Laparoscopic median arcuate ligament release with an antegrade approach in adolescents and young adults: a single center experience.

OBJECTIVE

Median arcuate ligament syndrome is a rare pathology where the median arcuate ligament causes compression on the celiac trunk. Different techniques are utilized in the treatment of median arcuate ligament syndrome, and studies on a standard laparoscopic technique are limited. The aim of this study is to evaluate the surgical and clinical outcomes of patients who underwent laparoscopic "antegrade" release of median arcuate ligament in a single tertiary center.

METHODS

This retrospective study includes nine adolescents/young adults who underwent laparoscopy for median arcuate ligament syndrome between 2016 and 2024. All laparoscopic procedures were performed with an antegrade approach. The patients' demographic data, symptoms, radiologic imaging methods, operative technique, and postoperative outcomes were recorded.

RESULTS

There were seven female and two male patients in our series. The median age at diagnosis was 17 (range: 15-26) years. The most common symptoms were postprandial abdominal pain (n=9), nausea and vomiting (n=8), and weight loss (n=7). Doppler ultrasonography and/or computed tomography angiography (n=9, 100%) were performed in all patients as preoperative diagnostic imaging. The mean operation time was 92 (range: 60-110) min. The mean oral intake time was 1.2 (range: 1-3) days. The mean hospitalization time was 3 (range: 2-5) days. There was no conversion to laparotomy. One patient had a recurrence during follow-up and underwent a secondary intervention. The mean follow-up time was 62.6 (3-88) months.

CONCLUSION

Laparoscopic median arcuate ligament release with an antegrade approach is safe and feasible to perform and adequate in terms of symptom relief and celiac artery compression release in both adolescent and young adult groups.