Evidence map›Paper›PMID 40998249›Full record

ArticleAnnals of vascular surgery2026

Robotic Median Arcuate Ligament Release May Offer Superior Symptom Improvement to Laparoscopic Release.

Kayla A Fay, Jennifer A Stableford, Jesse A Columbo, David H Stone, David J Finley

Abstract readComparative Study
In one paragraph

Article in Annals of vascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kayla A FaySection of Thoracic Surgery, Department of Surgery, Dartmouth Health, Lebanon, NH.
Jennifer A StablefordSection of Vascular Surgery, Department of Surgery, Dartmouth Health, Lebanon, NH.
Jesse A ColumboSection of Vascular Surgery, Department of Surgery, Dartmouth Health, Lebanon, NH.
David H StoneSection of Vascular Surgery, Department of Surgery, Dartmouth Health, Lebanon, NH.
David J FinleySection of Thoracic Surgery, Department of Surgery, Dartmouth Health, Lebanon, NH. Electronic address: david.j.finley@hitchcock.org.

Funding

Comparative-Effectiveness of Procedures for Carotid RevascularizationK08HL165087 · NHLBI · DARTMOUTH-HITCHCOCK CLINIC · PI Jesse A Columbo · 2023 to 2026
$587k
NHLBI NIH HHS K08 HL165087
6 · The paper itself

Abstract

backgroundMedian arcuate ligament (MAL) syndrome is a challenging disease process to treat. Laparoscopic ligament release can lead to early symptom improvement, but symptom recurrence is common. Recently, these MAL releases are being performed robotically at select institutions. The purpose of this study was to document symptom resolution and recurrence rates after laparoscopic and robotic MAL release (r-MALR) at our institution.

methodsWe performed a retrospective review of all patients treated with minimally invasive MAL release at a single academic tertiary medical center from 2017-2023. We stratified patients by operative approach, laparoscopic versus robotic. Our primary outcome was symptom resolution at 6-month follow-up.

resultsWe identified 38 patients who underwent MAL release, 27 (71.1%) that underwent laparoscopic release, and 11 (28.9%) that underwent r-MALR. Preoperative characteristics were similar between groups, including age (37.0 years vs. 41.1 years, P = 0.45) and preoperative psychiatric diagnosis (60.0% vs. 36.4%, P = 0.28). Patients who underwent an r-MALR had a higher likelihood of postoperative symptom resolution when compared to those who underwent a laparoscopic release at both 1 month (81.8% vs. 20%, P = 0.001) and 6 months (54.5% vs. 4%, P = 0.001). Postoperative length of stay was lower in the laparoscopic group (median 0 days vs. 1 day, P = 0.03), and there were more frequent reports of new postoperative gastrointestinal symptoms after r-MALR (27.3% v. 4.0%, P = 0.08).

conclusionAt 1-month and 6-months postoperatively r-MALR was associated with improved symptom resolution when compared to laparoscopic release. For patients who have this challenging disease entity, r-MALR should be considered.

Indexed as

LaparoscopyMedian Arcuate Ligament SyndromeRobotic Surgical ProceduresAdultFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesRisk FactorsTime FactorsTreatment Outcome

Identifiers

PMID40998249
PMCPMC12746071

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.