Chirurgia (Bucur). 2023 Feb;118(1):88-95. doi: 10.21614/chirurgia.2835.
There are very few reported cases of robotic surgery for median arcuate ligament syndrome. This clinical condition develops when the root of the celiac trunk is compressed by the median arcuate ligament of the diaphragm. The symptoms that typically accompany this syndrome are: discomfort and pain in the upper abdominal region, particularly after eating, and weight loss. During the diagnostic process, it is important to rule out other potential causes and demonstrate compression using any imaging technique available. Transecting the median arcuate ligament is the primary focus of the surgical treatment. We report a case of robotic MAL release, focusing on the particular aspects of the surgical technique. A literature review was also performed on the topic of robotic approach for MALS. Clinical case: A 25-year-old woman presented with sudden onset severe upper abdominal pain after physical activity and eating. She was then diagnosed with median arcuate ligament syndrome by imagistic means with computer tomography, doppler ultrasound, and angiographic computed tomography. After conservative management and careful planning, we performed robotic division of median arcuate ligament. The patient was discharged from the hospital without any complaint on the second day after surgery. Subsequent imaging studies revealed no residual celiac axis stenosis. Conclusion: The robotic approach is a safe and feasible treatment modality for median arcuate ligament syndrome.
鲜有机器人手术治疗正中弓状韧带综合征的报道。这种临床情况发生在腹腔干根部被膈肌正中弓状韧带压迫时。伴随这种综合征的典型症状有：上腹部不适和疼痛，尤其是进食后，以及体重减轻。在诊断过程中，重要的是要排除其他潜在原因，并使用任何可用的成像技术来证明存在压迫。横断正中弓状韧带是手术治疗的主要焦点。我们报告了一例机器人 MAL 释放病例，重点介绍了手术技术的特定方面。还对机器人治疗 MALS 的方法进行了文献综述。临床病例：一名 25 岁女性在剧烈运动和进食后突发严重上腹痛。然后通过计算机断层扫描、多普勒超声和血管造影计算机断层扫描等影像学手段诊断为正中弓状韧带综合征。经过保守治疗和精心规划，我们进行了机器人正中弓状韧带切开术。患者在手术后第二天无任何不适出院。随后的影像学研究显示，腹腔干无残留狭窄。结论：机器人方法是治疗正中弓状韧带综合征的一种安全可行的治疗方式。
