median arcuate ligament syndrome (MALS)
MALS is a condition that occurs when the median arcuate ligament, a band of tissue connecting the diaphragm to the spine, exerts pressure on the coeliac artery of the aorta and the celiac plexus nerves. Patients can experience persistent abdominal pain, digestive issues, and other distressing symptoms. Fortunately, there is hope for relief through a procedure known as MALS surgery, or Median Arcuate Ligament Release. This surgical intervention is designed to alleviate the pressure on the coeliac artery and nerves caused by the tightness of the median arcuate ligament.
MALS Surgery: Minimally-Invasive Techniques
In laparoscopic MALS surgery 5 small incisions are made on the upper abdomen. Through these tiny openings, a laparoscope, a thin tube with a camera and surgical instruments, is inserted. The key objective is to access the median arcuate ligament and perform the necessary ligament release while minimizing trauma to the surrounding tissues. During the procedure, Dr Carr-Boyd meticulously separates and releases the median arcuate ligament. This alleviates the compression on the coeliac artery of the aorta and relieves irritation of the nerves within the celiac plexus. The minimally-invasive approach not only reduces the risk of post-operative complications but also results in smaller scars and a faster return to normal activities for patients.
Before MALS surgery
Before considering Median Arcuate Ligament Syndrome (MALS) surgery, it is essential to thoroughly assess for other gastrointestinal, vascular, and functional disorders that may cause similar symptoms. Many patients with suspected MALS experience abdominal pain, nausea, weight loss, bloating, or food intolerance, which can overlap with other conditions. A comprehensive pre-operative evaluation ensures that MALS surgery is appropriate, improves surgical outcomes, and avoids unnecessary procedures.