laparoscopic repair of iatrogenic celiac artery injury during median arcuate ligament release: A retrospection and tips at troubleshooting.Journal of minimal access surgery · 2024Article
- Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience.World journal of gastrointestinal surgery · 2023Review
- Endoscopic findings do not predict per-oral pyloromyotomy (POP) response.Surgical endoscopy · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple retrospective studies have demonstrated the safety and feasibility of laparoscopic median arcuate ligament division with celiac neurolysis for the definitive management of median arcuate ligament syndrome (MALS). This study queries the clinical equipoise of robotic (RMALR) versus laparoscopic MAL release (LMALR) at a high-volume center.
methodsA retrospective analysis of consecutive 26 RMALR and 24 LMALR between March 2018 and August 2019 by a single surgeon at a quaternary academic institution was completed. Primary endpoint was postoperative decrease in celiac trunk expiratory peak systolic velocities (PSVs) measured by mesenteric duplex ultrasonography. Secondary outcomes included reported improvement in MALS-related clinical symptoms, distribution of first assistant seniority level, and involvement of second assistants in RMALR versus LMALR.
resultsMean operative times for LMALR and RMALR were 86 and 134 min, respectively (p < 0.0001). There were no open conversions and mean length of hospital stay was 1 day for both cohorts. Both groups provided an equally effective decrease in postoperative peak systolic velocities (PSVs) (LMALR p = 0.0011; RMALR p = 0.0022; LMALR vs. RMALR p = 0.7772). While RMALR had significantly higher reduction of chronic abdominal pain postoperatively, there were no significant differences in other postoperative symptom relief between groups. However, RMALR patients reported significant relief of postprandial abdominal pain (p < 0.0001) and chronic nausea (p = 0.0002). RMALR had significantly more junior first assistants (p = 0.0001) and less frequently required second assistants compared to LMALR (p = 0.0381).
conclusionsIn this study comparing RMALR to LMALR, postoperative chronic abdominal pain relief was significantly less in the former while other outcomes were equivalent. In comparison with LMALR, RMALR cases were associated with more junior first assistants, fewer second assistants, and longer operative times. Both approaches are safe and feasible for well-selected patients in experienced centers.
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