2009 Program and Abstracts: Laparoscopic Approach to Median Arcuate Ligament Syndrome
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Laparoscopic Approach to Median Arcuate Ligament Syndrome
Yves Borbely*1,2, Branislav Risti2, Othmar Schoeb2
1Departement of Visceral and Transplantation Surgery, Inselspital Bern, Bern, Switzerland; 2Departement of Surgery, Spital Limmattal, Schlieren, Switzerland
The median arcuate ligament syndrome is a rare entity, characterized by weight loss, chronic abdominal pain and epigastric bruit. It is caused by extrinsic compression on the celiac tripod either by an unusually low inserting fibrous band uniting the cura on either side of the aortic hiatus - the median arcuate ligament- or by a hypertrophic celiac plexus.Illustrated by the case of a 28-year-old woman, we demonstrate the management via laparoscopic approach.After diagnostic laparoscopy, preparation of the celiac tripod with division of the median arcuate ligament and resection of the neural fibers compressing the artery was performed via five trocar sites. Operative time was 110 min.
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