ROBOTIC ASSISTED MEDIAN ARCUATE LIGAMENT SYNDROME (MALS) RELEASE
kelly zhang, alejandro Feria, amelia Dorsey, Sergio Bardaro, Kevin El-Hayek*
Surgery, Case Werstern Reserve University - MetroHealth System, Shaker Heights, OH
48 y/o male with several year history of chest discomfort, that became worse in the past 15 months. Postprandial pain was usually 4/10. The cardiac workup was negative for abnormalities.
EGD was normal. The patient had a CT ABD/PELVIS which showed celiac artery narrowing.
Patient had a celiac plexus block which relieved the pain for 4-6 hours .CTA showed moderate to high-grade narrowing of the proximal celiac trunk. Uneventful postoperative course. Denied nausea or vomiting. No further postprandial pain. Tolerated diet progressively. Discharged home on POD 1
Robotic-Assisted MALS release is a safe and effective procedure when significant narrowing of the celiac artery is observed.
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