Riess Kevin P, Serck Luke, Gundersen Sigurd B, Sergi Michael, Kothari Shanu N
Surgery Residency, Gundersen Lutheran Medical Foundation, La Crosse, WI, USA.
Surg Endosc. 2009 May;23(5):1121-4. doi: 10.1007/s00464-008-0256-7. Epub 2009 Mar 6.
Median arcuate ligament syndrome (MALS) is a rare entity that manifests as abdominal pain, nausea, vomiting, and diarrhea. The median arcuate ligament is a fibrous band that connects the crura of the diaphragm. In some people, the ligament is positioned in a way that compresses the celiac axis, which in a subset of individuals causes the symptoms associated with MALS. Surgical release of the ligament can relieve these symptoms. After viewing a video that described the laparoscopic median arcuate ligament release technique at the 2006 SAGES meeting and reviewing the online video, we report our experience with two cases and discuss the lessons learned in performing the procedure within a training program. We also discuss the extent to which surgical resident participation contributes to intraoperative complications during a new and complex surgery.
正中弓状韧带综合征（MALS）是一种罕见的病症，表现为腹痛、恶心、呕吐和腹泻。正中弓状韧带是连接膈肌脚的纤维带。在一些人中，该韧带的位置会压迫腹腔干，这在一部分个体中会导致与MALS相关的症状。韧带的手术松解可以缓解这些症状。在观看了2006年SAGES会议上描述腹腔镜正中弓状韧带松解技术的视频并查看了在线视频后，我们报告了两例病例的经验，并讨论了在培训项目中进行该手术所吸取的教训。我们还讨论了外科住院医师的参与在一项新的复杂手术中导致术中并发症的程度。
